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                            SUBCOMMITTEE ON LABOR AND HEALTH, EDUCATION,
                                AND WELFARE, AND RELATED AGENCIES
                                  COMMITTEE ON APPROPRIATIONS
                                        92ND CONGRESS
                                         U.S. SENATE











                                           DEMOCRATS

                             Warren G. Magnuson, Washington, Chairman
                             John C. Stennis, Mississippi
                             Alan Bible, Nevada
                             Robert C. Byrd, West Virginia
                             William W. Proxmire, Wisconsin
                             Joseph M. Montoya, New Mexico
                             Ernest F. Hollings, South Carolina





                                          REPUBLICANS

                             Norris Cotton, New Hampshire
                             Clifford P. Case, New Jersey
                             Hiram L. Fong, Hawaii
                             James C. Boggs, Delaware
                             Edward W. Brooke, Massachusetts
                             Ted Stevens, Alaska

                             Ex oj'f-icio members:
                                 Allen J. Ellender, Louisiana
                                 Milton R. Young, North Dakota


                                      Harley M. Dirks, Professional Staff ',.'ember
                                      W. Proctor Jo-Lies, Professional Staff @lember
                                      Robert Clark, Professional Staff Mem'oer






                    LABOR @iD HEALTH, EDUCATII:)"", AND WELFAIUT SUBCO@IMITTEE
                           OF THE SENATE liPPRO-@2RIATIO'@NS COi"@'IITTEE
                                         92ND CO'@CIIESS



                                   ,I    Warren G. '.ia@,nuson  (Democrat)  of  Seattle,  Washington.
                                         Born in 1,@innesota, 1905.  Entered University of
                                                                            law  school  in   1929;
                                         Washington, graduating from the
                                         served  as  special  prosecuting  attorney  of  King  County,
                                         1.931; elected to the Washington   State      LeRislature,
                                            ed  ia  the  regular  and  special  sessions  of  1933;
                                         serv
                                         chairman  of  the  Judiciary  Committee;  assistant   United
                                         States  district  attorney,  1934;   elected   prosecuting
                                         attorney of King County, November 1934; member of
                                         American Legion  and  Ve'terans  of  Foreign  Wars;  served
                                         as lieutenant commander i
                                                                    n  U.S.N.R.  in  Pacific   Fleet;
                                         married Mrs.  Je-rmaine  Elliott  Peralta  on  October  4,
                                         1964; elected  to  the  75th  through  the  78th  Congresses;
                                         elected  to  the  Senate  November,  1944  and  re-elected
                   Warrc@ G.
               of Seattle, Washi?-,gt;on for all subsequent terms.     Chairman  of  Committee   on
               Democrat--Dec. 14, 1944   Commerce.  Member  of  Committee   on   Aeronautical   and
                                         Space Sciences.








                                         John Cornelius Stennis (Democrat) of De Kalb,
                                         Mississippi.  Born in Kemper County, Mississippi,
                                         August,3,  1901.  Married,  two  children;   attended   the
                                         county schools and graduated from Kemper County
                                         Agricultural  High  School,  Scooba,  1919;  B.S.   degree,
                                         Mississippi State College, 1923; LL.B. degree,
                                         University  of  Virginia  Law  School,  1928,  member   of
                                         Phi  Beta  Kappa,  Phi  Alpha  Delta  (legal),  and  Alpha
                                         Chi Rho Fraternities; Presbyterian, Mason, Lion,
                                         member of Farm Bureau, Mississippi, and American
                                         Bar Associations; past president, State 4-H Club
                                         Advisory Council; elected Mississippi House of
                                         Representatives  from  Kemper   County,   1928-32;   elected
                                         district prosecuting attorney, 16th Judicial District,
                                         1931  and  1935;  appointed  circuit  jud?,e,  16th  Judicial
                                                               elected  1938,  1942,   1946;   elected
                                         District, 1937, and
              L,                         United States Senator November 4, 1947, to fill unexpired
                                                                                in November 17, 1947;
                              .  .  .    term of the late T.G. Bilbo; sworn
                 of De Yalb,
                DemucraL-Nov. 5, 1947    re-elected 195?; 1958, 1964, and 1970.       Chairman    of
                                         Armed   Services   Committee.   Member   of   Aeronautical
                                         and Space Sciences Committee.




                                                                                          2






                                                Alan   Bible (Democrat)  of  Reno,  Ilevada;  born
                                                                                                   in
                                                ov@el-@@@, @@@evada,  Yovember-20,  1909;  married
                                                Loucile  Jacks;  children--one  diug,iter  and   three
                                                sons;  A.B.  University  of  Nevada,  1930;  LL.B,
                                                Georgetown University School of Law, 1934;
                                                admitted  to  the  Nevada  State  Bar,  1935;  asso-
                                                ciate la@.7 partner of late United States
                                                Senator Pat NlcCarran, Reno, 1935--38; appointed
                                                then  elected  district  attorney  of  Storey   County
                                                (Virginia City), 1935; appointed deputy
                                                attorney  aeneral  of  Nevada  in  1933;   elected
                                                attorney  c-ene
                                                              ral of Nevada  in  1942  at  age  of
                                                32   years, becoming  youngest   attorney   general
                                                in  tTnited States;   reelected   attorney    general
                                                in 1946  iTithout  opposition;  served  as   president
                                                and vice  president  of  National   Association   of
                                                Attorneys  General, private practice of law under
                        S6-,n.' @3i ib' Le      firm   name of Bible & I-IcDonald, Reno, from January 1951;
                        of Rero, lievada        member   of American   Bar   Associatio-n,   chairman_of
                        Democrat--Dec. 2, 1954  State  delegation  of  Committee  on  Improvement   of
                                                Judicial Administration, National.Safety Council,
             Nevada State Bar Association,      University  of  Nevada  Alumni   Association,   Lambda
             Chi  Alpha  social  fraternity,  Reasons,  and  Eagles;  elected  to  the  United  States
             Senate November 2, 1954, to fill the unexpired term, of late Senator Pat McCarran;
             re-el6cted  for  all  subsequent  terms.  Member  of  Committees  on   Interior   and
             Insular Affairs and Committee on District of Columbia.






                                                Robert C. Byrd (Democrat) of     Sophia, West Virginia;
                                                born in North Wilkesboro, North Carolina, January 15,
                                                1918;-student - Beckley College; Concord College;
                                                Morris Harvey College, 1950-51; Niarshall College,
                                                    -52; LL.B
                                                1951           . cum laude, American University;
                                                married Eri@.,a Ora James, May 29, 1937, two daughters;
                                                elected to the West Virginia House of Delegates in
                                                1946 and re-elected in 1948; elected to the West
                                                Virginia Senate  in  1950  and  elected  to  the  U.S.
                                                House of Representatives in 1952, 1954 and 1956;
                                                elected to the U.S. Senate in 1958; re-elected to
                                                the U.S. Senate in 1964 and 1970 by the greatest
                                                vote ever accorded a I-lest Virginia candidate.  He
                                                was elected secretary of the Senate Democratic
                                                                                         cted   by
                                                Con.Lerence in January 1967 and reele
                       Sen. Robert C. Byrd      unanimous vote in January 1969; elected Senate
                       of Sophia, West Yirginia Democratic @fajority INThip in January 1971.
                       Democrat--Jan. 3, 1959   Member  of  Committees  on  Judiciary  and   Rules
                                                and Administration.







                                                                                                      3







                                       William W. ProxT,@@1re (Democrat) of, Wisconsin; born in
                                       Lake Forest, Illinois, November 11, 1915.  Ile earned
                                       his undergraduate degree from Yale and two graduate
                                       degrees  from  Harvard  University;  taught  government
                                       at Harvard, worked for J.P. Morgan and Co-,P.Dany on Wall
                                       Street, n ne months before Pearl Harbor, lie enlisted
                                       as a private in the U.S. Army to serve in the counter-
                                       intelligence corps, leaving  active  duty  in  1946  as
                                       a first lieutenant; he has been in politics since 1950,
                                       when he was elected to the Wisconsin State Assembly.
                                       He was elected to the United States Senate in 1957 to
                                       fill the seat left vacant by the death of Senator Joe
                                       McCarthy.  He was re-elected the following year to a
                                       full 6 year term and again re-elected in 1964 and 1970.
              Sen. WitZi= W. Prv.,7,my,e He is married to Ellen-flodges Si\,iall. Mr. Proxmire is
              oj@ Y.2dison, Wiscons@n  Chairman of  the  Joint  Economic  Committee;  ranking
              Demcrai--August, 1957    Democrat on the  Banking,  Housing  and  Urban  Affairs
                                       Co=nittee.' and member of the Joint Committee on
                                       Defense Production.









                                       Joseph M. i4o@a (Democrat) of Santa Fe, New Mexico;
                                       born in Sandoval County, New Mexico, September 24, 1915;
                                       attended Regis College in Denver, Colorado, and
                                       Georgetown University Law School in Washington, D.C..,
                                       receiving LL.B. in 1938; a lawyer by profession;
                                       actively  engaged  in  various  business  enterprises;
                                       elected to.1,7ew Mexico House  of  Representatives  in
                                       1936 at age 21 while still in college; reelected in
                                       1938 and named majority floor leader; elected as
                                       youngest member of State  senate  in  1940  and  named
                                       .ajority whip; reelected to State senate in 1944
                                       and named chairman, Senate Judiciary Committee; was
                                       elected  Lieutenant  Governor  in  i946  and  reelected
                                       in 1948; in 1952 again was elected to the State senate;
                                       in 1954 was returned to the office of Lieutenant
                                       Governor, and re-elected in 1956; married Della Romero
                                       and they have three cliildren--Joseph II, Patrick, and
                                       Lynda; delegate, ilexico-United States Interparliamentary
                Sen. Joseph m. wntoga  Conference, 1961-65; official United States observer,
                of @.ta Fe, He's @,zleo Latin American Parliamentary Conference, Lima    ' Peru,
                Democrat--Nov. 3, 1964 1965;  elected to the 85th Congress in special election
                                              n  I n C -7  r-. 1 1tl-                ily the death
                                          l@  ?,  .2 , I, to         -%Taca,-,c-y c -,@ -1
                                       Apr"                @ -L  @ic            a,,,c.
        of Antonio M.  Fernandez;  re,@etted  to  the  8Gth,  and  88tli  Congresses; elected to the
                                   -                                                 Torks and
        U-ni:ted- States Senate in 1.964 'and 1970.  Member of  Committee  on  Public
        Select  Committee  on  Small  Business.



                                                                                            4






                                                              Ernest F.                   (Democrat)  of Charleston,  S.C.;
                                                              born    in    Charleston,    S.C.,    January    1,    19.12-,    son    of
                                                              Willielmine     Meyer     and     Adolph     G.     Hollings;      attended
                                                              public      schools,      Charleston,      S.C.:      graduate,       The
                                                              Citadel,  B.A.,  1942;  the University of South
                                                              Carolina,  LL.B.,  1947;  LLD.  conferred by The
                                                              Citadel,     June     1959;     married      Patricia      Salley      of
                                                              Col--,z,,ibia,    S.C.,    -1",arch    30,    1-946;    four    children;
                                                              ember     of     Charleston      County,      South      Carolina,      and
                                                              m
                                                              America-,i     Bar      Associations;      admitted      to      practice
                                                              before South Carolina Supreme Court,  'U.S.  District
                                                              Court;    U.S.     Circuit     Court     of     Appeals;     U.S.     Tax
                                                              Court,    U.S.    Customs     Court     and     U.S.     Supreme     Court;
                                                              Armed Forces,  1942-45,  served overseas  from Africa
                                                              to     Austria;     elected      to      South      Carolina      General
                                              i@              Assembly     from     Charleston     Countv,      1948,      1950,      and
                                                              1952;        chairman,        Charleston        County        Legislative
                                                              delegation;      speaker      pro      tempore,      South       Carolina
                                                              House of Representatives;  elected twice by unanimous
                     Sen. Ernest F. BotTi@ige                 vote    1951,       1953;       elected       Lieutenant        Governor,
                     of Charleston, South CaroZira            November     2,     1954;     elected      Governor,      November      4 1958;
                                                                                                                                      9
                     Democrat-Nuv. 8, 1966                    served     as     Governor,     1959-63;      appointed      to      Hoover
                                                              CoTmaission     May     15,     1955;     appointed     by      President
                                                              Eisenhower to Advisory Commission on Intergoverranental
                                                              Relations,  December 1959;  re-appointed by
                                                              President Kennedy February 1962;  chairman,  Regional
                                                              Advisory Council on Nuclear Energy;  elected
                                                              November    8,     1966,     to     complete     the     unexpired     term
                                                              of    the    late    Senator    Ol.in    1).    John-,ton-    rp.-c,.Iected
                                                              to full 6-year  term November 5,  1968.   Chairman of
                                                              Appropriations  Subcommittee on Lec,3.slative Branch;
                                                              member     of     Subcommittees     on     District      of      Columbia-,
                                                              Military  Construction;  State,  Justice,  and Commerce,
                                                              the Judiciary,  and Related Agencies.


                                                              i@lorris  Cotton  (Republican)  of Lebanon,  New
                                                              Hampshire;     born     Warren,     New      Hampshire,      May      11,
                                                              1900.      Educated      Tilton       School,       Phillips       Exeter
                                                              Academy,        Wesleyan        University,        George        Washington
                                                              University     Law     School;     lawyer,      firm      of      Cotton,
                                                              Tesreau & Stebbins,  Lebanon,  New Hampshire.
                                                              Married.       Secretary       of       United       States       Senator
                                                              George Moses,  199@4-28;  prosecuting attorney,
                                                              from      Grafton      County,      1933-39;       justice,       municipal
                                                              Court     of     Lebanon,     1939-43;     majority     leader      a-,id
                                                              later speaker New Hampshire House of  Representatives;
                                                              elected  to  the 80th Congress  on November 5,  1946;
                                                              re-elected to  the 81st,  82nd,  and 83rd Congresses;
                            Sen. no@8 cot@,                   elected  to  the United States Senate November 2,  1954;
                            @ @L.,anon, !ie-o Hs7vali@,       to copplete  the term of  the I-ate Senator Charles W.
                            Republican--@ov. S. 1954          Tobey     ending     January     3,     1957;     re-elected     to     all
                                                              subsequent  terms.  Member of Committee on Commerce
                                                              and Joint Coripittee on Atomic Energy.



                                                                                                                                      5





                                                         Cliffor&  0.  Case  (Reptiblican)  of  Rahway,
                                                         N.J.;    born    in    Franklin    'ark,    N.    J.,     April     16,
                                                         1904.      @iarried      with      three       children.       Attended
                                                         public     schools     in     Poughkeepsie,     i@.Y.,     and      was
                                                         graduated     from     Rutgers     University     with      A.B.      degree      in
                                                         1925,     and     from     Columbia     University     with      LL.B.      degree
                                                         in     1928;     received     honorary     LL.D.      from      Rutgers
                                                         University,  Middlebury College,  Rollins  Co lege,
                                                         Rider College,  Bloomfield College,  Princeto-,i University,
                                                         and Columbia University;  was admitted to the New
                                                         York    bar    in    1928    and    practiced    in    New    York    City    from
                                                         1928  to 1953;  member of  the Rahway Common Council,
                                                         1938-42 and of  the New Jersey House of Assembly,
                                                         1943-194'-t;    served    as    a    Member    of    the    House    of
                                                         Representatives,  1945-53;  trustee of Rutgers University
                                                         from    1945    to    1959;    trustee    of    New     Jersey     Society     for
                                                         Crippled      Children      and      Adults;      director,      N.J.       Chapter,
                                                         Arthritis  and Rheumatism Foundation;  director,  American
                                                         Institute for Retarded Children;  trustee,  Rahway  (N.J.)
                       Sen. Cliffoiq P. Case             Chapter,     American     Red     Cross;     member     of      various      civic
                       of RahwV, New -Je2,sey            and       fraternal       organizations;       Presbyterian;       elected        to
                       Republican--Jan. 3, 1955          the    United    States    Senate    on    November     2,     1954;     was     re-
                                                         elected for all subsequent terms.   Member of Committee
                                                         on Foreign Relations.






                                                         Hiram  ecn@ Fon@,  (Republican)  of Honolulu,
                                                         Hawaii;  born in Honolulu,  October 1,  1907                    ;
                                                         attorney and businessman;  corporation president
                                                         of  several business. firms;  operates banana farm
                                                         in Honolulu;  attended Kal.iliiwaena Grammar School,
                                                         i@lcl',inley HiRh School and St.  Louis. Co-Ilp-ize-
                                                         University     of      Hawaii,      B.A.,      LL.D.      (Ilonorgr@);      member
                                                         Phi Beta Kappa;  Harvard Law School,  LL.B.;  Tufts
                                                         UT-tivers4.
                                                                           1,L.D.  (Honorary);  Lafayette College,  LL.D.
                                                         (Honorary),  Director,  Hall of Fame for Great Americans;
                                                         14 years  in Legislature of  the Territory  of Hawaii;
                                                         6 years as  speaker and 4 years as vice speaker;
                                                         delep-ate     to      the      Repu'olican      National      Conventions      1952,
                                                         @956,  19.60,  1964 and 1968;  vice president of Territorial
                                                         Constitutional Convention,  1950;  judge advocate of
                                                    i    the    Seventh    Fighter     Command     of     the     Seventh     Air     Force
                                                         with rank of major in World War II;  presently colonel,
                                                         U.S.  Air Force Reserve;  married  to Ellyn Lo;  4 children;
                       Sen. Eirwn L. Fong,
                       of HonoZulu  Ha-@ii               elected to the United States Senate July 28,  1959,  for
                       Republican--Aug. 21, 1959         the term beginning August 21,  1959;  re-elected 1964 and
                                                         1970.   Member of Committees on Judiciary and Post
                                                         Office and Civil Service.





                                                                                                                                 6








                                                James  Cnleb  Bo,-,s  (Republican)  of  Wilmin@-'.p,.-,,   I)ela-ware;
                                                born   Kc@nt   County,   Delaware,   May   15,   1909;   educated   in
                                                the   pul)14@c   scliools,of   Delaware;   A.B.   degree,   University
                                                                                        -are State College,
                                                of              LL.B. decree, Dela.i.,
                                                married  Elizabeth   Muir;   two   children;   member   of   the   bar
                                                of  the  State   of   Delaware   and   the   United   States   Supreme
                                                Court;  former  judgc,   of   the   Family   Court   of   New   Castle
                                                County, Delaware; elected as U.S. Representative at
                                                Large from Delaware to the 80th, 81.st, and 82d Congresses;
                                                elected Governor of the State of Delaware for two '+-year
                                                terms, 1.952 and 1956; chairman of the National Governors
                                                Conference, 1959; president of the Council of State
                                                Governments, 1960; enlisted as private in Delaware
                                                National Guard, 1926; colonel USAR, ret.; brigadier
                                                general,   ret.,   Delaware    National    Guard;    five    campaigns
                                                in the European Theater of Operations during World War II;
                                                Legion  of   Merit,   Bronze   Star   with   cluster,   French   Croix
                                                de Guerre with Palm; elected to the United States
                       J. Caleb Bogga           Senate November 8, 1960, for the term ending
                   of Wi@rgton, De@-zre         January 3, 1972.      Member   of   Committees   on    Public    Works
                   Republican--Jan. 3. 1961     and Post Office and Civil Service.




                                                        Edward   W.   Brooke   (Republican)    of    Newton    Centre,
                                                        Mass.; born in Washington, D.C,, October 26, 1919;
                                                        attended public schools of Washington, D.C.;
                                                        B.S. degree, Hi@ ard University, 19,'!; master
                                                        of laws, Boston University Liw School, 1950
                                                        (editor of Law Rev-Lc@w, 1946-48); honorary
                                                        degrees: Doctor of Jurisprudence, Portia Law
                                                        School Boston, 1963; Doctor of Public
                                                        Administration,     Northeastern      University,      Boston,
                                                        1964; Doctor of SciLr,.ce, Worcester Polytechnic
                                                        Institute, 1965; Doctor of               '@--2rican
                                                        International    College,    Springfield,     1965;     Doctor
                                                        of Laws, Emerson College, Boston, 1965;
                                                        Captain, U.S. Army, Infantry; 5 years' active
                                                        service, EuropeL@il theater of operations;
                                                        recipient   of   Bronze   Star   and   Combat   Infantry--an's
                                                        badge; served with "Partisans" in Italy;
                                                        chairman   of   Finance   Co-,imission,   citv   of    Boston,
                                                        April  1961   to   September   1962;   member   of   President
                                                        Johnson's Commission for Civil Rights under
                                                        law; the Republican Club of Massachusetts;
                                                        National Association of Attornevs General;,
                                                        National Association of District Attorneys;
                 Sen. E,@ W.  B--ogk--                  American Massachusetts, and Boston Bar "-qsoz,'-ations;
                 of      C-,ntze@ Uyssach-asetts        married Remigia Ferrari Scacco, two children;
                                                        elected  Attorney  General   of   the   Cc--:nonwealt',,i   of
                                                        Massachusetts, 1962; re-elected 1964; electe-4
                                                        to the U.S. genate Novc-T-@iber 8, 1966.       Member       of
                                                        Appropriations Subcommittees on Forei@n Operations;
                                                        Legislative B-rcticli, llj@,'@li-f--arv Constr--Tcti---n; @-d
                                                        State,  Justice,  a.-'d  Conirerce,  the  j-,idic-,.ary,   and
                                                        Related Agencies.
                                                                                                                      7











                                                         Republican,  of  Anchorage,  Alaska;  born  in
                                           TED STEVENS,
                                           Indianapolis, Ind., November 18, 1923; graduated
                                           from high school, Redondo Beach, Calif.; attended
                                           Oregon State  College,  Montana  State  College;   graduated
                                           from  U.C.L.A.,  1947,  Harvard  Law  School,  1950;  served
                                           in the Air Force in World War II in China, 1943-46,
                                           first  Lieutenant  (pilot)  14th  Air  Force;  awarded   two
                                           Distinguished  Flying  Crosses,  two  Air  Medals,  and  the
                                           Yuan Hai Medal (by Chinese Nationalist Government);
                                           practiced  law  in  office  of  Northcutt  Ely,  Washington,
                                           D.C4, 1950-52; member, law firm of Collins & Clasby,
                                           Fairbanks, Alaska, 1953@; appointed U.S. Attorney,
                                           Fairbanks, Alaska, September 1953; transferred to
                                           Department of the Interior, Washington, D.C., as
                                           legislative  counsel,  1956;  appointed  assistant  to   the
          Sen. Theodo2v   F. Ste?)ens      Secretary of the Interior (Fred Seaton), 1958; appointed
          of Anchoraqe-,  AZaska           solicitor of the Department of the Interior by
                                           President  Eisenhower,  1960;  returned  to  Alaska,   1961,
          Republican -Dec. 24,    1960     opened law office in Anchorage; president Anchorage
                                           Republican Club, 1962-63; elected to the State House
                                           of Representatives, 1964, reelected 1966, served as
                 p-ro t= and             leader; member Americnn, Federnl, Cplifornia, Alaska,
         OP                      i    -1
         and District of Columbia Bar Associations; admitted to practice before the United
         States Supreme Court, 1954; member, Rotary, American Legion, Veterans of Foreign
         Wars; Republican Club, Petroleum Club, Anchorage Press Club, and Alaska Press Club,
         married Ann Mary Cherrington, of Denver, Colo., 1952; five children: Susan, Beth         '
         Walter, Ted, Jr., and  Ben;  appointed  December  23,  1968,  by  Governor  Walter  J.  Hickel
         to fill the U.S. Senate vacancy created by the death of Senator E.L. Bartlett;
         reelected November 3, 1970, for the term ending January 3, 1973.





                                                  Allen JoseDh Ellender (Democrat) of Houma, La.;
                                                  born in Montegut, Terrebonne Parish, La.,
                                                  September 24, 1890; lawyer and farmer; graduate
                                                  of St. Aloysius College, New Orlean             s, La., and
                                                  Tulane University of Louisiana, at New Orleans,  with
                                                  degrees of M.A. and LL.B.; married to Miss  Helen
                                                  Calhoun Donnelly (died September 30, 1949); one  son,
                                                  Allen J., Jr.; served in World War I; city  attorney
                                                  of Houma, 1913-15; district attorney,  Terrebonne
                                                  Parish, 1915-16; delegate to Constitutional
                                                  Convention of Louisiana in 1921; member of the  house
                                                  of representatives of Louisiana, 1924-36; floor
                                                  leader, 1928-32, during administration of the
                                                  late Huey P. Long, Governor; speaker of the  house
                                                  of representatives, 1932-36; Democratic nominee  for
                                                  United States Senator from Louisiana, and  elected
                                                  without opposition in the general election held
                                                  on November 3, 1936, for the term ending January  3,
                                                  1943; reelected November 3, 1942, in the  general
                                                  election, without opposition,for the term  ending
                                                  January 3, 1949; reelected without opposition
                                                  in the general election held on November 2-, 1948,
                                                  for the term ending January 3, 1955; again re-elected
                                                  without opposition in the general election held
                                                  on November 2, 1954, for the term ending January  3,
                                                  1961; re-elected November 8, 1960, for the term
                                                  ending January 3, 1967; re-elected November 8,  1966,
                   Sen, AlZen J. Ellender         for the term ending January 3, 1973; Democratic
                   of Ilour=, Louioiz-,a          national committeeman from Louisiana, 1939-40.
                                                  Chairman of Committee on  Appropriations.  Member
                                                  of Committee on                        and  Fcrestr-;  a,-,--,
                                                  Joint Committee on Nonessential Federal Expenditures.

                                                  Milton R. Young (Republican)  of LaMoure,
                                                  Tor-th Dakota; born December 6,  1897 in Berlin,
                                                  North    Dakota;    attended    the     LaMoure     County     public
                                                  schools    and    was    graduated    from    LaMoure     High
                                                  School    in    1915;    attended    North    Dakota     State
                                                  Agricultural College and Graceland College
                                                  at    Lamoni,    Iowa.    Married    Malinda     Vi     Benson
                                                  of LaMoure, N. Dak., July 7,  1919;  three
                                                  sons.   Member of school,  township, and county
                                                  AAA    boards;    elected    to     House     of     Representatives
                                                  of',North Dakota State Legislature in 1932;
                                                  elected to State Senate of North Dakota in
                                                  1934    and    served    continuously     until     his
                                                  resignation March 14, 1945;  elected president
                                                  pro tempQre 1941; majority floor leader 1943.
                                                  Was actively engaged in the operation of his
                                                  farm    near    Berlin,    N.    Dak.,    until    his    appointment
                                                  to the U.S. Senate.   Appointed to the U.S
                                                  Senate Ma ch 12,  1945;  elected at special'
                                                               r
                                                  election     June   25,   1946    for    term    ending
                                                  January 3,  1951; re-elected to successive
                   Sen. Witon R. yomg             terms;  served as secretary to the Senate
                                                  Republican     Conference      Committee      since      1948.
                   of La.Afouiv, -Iorth Dakota    Member    of    Committee    on     Agriculture     and
                   Republican--March 12, 1945     For6stry    and    ranking    Republican     on     the
                                                  Appropriations Committde.                                               9










                                            LABOR-WELFARE SUBCOMMITTEE OF THE
                                              HOUSE APPROPRIATITt4S COMMITTEE
                                                         92ND CONGRESS












                                                            DANIEL J. FLOOD (Democrat)  Of Wilke-,-Barre
                                                            Pennsylvania.   B.orn in Hazleton, Pennsylvania,
                                                            Novon@ber 26, 1903.   Received early education
                                                            in public schools of Wilkes-Barre, Pennsylvania,
                                                            and St. Augustine, Florida.   Graduate of
                                                            Syra-tise    University,    A.B.    and    M.A.    degrees,
                                                            and ater attended Harvard Law School and
                                                            Dickinson School of Law,  Carlisle, Pensylvania,
                                                            graduating in 1929 with L.L.B. degree.   Admitted
                                                            to the bar of various State and Federal Courts
                                                            in  i930.   Attorney -,r liome Owners' Loan Corpor-
                                                            ation 1934-35, Deputy Attorney General for
                                                            Pennsjlvania and Counsel for Pennsylvania Liquor
                                                            Control    -,ard,    1935-39;    Director,    Bureau     of
                                                            Public Assistarice Disbursements,  State Treasury,
                                                            and    Executive    Assistant    to    State     Treasurer,
                                                            Pe..nsylvania,    1941-44;     married     Catherine     H.
                  Daniel J. F16od                           Swank   on   September   24,   1949;   member    of    many
                  of Wflkes-Ra-re (lith Dist.)              local civic,  fraternal, beneficial, and social
                  Democrat - 12th  tem                      societies.      Elected to 79th,  81st,  82nd,  84th
                                                            Congress and re-elected to succeeding Congres@ .
                                                            Former Vice Chairman of Special Committee to
                                                            investigate Katyn Massacre (murder of Polish
                                                            officers by Russians).   Also member of Sbcom-
                                                            mittee c,.i Defense,  Committee on Appropriations.













                                                                                                              2





                                                WILLIAM  @lA@fC  Lla  (Democrat)  of  Bowling  Green,
                                                Warren  County,  Kentucky;  born  in  Bowlin@  GreEnp
                                                Kentucky, educated in the public schools of
                                                Bowling Green, Kentucky, and high school at
                                                Ogden Preparatory Department; A.B. degree,
                                                Western  Kentucky  State  College,  Bowling   Green,
                                                Kentucky;  L.L.B.  degree,  Ohio  State   University,
                                                Columbus,  Ohio;  married  to  Miss  Virginia  Reardon,
                                                of Bowl-i.ng Green, Kentucky, on June 17, 1937;
                                                two daughters: Celeste White, 26, and Louise
                                                Lewter, 22; practicing attorney, Bo
                                                                                       wl.ing  Green,
                                                Kentucky,  since  March  18,  1934;  Federal  concili-
                                                at
                                                  ion  commissioner  1936-37  for  Western   District
                                                of Kentucky;  elected  county  attorney  of   Warren
                                                County i  1937  and  served  three  l'our-year  terms,
                                                        n
                    William II. Natcher         elected  Commonwealth  attorney  of  the  8th  Judicial
                    Bowli?7g Green (2d Dist.)   District,  composed  of  Allen  and  Warren  Countries,
                    Democ-pat - 10th term       in 1951 and served  unti.1  August  15,  1953,  having
                                                been elected to Congress; Baptist; member of
                                                Kiwanis club, Odd Fellows, Ameri.cal Leg on
              Post 23, and 40 and 8 Mammoth     Cave Voiture  1146;  past  president  of  the  Bowling
              Green Bar Association; past president of the Youn- Democratic Clubs of
              Kentucky, 1941-46; during  World  War  11  served  in  the  United  States  Navy  from
              October 1942  to  December  1945;  elected  to  the  83d  and  succeeding  Congresses.
              Also member of Subcommittee on Agriculture, and Subcommittee on District of
              Columbia (Chairman), Committee on Appropriations.




                NEAL SMITH  (Democrat)  of  Altoona,  Iowa.,
                born March 23, 1920  at Hedrick, Iowa;
                married Beatrix Havens, two children,
                Douglas  and   Sharon; farmer and lives   on
                farm near Altoona,   Iowa; engaged in    the
                practice of law in   Des Moines, Iowa;
                graduated Drake University Law School;
                attended 14iss,ouri  University  College  of
                                                  ersity
                Liberal  Arts  and  Syracuse   Univ
                Schools  of  Public  and   Business  Adminis-
                tration- 4-H Club member and leader      for
                ten  years,  farm  o  rator   since 1937
                                   .pe
                except  for  time  and armed services  and
                some of  the  time  in college; spent   four
                years in World War II, citations include               Neal Smith
                nine battle stars, Air Medal, 4 Oak Leaf               of Altoona (5th Dist.)
                Clusters, and Order of the Purple Heart;               Democrat -7t@t tem
                elected National President Young Demo-
                cratic Clubs of America 1953--served
                usual two-year term 1953 to 1955; former chairman, Polk County Board of Social
                Welfare  (a  nonpaying  civic  board  which  distributed  several  million   dollars
                per year to needy families and elder citizens)- former assistant county attorney
                for Polk County, Iowa; member of Disabled American Veterans, Masonic Order, and
                various  farm,  school,  and  service  organizations;  elected  to  86th  and  succeed-
                ing  Congresses.  Also  member  of  Subcommittee  on  State,  Justice,  Commerce,   and
                the Judiciary, Committee on Appropriations; and Select Committee on Small Business.

                                                                                                 3









             W.R. HULL, JR. (Democrat) of Weston,
             Missouri; born in  Weston,  Platte  County,
             Missouri, April 17, 1906; widower;
             children, Mrs. Susan Hudson and W. R.
             Hull 3d; elected to the 84th Congress
             and  succeeding  Congresses.  Also   member
             of Subcommittee on Agriculture, Coui-.
             mittee on App:ropriations.



                                                                      W. R. Hull, Jr.
                                                                      of Weston (6th Dist@)
                                                                      Democrat - 9th term











                                                       ROBERT (BOB)RANDOLPH  CASEY  (Democrat)  of
                                                       Houston, Texas; born in Joplin, Missouri,
                                                       July 27, 1915, moved to Houston, Texas,
                                                       in 1930, and graduated from San Jacinto
                                                       High  School;,attended  the  University
                                                       of Houston end the  South  Texas  School
                                                       of l,aw all night, was admitted to  the
                                                       State bar of Texas in 1940; opended
                                                       law office in Alvin,  Texas,  and  served
                                                       as city attornev and also  a  member  of
                                                       the -school board; assista  t  district
                                                                                 n
                                                       Attorney in Harris  County,  in  charge
                                                       of the civil department;  in  1948  was
                                                       elected to the State house of
                                                       representatives and served in the
                                                       regular and special sessions  of  the  51st
                                                       Legislature; elected  county  judge  of
                  Bob Casey                            Harris County in 1950  for  a  two-year
                  of Houston (22d Dist.)               term; re-elected in 1952 and  again  'in
                  Democrat 7th term                    1954 for a four-year  term;  member,  First
                                                       Christian Church;  married  Hazel  Marian
                                                       Brann on August 13, 1935,  and  have  ten
                                                       children; elected from  the  newly  created
                                                       22d district to the  86th  Congress  and
                                                       succeeding  Congresses.  Also  member  of
                                                       Subcommittee on Legislation, Committee on
                                                       Appropriations.









                                            EDWARD JAMES PATTEN (Democra't),bf Perth
                                            Amboy, Nj., iTrn@in Perth Amboy, August 22,
                                            1905; graduated from Newark State College,
                                            Rutgers Law School, L.L.B., and Rutgers
                                            Un-Lversity, B.S. ED.; member of Eagles,
                                            Moose, Elks, Kiwanis, Knights of Columbus,
                                              tion 1 Conference of Chri tians and Jews,
                                            Na     a                    s
                                            Chamber of Commerce, and NAACP;  lawyer,  1927;
                                            teacher public schools, 1927-34; mayor  of  the
                                            city  of Perth Amboy, 1934-40; county  clerk  of
                                            Middlesex County
                                                               1940-54; campaign manager
                                            for Robert B. Meyner, 1953 and 1957- secretary
                                            of state of the State of New  Jersey,  1954-62;
                                            president, Salvation Army Board; past president
                                            of the Middlesex Bar Association;  chairman  of
                                            the Middlesex County Democratic Colmnittee,
                                            1934-36; member of the Democratic State
                                            Committee and member of American Judicature
                                            Society; recipient of "Outstanding Citizenship"
                                            award from American Hp-ritage Foundation and
             Edward J. Patten               Btnai Blrith',-, "Brotherhood" award; married
             of Perth @boy (15th Dist.)
             Democrat 5th teym              February 22, 1936, to Anna Quigg of South Amboy,
                                            N.J.; one daughter, Catherine M.; elected
                                            to the 88th Congress November 6, 1962;
                                            reelected to the 89th, and succeeding Congresses.
                                            Also member of Subcommittee on Military
                                            .Construction



























                                                                                5











                                                ROBERT H. MICHEL (Republican) of Peoria,
                                                Illinois.  Born March 2, 1923, in Peoria,
                                                Illinois.  Graduate  of  Peoria  Public
                                                Schools and Bradley  'University,  B.S.
                                                1948, business administration.    Served
                                                in the enlisted ranks  during  World  War  II;
                                                  arded the Bronze  Star,  Purple  Heart,  and
                                                aw
                                                four battle  stars,  Married,  four  children.
                                                Elected to the 85tli and succeeding Congresses.
                                                Also member of Subcon  ittee  on  Agriculture,
                                                Committee on Appropriations.
             Robert B. Michel
             of Peoria (18th Dist.)
             Republican 8th team








                                                GAPD,TER E. SHRIVER (Republican)  of  Wichita,
                                                Kansas.  Born July 6, 1912, in Towanda,
                                                Kansas; married in 1.941, three children.
                                                Attended public schools of Towanda and
                                                Wichita; graduate of University of.
                                                Wichita in 1934 (post-graduate study at
                                                University of  Southern  California  in  1936)
                                                and Washburn La-v7 School, L.L.B.  degree.  in
                                                1940. trgaged  in  law  practice  since  1940;
                                                served for three years in the U.S.  Navy  as  an
                                                enlisted man and officer during  World  War  II;
                                                State representative 1947-51 and State
                                                Sena        -60;  member  of  American,
                                                    tor 1953
                                                Kansas and  Wichita  bar  associations,
                                                Veterans of  Foreign  Wars,  American  Legion,
             Garner E. Shriver                  National Sojourners, Albert Pike Masonic
             of Wichita (4th Dist.)             Lodge, Wichita C6nsistai-y,  De  Molay  Legion
             Republican 6th term                of Honor, and College Hill Methodist Church;
                                                elected to the 87th Congress  November  8,  1960
                                                and  succeeding  Congresses.  Also  member  of
                                                Subcommittee on  Foreign  Operations,  Committee
                                                on Appropriations.












                                                                                             6










                                                               SILVIO    0.    CONTE    (Republican)    of    Pittsfield,
                                                               Mass.; born in      Pittsfield    November    9,     1921,
                                                               son   of   Mr.   and   Mrs.   Ottavio   Conte;    attended
                                                               public schools in Pittsfield and the
                                                               Pittsfield Vocational High School, graduating
                                                               in   1940;   machinist   at    General    Electric    Co.
                                                               in   Pittsfield    before    joining    the    Seabees
                                                               in World War II; served in Southwest Pacific;
                                                               attended    Boston    Colleae    and    Boston    Colleae
                                                               Law   School,    graduating    in    1949;    admitted
                                                               to the bar same year; in November 1950
                                                               elected    tb    the    Massachusetts    State    Senate;
                                                               served   as    Senator    from    Berkshire    District
                                                               1951-58;     Massachusetts      Bar      Association,
                                                               Federal   Bar   Association.;    married    to    the
                                                               former    Corinne    Duval,    four    children,    elected
                                                               to the 86th and succeeding Congresses;
                silvio o. Conte                                delegate    to     Republican     National     Convention;
                .of Pittsfield (lst Dist.)                     1968, member of Platform Committee; member of
                Republican    ?th term                         Appropriations      Committee;      Subcommittees      on
                                                               1--asury-Post    Office;     Foreign     Operations     and
                                                               Transportation;    Select    Committee     on     Small
                                                               Business;   Joint    Conmiission    on    the    Coinage;
                                                               Migratory     Bird      Conservation      Commission.




                                                               J. KENTNETH ROBINSON (Renublican) of
                                                               Winchester, Va.; born in Frederick County, Va.
                                                               on  May   14,   1916;   attended   public   schoo   s   in
                                                               Winchester;    received    B.S.     in     Horticulture
                                                               from Virginia Polytechnic Institute,
                                                               Blacksburg,   Va.,    in    1937;    entered    family
                                                               fruit    growing    and    packing    business;    served
                                                               four   years   in   U.S.   Infantry,    retiring    as
                                                               Major, married Kathryn Rankin of Richmond, Va.,
                                                               ane. they have seven children; member aid officer
                                                               of nwerous local civic, fraternal, social and
                                                               business    organizations,     lifelong     member     of
                                                                                         ds;    elected    to    Virginia
                                                               the Society of Frien
                                                               Stzte   Senate   for   21st    Senatorial    District    in
                                                               1965,   was   re-elected   in    1967,    and    resigned
                                                               upon election to Congress; committee
                                                                                                s,    Agriculture     and
                                                               assignments:   General Law
                                                               Mining, Welfare, Enrolled Bills, and
                                                               Nominations    and    Confirmations;     served     as
                                                               chairman   of   Ret)ublicin   Delep,,ation   to    1968
                                                               and   1969    General    Assemblies;    J.    Kenneth
                                                               Robinson   was   elected   to   the    92nd    Congress
                                                               November,3, 1970.   Also member of Subcommittee
                                                               on Foreign Operations, Committee on
                 J. Kenneth Robinson
                 of ;;inchester (7t;,Dist.)                    Appropria:tioris.
                 I?epublican - lot tem
                                                                                                                        7









                           SUBCOM4ITTEE ON LABOR AND HEALTH, EDUCATION
                               AND WELFARE, AND RELATED AGENCIES
                                 COMMITTEE ON APPROPRIATIONS
                                       92ND CONGRESS










                                         Democrats

                            Daniel J. Flood (Pennsylvania) - Chairman
                            William H. Natcher (Kentucky)
                            Ne al Smi th. (I ow-a)
                            W.R. Hull, Jr. (Missouri)
                            Robert (Bob) Randolph Casey (Texas)
                            EdTiard J. Patten (New Jersey)




                                         L,epublicans

                            Robert H. mi chel (Illinois)
                            Garner E. Shriver (Kansas)
                            Silvio 0. Conte (Massachusetts)
                            J. Kenneth Robinson (.Virginia)



                                           Robert M. Moyer, Professional
                                              Staff Assistant
                                           Henry A. Neil, Professional
                                              Staff Assistant






   0













   0








                IVASI-IINGTON'/AL-NSK-@:  Ted Stevens (R. -.,Alaska)

                 1.  B.ACKGIZOUi\'D
                     A.  Grantee or Sponsor:  UniNTersitv of l@,ishiiicyton Scl-iool' of Medicine
                     B.  Coordinator:  Donal R. Sparl@iiian, M.D.
                     C.  Boundaries':  cotenninous x%,itli those of the tivo states
                     D.  History
                         1.  Initial planning grant:  Septenber 1966
                         2.  Operational status:  February 1968

                II.  FUi\DII\'G
                     A.  Support throuah FY71:        $6,999,000
                     B.  FY72 aiiard:                  1,868,000
                     C.  Total support to date:      --s@867,000

               III.  ORCANIZATION

                     A.  Regional Advisory Group
                         1.   Chairman:  C. Robert Ogden, Presidei-it, Nort]-i Coast Life
                              Insurance Conpany
                         2.   Composition (43 rombers)
                              a.  Practicing physicians                       11
                              b.  Medical center officials                    3
                              C.  ll'O,---,,,ital aciiiris@l-rators           5
                              d.  Voluntary  heal  'I   agency
                                  representatives                             2
                              e.  Other health ivorkers                       5
                              f.  Public   health    officials                3
                              g   @lembers of the public                      12
                              h.  Other                                       2
                                                             TOTAL            4S
                    @B.  Program  staff:  33.8 Full-time     equivalents

                IV.  PROGRAM PRIORITIES

                     A.  Improve the availability of care
                     B.  Improve the accessibility of care
                     C.  Improve the acceptability of care
                     D.  Maintain and improie the quality of care
                     E.  Assist in the contaiment of costs.of care

                 V.  OPMATIO,\TAL ACTIVITIES

                     7ne -recion currently sl-,,,-orts 20               a,@4,,4+,CS a4- a   okro 0
                                          .1    't,              I  I"@  @ LI -L V J- LI.L LIL
                     1,003,000.  These incl.ude an emphasis on the      coordination of health
                     services and manpim@r develolinent and training.  Kidney disease is
                     given eq)hasis ivith five components funded at a level of $125.000.








                                                     2

              VI.  SELECTED IT-GIO.@U Cfl!aA=-RISTICS
                    A   Popu@altion:  3.7 million -- 59% urban, 8% minority
                    B.  fieal@li resources
                        1.   I)niversity of l@asliinaton School of  @ledicine
                        2.   121 short-term., non-Fed-@ral hospitals with 11,863 beds.
                             ,(Alaska   13 hospitals, Washington - 108 hospitals).
                        3.'  Alaska    183 physicians (,\ID's and DO's)
                             IVashington 4,208 physicians  (@ID's  and  DO's)
                        4.   Alaska - 590 active registered nurses
                             Wasliinc,,ton ll,.361 active  registered  nurses

             VII.   ILLUSTRATIO.,\'S OF ACTIVITY

                    One illustration of IN'ashi@aton/Alaska R%Tls efforts to improve health
                    services coordination  is  the  development  of  an  unusual  cooperative
                    arrangement betiveen the 39-bed IVillapa Harbor Hospital, located in a
                    remote lumbering community m the lVest coast of IVasliingtoia, and the
                    300-bed  Virginia  Mason  medical  center  in  Seattle.,.

                    In 1969 the small community was serviced by one physician nearing
                    retirement and a failin- hospital for a population of 9,000 people.
                    Two years later, through the aid of I%lashincton/Alaska P,',[Pls Com-
                                                                  C>
                    munity Health Services P-roaram, the toi%n iia,,; has ti@o resident
                    physicians, an elected 'liealtJi board, a Comprehensive Health Planr,4Lncl,-
                    agency, an emergency military helicopter service i ic:.,l  lies patients
                    to a specialized service  center,  as  well  as  a  cooperative  arrange-
                    ment beti.;eeii the two hospitals.  The latter has produced a "hot-
                    line" for consultation between the hospitals, air and land transpor-
                    tation, arrangements for continuity of patient care, a druc, inventory
                    and formulary (resulting in a savinas of $S,000 in one ),ea-r), as
                    well as continuing staff education for the smaller hospital.

                    The success of this program  has  prompted  Virginia  @lason  to  request
                    IVashington/Aldska R\IP to help  in  identifying  other  communities  for
                    similar arrangements.






               GREATER DELAIVARE VALLEY RMP*:  James C. Boggs (R.-Delaware)

               I.  BACKGROUND

                   A.   Grantee or Sponsor:  University City Science Center,        Philadelphia
                   B.   Coordinator:  Martin Wol         ,  M.D.
                   C.   Boundaries:  Region encompasses the State of Delaware and a
                        number of counties in eastern Pennsylvania and southern New Jersey
                        (Delaware River basin area).
                   D.   History
                        1.  Initial planning grant:  April 1967
                        2.  Operational status achieved:  April 1969

              II.  FUNDING

                   A.  Support through FY71:          $81838,000
                   B.  FY72 award (projected):         2,433,000
                   C.  Total  support  to   date:   $11-,271,000

             III.  ORGANIZATION

                   A.  Regional Advisory Group
                        1.  Chairman:  Leonard Wolf., Ph.D.;.Vice President for Planning,
                            University of Scranton, Scranton, Pennsylvania
                        2.  Composition (61 members)
                            a.   Practicing physicians                    14
                            b.   Medical cen-tler offit-Lals              10
                            c.   Hospital     administrators                8
                            d.   Voluntary   health   agency
                                 representatives                            5
                            e.   Other health workers                       2
                            f.   Public   health   officials                9
                            g.   Members of the public                    11
                            h.   Others                                     2
                                                           TOTAL          61
                   B.  Program   Staff:   46.08 Full-time equivalents

              IV.  PROGRAM PRIORITIES

                   Improving the quality, quantity, and accessibility of health         care.

               V.  OPERATIONAL ACFIVITIES

                   The Region currently has 16 ongoing operational- activities with a
                   total funding level of $796,667.  Approximately 19% of funds are
                   related to training of nurses for coronary care unit operations.  The
                   lar e majority of remaining funds are devoted to man-omier deve-lon7.@.nt,
                        9
                   including continuing education and training.  Activities are beinc,
                   reoriented in line with changing priorities, and include recruitment
                   and reactivation of health care personnel, special training for
                   -respiratory disease care, etc.








                                                  2


             VI.  SELECFED REGIONAL CI"CRERISTICS

                   A.  Population:  6,200,000 -- 72% urban, 97% white
                   B.  Health resources
                       1.  6 medical schools
                       2.  165 short-term, non-Federal hospitals with 40,000 beds
                       3.  13,300 practicing physicians M's and DO's  28,500
                           registered nurses

            VII.   ILLUSTRATIONS OF ACTIVITY

                   Ten participating hospitals have joined in a 3 phase program of
                      roving patient care through a deliberately planned process of
                   pinpointing patient care deficiencies, determining the causes, and
                   then developing training processes which will overcome those
                   deficiencies in the future.  This is a group approach to self-
                   evaluation by physicians.  Current year funding is supporting
                   development and adoption of care criteria for at least three
                   conditions.  As that progresses other conditions will be assimi-
                   lated into the process.




                   *NOTE:  As of May 1, 1972, the Greater Delaware Valle@ RNT will
                   become two separate RN@lPs, with the splitting off of the state of
                   Delaware.  The new Delaware P.%!P will attain planning status as of
                   @ 1, with an initial funding of $200,000 for the first yea .
                   Details of organizational structure and staffijig-for the new Tegion
                   Ea-ve not yet been completed.







              HAIVAII RMP:  Hiram L. Fong (R.)

              I.  BACKGROUTO

                  A.  Grantee or sponsor:  Research Corporation of the University of
                      Hawaii
                  B.  Coordinator:  @lasato M. Hasegawa, M.D.
                  C.  Regional boundaries:  The entire state of Hawaii, including
                      American Samoa, Guam and the Trust Territory of the Pacific
                      Islands (Micronesia).
                  D.  History:
                      1.  Initial planning grant:  July 1966
                      2. Operational  status  achieved:  October  1968

             II.  FLJNDING

                  A.  Support through FY71:     $2,963,000
                  B.  FY72 award: -                937,000
                  C.  Total support to date:    $3,900,000

            III.   ORGANIZATION

                  A.  Regional Advisory Group
                      1.  Chairman:  Eucene Helbush,, Member Public Health Committee of
                          Chamber of Comerce - Hawaii
                      2.  Composition (32 members)
                          a.  Practicing physicians                  10
                          b.  Medical center officials               3
                          C.  Hospital administrators                5
                          d.  Other health workers                   I
                          e.  Public health officials                2
                          f.  Members of the public                  9
                          g.  Voluntary health agency
                              representatives                        0
                          h.  Other                                  2
                                                   TOTAL             @2
                  B.  Program Staff:  17 Full-time equivalents

            IV.   PROGRAM PRIORITIES

                  A.  Assist in improvement of-health care delivery system by improving
                      equity of access; quality of care and influence cost reduction
                  B.  Improve organization patterns, develop cooperation, arrangements
                      and serve in catalytic role
                  C.  Improve quality controls in health services.

             V.   OPERATIONAT-.AC7D!ITIES

                  The Hawaii RW currently has 6 ongoing activities funded at a level
                  of $393.,828.  Fifty-three percent of their money is aimed at projects
                  for improving health manpower recrutiment.  The Ynaior shift in








                                                    2

                   emphasis is directed toward improved and expanded      services by
                   existing physicians, nurses and other allied health personnel;
                   increased utilization of new types of allied health personnel; new
                   and specific mechanisffr@that provides quality control and improved
                   standards and-decreased costs of care in hospitals.

              VI.  SELECTED REGIONAL CHARACTERISTICS

                   A.   Population:  1.0 million -- 81% urban, 62% minority
                   B.   Health Resources
                        1.  @dical School -  University  of  Hawaii  School  of  @ledicine
                        2.  Hospital and  beds  -  22  short-term,  non-Federal  hospitals
                            with 2,453 beds; 86% involved with R4P
                        3.  Physicians and nurses  -  949  physicians  (MD's  and  DO's),
                            2,334 nurses

            VII.   ILLUSTRATIONS OF ACTIVITY

                   The Hawaii  Regional  Medical  Program  is  assisting  in  improvement of
                   the health care system  of  Hawaii  by  improving  equity  of  access;
                   iWroving  quality  of  care;  and  influencing  constraints  in  health
                   care costs.

                   In general the heart  program  satisfied  basic  needs  in  Hawaii  by
                   establishing coronary care units throughout the Islands and training
                   ample @ers of physicians and nurses to staff units.
                   'Ihe Hawaii RMP is  currently  working  toward  improving  the  overall
                   health care delivery system in general, rather than specific cate-
                   gorical diseases.







               TRI-STATE Ri'v[P:  Edward W. Brooke (R.,Massacliusetts)

               I.   BACKGROUI\TD

                    A.  Grantee or   Sponsor:  Medical Care and Education Foundation, Inc.,
                        Boston
                    B.  Coordinator:  Leona Baumaartner, M.D.
                    C.  Boundaries:  States of Massachusetts, New Hampshire, and Rhode
                        Island (some western counties of Massachusetts are also served
                        by the Albany RMP) .
                    D.  History
                        1.  Initial planning grant:  December 1967
                        2.  Operational   status   achieved:   February   1969

               II.  FUNDING

                    A.  Support   through   FY71:   $5,3361000
                    B.  FY72 award:                  2,461,000
                    C.  Total  support  to  date:   $7,797,000

              III.  ORGANIZATION

                    A.  Regional Advisory Group
                        1.   Chairman-  Louis A. Leone, M.D., Director, Department of
                             Oncology,  Rhode  Island   Hospital,   Providence
                        2.   Composition (,62 members
                             a.  Practicing physicians                     27
                             b.  Medical center officials                   3
                             c.  Hospital administrators                    4
                             d.  Volmtary health agency
                                 representatives
                             e.  Public health officials                    4
                             f.  Other health workers                       5
                             g.  Members of the Public                     10
                             h.  Others                                     4
                                                  TOTAL                    62
                    B.  Program  staff:   43.0 Full-time equivalents

               IV.  PROGRAM PRIORITIES

                    A.  Supply distribution and-education of health/manpower
                    B.  InstitLitional   cooperation   and   reuionalization
                    C.  Geographic gap filling
                    D.  Medical care financing

                V.  OPERATIONAL ACTIVITIES
                    Tri-State PM currently has 6 ongoing operational components with a
                    funding level of $613,500.  About 60% of that.sm supports activities
                    in the area of intensive coronary care.  Better manpower utilization
                    is the iia 4or --F--@as of programs      are.sup-@orted by approximately








                                                   2

                   half of the available funds, the remainder supporting various types
                   of patient care demonstrations.  Approximately S9% of funds ($365 000)
                   go to activities directed against health problems of the black popu-
                   lation in@the three state area.

             VI.  SELECFED REGIONAL CHARACFERISTICS
                   A.  Population:  7,374,000 -- 89% urban, 5% minority
                   B.  Health resources
                       1.   5 medical schools; 1 @,o-year medical sciences school
                       2.   188 short-term,@non-Federal hospitals with 33,07S beds,
                            20% of these a-re participating in R4P planning bodies and
                            operational activities
                       3.   11,200 active physicians; 35,800 active nurses

            VII.   ILLUSTRATIONS OF ACFIVIIY
                   The major thrust of the Tri-State R4P is undergoing     change in accord
                   with changing emphasis of the national program.  Greater emphasis is
                   being placed on actions which affect the delivery of health care
                   services, and chanaing the  system,  while  attacks  on  individual  disease
                   problems are being de-cm        ed.  Existing  disease  control   activities
                                            ,phasiz
                   a-re being reoriented as the transition process indicates.
                   There has also been an increased emphasis on awarding of contracts to
                   meet specific needs of the program, while awarding of grants for
                   marginally related activities has been de-emphasized.  The end point
                   ha s been a greater reliance on program expertise in meeting the Region's
                   needs through priority programming.
                   During the  past year the Tri-State Region instituted a $300,000 program
                   "To assure  that no patient with end-stage  kidney  disease  will  die  from
                   lack of necessary services."  I\Teiv England states other than those of
                   the Tri-State Region are involved.  The short-yan2e objective is to
                   develop a method of procuring donor organs and to identify problem
                   of funding. The long-range  objective  is  to  furnish  an  adequate  supply
                   of cadaver organs to satisfy patients needs in various transplant
                   units.








              MISSISSIPPI:  John C. Stennis (D.)
              I.   BACKGROUT
                   A.  Grantee or sponsor:  University of Mississippi Medical Center,
                       Jackson
                   B.  Coordinator:  Theodore D. Lampton, M.D.
                   C.  Boundaries:  Coterminous iNTith State (a few northern counties are.
                       also,served by Memphis RN@IP).
                   D.  History
                       1.  Initial planning grant:  January 1967
                       2.  Operational status:  July 1969

             II.  FUNDING
                   A.  Support through FY71:    $4,S99,000
                   B.  FY72 award:               1,053,000
                   C.  Total support to date:       52,000

            III.   ORGANIZATIOIN

                   A.  Regional Advisory Group
                       1.  Chairman: Lewis Nobles,  Ph.Di,  President, Mississippi College
                       2.  Composition:  (30 members)
                           a.  Practicing  physicians                4
                           b.  Medical center officials              I
                           c.  Hospital administrators               s
                           d.  Other health workers                  4
                           e.  Public health officials               2
                           f.  Members of the  public                4
                           g.  Voluntary health agency
                               representatives                       9
                           h.  Others                                1
                                                    TOTAL            30
                   B.  Program staff:  22 Full-time equivalents

             IV.  PRO@L PRIORITIES
                   A.  Remolding the program structure to respond to nei-z initiatives and
                       expanded opportunities-in planning for the statels health needs
                   B.  Improving both quality and quantity of health manpower by up-
                       grading abilities-in the field and attracting new personnel to
                       the field

              V.   OPERATIONM ACTIVITIES
                   The region is currently supporting nine operational components at a
                   funding level of $920,000.  The major emphasis is on improved health
                   manp(x,ier training and utilization.









                                                   2
             VI.  SELE=     @GIONAL   @CRERISTICS
                   A.  Population:  2.2 million -- 17% urban, 37% minority
                   B.  Health resources
                       1.  One medical school
                       2.  97 short-term, non-Federal hospitals with 8,698 beds
                       3. -1,610 physicians (@ID's and DO's; 3,670 active registered
                           nurses


            VII.   ILLUSTRATIONS OF ACFIVITY

                   A stroke intensive care unit serves   as a learning center to upgrade
                   skills of physicians, nurses and allied health professionals.
                   Additionally, it serves the poor who are obtaining care where none
                   was previously available.  The skills of the following groups have
                   been upgraded by assignment to, or rotation through the unit:

                       89  medical  students
                       18  nursin   students
                                9
                       33  practical  nurses
                        2 nurses aides
                        8 house  staff  phys cians.






               MOUIWAIN STATES R,,T     Alan Bible (D. - Nevada)

                I.  BACKGROUNI)
                    A.   Grantee or Sponsor:    WIcliE-9  P.0'Drawer "P",, Boulder,, Colorado
                    B.   Coordinator:   John    W.Gerdes, Ph.D.
                    C.   Boundaries:  Including the States of Idaho, Montana, Nevada, and
                         Wyoming
                    D.   History
                         1. 'Initial planning grant:  November 1966
                         2.  Operational status achieved:  March 1968

               II.  FUNDII\'G
                    A.  Support   through   FY71:       $7,676,000
                    B.  FY72 award (projected):         13,764@000
                    C.  Total support to date:        $9   440,000

             III.      ORGANIZATION

                    A.  Regional Advisory Group
                             Chairman:  Arthur R. Abbey,, Executive Director  Wyomina Hospital
                         1.
                             Medical Service
                         2.  Composition (26 members)
                             a.   Practicing physicians                       4
                             b.   Medical center officials                    2
                             C.   Hospital     administrators                 A
                             d.   Other health i%Drkers                       4
                             e.   Public   health   officials                 0
                             f.   Members of the public                       8
                             9.   Voluntary   health   agency repre-
                                  sentatives                                  2
                             h.   Others                                      2
                                                         TOTAL                TC
                    B.  Program   staff.t 27 Full-time equivalents

               IV.  PR@l       PRIORITIES
                    A.  Assist in subregional centers for continuing education
                    B.  Improve health centers for rural residents
                    C.  Stimulate health manpower development and utilization
                    D.  Provide specialized centers development

                V.  OPERATIONAL ACTIVITIES
                    The Mountain States RT currently has 11 ongoing activities funded at
                    a level of $784,200.  At present a great deal of money (56 per cent)
                    goes to continuing education and trainina         Most projects are aimed at
                    provider  groups.  New  and   expanded   roles C, ior existing health professionals
                    who will serve the disadvantaged rural and poor are being explored
                    throughout the Region.      IlVhile stimulating the improvement of existing
                                                                                               0-r-
                    resources,      P@.IP ivorks cooperatively to create greater awareness
                    health manpower opportunities.







             VI.       SELE= REGIO,@ CHARACTERISTICS
                   A.  Population:  2.2 million  30% urban and 5% minority
                   B.  Health Resources
                       1.  Medical schools - none
                       2.  Hospitals and beds
                           a.  Mountain States - 131 short-term, non-Federal hospitals
                               with 8,517 beds; 29% involved with @IP
                           b. Nevada - 17  short-term,  non-Federal  hospitals  with  1,967
                               beds
                       3.  Physicians and nurses
                           a.  @lountain States - 1,536 physicians (MD's and DO's)
                                                  5,646 nurses
                           b.  Nevada - 463 physicians (NID's and DO's)
                                      1,060 nurses

            VII.   ILWSTRATIONS OF ACTIVITY
                   The Mountain States Regional @ledical Program as a whole is faced with
                   the problems of providing quality health care in sparsely populated
                   areas. The Region can never get enough  physicians  to  cover  the  vast
                   rural areas or to serve the populace in every small community, therefore,
                   emphasis is placed on assisting subregional centers for continuing edu-
                   cation to seek solutions so that health  practitioners  will  be  better
                   trained to help meet the needs in their surrounding communities.
                   In summary, throuah continuing education  offerings  and  such  outreach
                   programs as the Comunity Teams in Nevada and off-campus nursing work-
                   shops a new rapport has become manifest among,the urban and rural
                   health workers.



























                                                      2








               TRI -STATE @LP:  I\Tor-ris Cotton (R. -,\Teii Ham
                                                          ,pshire)

               I.  BACKGROtiND

                   A.  Grantee or Sponsor:  Medical Care and Education Foundation, Inc.,
                       Boston
                   B.  Coordinator:  Leona Baumgartner, M.D.
                   C.  Boundaries:  Statesof Massachusetts, New Hampshire, and Rhode
                       Island (some western counties of Massachusetts are also served
                       by the Albany RMP).
                   D.  History
                       1.  Initial planning grant:  December 1967
                       2.  Operational  status  achieved:  February   1969

              II.  FUNDING

                   A.  Support through FY71:     $S.*3363,000
                   B.  FY72 award:                 2,461,000
                   C.  Total support to date-    $7,797,000

             III.  ORGANIZATION

                   A.  Regional Advisory Group
                       1.  Chairman:  Louis A. Leone, M.D., Director, Department of
                           Oncology,  Rhode  Island  Hospital,  Providence
                       2.  r-oT.Posil+-ion (61& -,,e,-,bers'
                           a.  Practicing physicians                    27
                           b.  Medical center officials                 3
                           c.  Hospital    administrators               4
                           d.  Voluntary  health   acency
                                                  C>
                               representatives                          5
                           e.  Public  health   officials               4
                           f.  Other health workers                     5
                           g.  Members of the public                    10
                           h.  Others                                   4
                                                 TOTAL
                   B.  Program staff:   43.0 Full-time  equivalents

              IV.  PROGRAM PRIORITIES

                   A.  Supply distribution and-- education of health/manpower
                   B.  Institutional cooperation and regionalization
                   C.  Geographic gap filling
                   D.  Medical care financing

               V.  OPERATIONAL ACFIVITIES

                   Tri-State RV currently has 6 ongoing operational components with a
                   funding level of $613,500.  About 60% of that sum supports activities
                   in the area of intensive coronary care.  Better manpower utilization
                   is the major focus of programs which are supported by approximately









                                                2
                  half of the available funds, the remainder supporting various types.
                  of patient care demonstrations.  Approximately S9% of funds ($36S,000)
                  go to activities directed against health problems of the black popu-
                  lation in the three state area.

             VI.  SELECFED REGIONAL CHARACRERISTICS
                  A.  Population:  7,374,000 -- 89% urban, S% minority
                  B.  Health resources
                      1.  5 medical schools; 1 t-io-year medical sciences school
                      2.  188 short-term, non-Federal hospitals with 33.,07S beds,
                          20% of these are participating in RV planning bodies and
                          operational activities
                      3.  11,200 active physicians, 35.,800 active nurses

            VII.  ILLUSTRATIONS OF ACRIVITY
                  The major thrust of the Tri-State RNP is undergoing change in accord
                  with changing emphasis of the national program.  Greater emphasis is
                  being placed on actions which affect the delivery of health care
                  services, and changing the system, while attacks on individual disease
                  problems are being de-emphasized.  Existing disease control activities
                  are being reoriented as the transition process indicates.
                  There has a]-so been an increased emphasis on awarding of contracts to
                  meet specific needs of the program, while awarding of grants for
                  marginally related activities has.been de-empl-iasized.  The end point
                  has been a greater reliance on program expertise in meeting the Region's
                  needs through priority programming.
                  Du-ring the past year the Tri-State Region instituted a $300,000 program
                  "TO assure that no patient with end-stage kidney disease will die from
                  lack of necessary services."  iNew England states other than those of
                  the Tri-State Region are involved.  The short-range objective is to
                  develop a method of procuring donor organs and to identify problems
                  of funding.  The long-range objective is to furnish an adequate supply
                  of cadaver organs to s@tisfy patients needs in various transplant
                  units.







              NBV JERSEY @IP:  Clifford P. Case (R.)

                I. BACKGROLINID

                   A.  Grantee or Sponsor:  New Jersey Joint Committee for Implementation
                       of P.L. 89-239.
                   B.  Coordinator:  Alvin A. Florin M.D.
                   C.  History
                       1.  Initial planning grant:  July 1967
                       2.  Operational status:  April 1969

              II.  FUNDI NTG

                   A.  Support through FY71:    $416841000
                   B.  FY72 award (projected):  1,400,000
                   C.  Total support to date:  $6,084,000

             III.  ORGANIZATION

                   A.  Regional Advisory Group
                       1.  Chairman:  Richard J. Cross, M.D., Professor of Medicine,
                           Rutgers Medical School
                       2.  Composition (27 members)
                           a.  Practicing physicians                  6
                           b.  Medical center officials               3
                           c.  Hospital administrators                5
                           d.  Voluntary health agency
                               representatives
                           e.  Public health officials                3
                           f.  Other health ivorkers                  2
                           g.  members of the public                  .6
                                                   TOTAL              27
                   B.    Program staff:  20.5 Full-time equivalents

              IV.  PWGRAM PRIORITIES

                   A.  improvement of services to urban poor
                   B.  Health manp(xier education
                   C.  Regionalization of Health service resources

               V.  OPERATIONAL ACTIVITIES

                   The region currently has t%,elve ongoing-operational activities with
                   direct cost funding of $814,000.  Approximately one half of the projects
                   are directed toi@ards categorical diseases (heart, cancer and stroke)
                   and the other half are nulti-cateuorical disease programs.  In terms
                   of prina-r,, focus, +.",-- NTc,,v lo-rsey J'rog-raii-i is U'irecceu' ratlier evenly in
                   three areas -- continuing education, patient care delivery and coordin-
                   ation of health services.  Close to half of the NJW's operational
                   monies support inner city programs for blacks and spanish surname
                   populations.








                                                    2


              VI.  SELECTED REGIONAL CHARACFERISTICS

                   A.   Population:  7.2 million -- 89% urban,, 18% minority
                   B.   Health resources
                        1.  2 medical schools
                        2.  107 short-term, non-Federal   hospitals with 25,247 beds;
                            58% (62) of these hospitals   are involved in RMP planning
                            and activities
                        3.  9,176 physicians (',,ID's and DO's); 24,900 active nurses
                            (42,400 total)

            VII.   ILLUSTRATIOINS OF ACTIVITY

                   With more than 85% of New Jersey cancer patients being treated in
                   co     ity or general hospitals of 500 beds or  less,  it  is  the  aim  of
                   the New Jersey @IP - Tumor  Conference  Boards  to  bring  the  most  up-to-
                   date medical  information  to  the  practicing  physician  responsible  for
                   cancer patient  care.  Thus,  four  agreements  of  affiliation  have  been
                   executed with  eighteen  hospitals  and  negotiations  are  currently  under-
                   way with six additional hospitals.  More than 10,000 patients have
                   been brought under team -review of  the  status  of  their  disease,  treat-
                   ment jmdes, and  rehabilitation  plan.  By  March  1972,  it  is  anticipated
                   that 43 hospitals will be totaling an estimated 15,000 annual admissions
                   for cancer.

                   An objective of the project is to establish joint tumor conference
                   boards for two  or  more  hospitals.  In  Middlesex  County,  a  demonstration
                   of a joint conference board  is  planned  for  St.  Peter's  General  Hospital
                   (ongoing) and @lidcllesex Hospital.  The  encouraging  factor  in  support  of
                   a joint program for these  two  institutions  is  thb  recent  program  amal-
                   gamation of radiation therapy  services  in  St.  Peter's  Hospital  to  serve
                   both hospitals.
                   New Jersey @ has provided staff and technical assistance to six Federally-
                   designated  Model  Cities  Program  through  the  assignment  of  full-time
                   Urban Health  Coordinators.  In  each  city  the  Urban  Health  Coordinator
                   helps plan and organize,facilities and manpower resources to increase the
                   effectiveness of local  health  care  delivery  system  .  This  project,  now
                   in its second year of  operation,  serves  a  population  of  200,000  dis-
                   advantaged residents and has secured or applied for more than five million
                   dollars from sources outside the RMP for funding health program in these
                   cities.  Plans call for expanding the project to include 367,000 residents
                   of the 14 newly approved State Co       ity Development cities.
                   A project has been developedtd organize providers of services and health
                   care facilities  into  a  comprehensive  care  program  especially  directed
                   at serving the disadvantaged and others without regular sources of
                   medical'care.  The  project,  at  Middlesex  General  Hospital,  is  designed
                   to serve a patient population of  4,000  persons  with  a  program  of  pre-
                   ventive medicine and treatment -,"-il.izing a full-tiire family healt]-i  care
                   team   The  project  includes  multiple  funding  from  Medicaid,  Medicare,
                   hospital resources, and the @IP.






                NOV @ICO:  Joseph M. Montoya (D.)

                 I. BACKGROUN'P

                    A.   Grantee or sponsor:@ The University of New Mexico
                    B.   Coordinator:  James R. Gay, M.D.
                    C.   Boundaries:  Covers the entire State of New Mexico
                    D.   History
                         1.  Initial Planning grant:  October 1966
                         2.  Operational status:  July 1968

                II. FLJNDING

                    A.  Support through FY71:        $4,331,000
                    B.  FY72 award:                   1,033,000
                    C.  Total support to date:       $5@364,000

               III. ORGANIZATION

                    A.  Regional Advisory Group
                         1.  Chairman:  Hugh B. Wooclvard, M.D., Medical,Director, Mountain
                             Bell Telephone Company
                         2.  Composition (41 members)
                             a.   Practicing    -physicians                  13
                             b.   Medical c;@t'e'r officials                 2
                             c.   Hospital administrators                    4
                             d.   Voluntary health agency
                                  representatives                            2
                             e.   Public health officials                    4
                             f.   Other health workers                       I
                             9.   Members  of  the   public                  13
                             h.   Other                                      2
                                                          TOTAL
                    B.  Program   staff:  15 Full-time equivalents

                IV. PRO@ PRIORITIES

                    A.   Manpoi%,er
                    B.    Prevention/health     maintenance
                    C.  Availability of care
                   .D.  Quality of care

                 V. OPERATIONAL ACTIVITIES

                    The region is currently supporting 12 operational activities in the
                    amount of $461,317.     Monies are divided among the following disease
                    categories:  heart 11%, cancer 7%, stroke 24%, and multicatezorical
                    58%.  Over 60% of the funds support training existing health personnel
                    in new skills.









                                                   2

             VI.  SELECFED REGIOINM CHAP,,%CTERISTICS

                   A.  Population:  1.0 million -- 29% urban  52% white
                   B.  Health resources
                       1.  I medical school
                       2. 39 short-term  general,  non-Federal  hospitals  with  3,351  beds.
                           47% of hospitals participating in RMP
                       3.  969 physicians (,\fl)ls and DO's); 2,511 active registered nurses

            VII.   ILLUSTRATIO@NS OF ACTIVITY

                   "Coronary Care Nurses Training Project" - the project emphasizes the
                   relationship between training of  personnel  in  cardiovascular  care  and
                   their functions in the Central monitoring units and remote stations.
                   It will continue the four-week course to prepare nurses to work in a
                   Central @nitoring Unit, and  accelerate  the  teaching  of  personnel  who
                   will be working in the Remote Stations (one-week courses).

                   The Remote Monitoring Project  will  establish  eight  Central  Monitoring
                   Units and 23 Remote Units to provide quality care to myocardial
                   infarction victims in local facilities.  The plan encompasses ap-
                   proximately one-half of the small hospitals in New Mexico.

                                                       -i%,o licensed practical
                   Forty-seven registered nurses and t                         nurses
                   Completed a training program ",N'arsina in the Coroi-iaiy fare U.-lit.,,
                   Three continuing education programs for  CCU  nurses  have  been  planned.
                   In conjunction with the remote monitoring project, approximately 30
                   nurses and other paramedical Personnel received a one-week training
                   program.  This program will provide the nurses in smaller hospitals
                   (remote units) with the knowledge and skills necessary for the nursing
                   management of patients with coronary heart disease.








              SOUIH CAROLINA:  Ernest F. Holli@cys (D.)

              I.  BACKGROUND

                  A.  Grantee or sponsor:  Medical University of South Carolina,
                      Charleston
                  B.  Coordinator:  Vincent  Moseley,  M.D.
                  C ' Boundaries:  Coterminous  with  State
                  D.  History
                      1.  Initial planning grant:  January 1967
                      2.  Initial operational period:  August 1968

             II.  FUNDING

                  A.  Support through FY71:      $4,184,000
                  B.  FY72 award:                 1,341,000
                  C.  Total support to date:     $5,525,000

            III.  ORGANIZATION

                  A.   Regional Advisory Group
                      1.  Chairman:  James W. Colbert, M.D., Vice President, Academic
                          Affairs, @l.U.S.C.
                      2.  Composition (70 members)
                          a.  Practicing physicians                  37
                          b.  Medical center officials               2
                          c.  Hospital administrators                6
                          d.  Voluntary health agency
                              representatives                        6
                          e.  Public health officials                3
                          f.  Other health workers                   3
                          g.  Menbers of the public                  10
                          h.  Other                                  3
                                                   TOTAL             70
                  B.  Program staff:  30 Full-tijne equivalents

             IV.  PROGRAM PRIORITIES

                  A.  Redirection of program efforts to identify with emerging Federal
                      and State initiatives in planning and delivery of health services.
                  B.  Continue to upgrade patient care by upgrading skills and abilities
                      of health practitioners.

             V.   OPERATIONAL ACTIVITIES

                  South Carolina RW currently ha--- 13 operational activities
                  at a cost of $724,000.  The major emphasis of these activities are
                  health manpower training and utilization and improved coordination of
                  health services.


            VI.  SELECTED REGIONAL CHARACRERISTICS

                  A.  Population:  2.6 million -- 38% urban, 31% minority









                                                   2


                   B.  Health resources
                       1.   one medical school
                       2.   70 short-tem., non-Federal hospitals with 9,213 beds.
                            Sixty percent of hospitals participate with  the South
                                      '%IP
                            Carolina R
                       3.   1,955 physicians (ND's  and  DO's);  5,62S  active  registered
                            nurses


            VII.   ILLUSTRATIOINS OF ACFIVITY
                   Noteivorthy among continuing projects is one which is designed to
                   improve and  expand  existing  continuing  education  opportunities  in
                   the health sciences at the community level.  It's efforts are
                   directed to  professional,  technical,  and  allied  health  personnel.
                   A kidney disease education and service program is aimed at expanding
                   facilities to provide additional patient-training and provide
                   equipment and professional support  for  home  dialysis  of  the  renal
                   patient.







               IVASHINGTOiN/ALASKA:    l@larren G.  @la,@on.  (D.  -Washington)

                 I. BACKGROUND

                    A.   Grantee or Sponsor:  University of Washington School of @ledicine
                    B.   Coordinator:  Donal R. Sparkman, @I.D.
                    C.   Boundaries:  coterminous with those of the two states
                    D.   History
                         1.  Initial planning grant:  September 1966
                         2.  Operational status:  February 1968

               II.  FLJNDING

                    A.  Support through FY71:        $6,999,000
                    B.  FY72 award:                   1,868)000
                    C.  Total support to date:        8@867,000

              III.  ORGANIZATION

                    A.  Regional Advisory Group
                         1.  Chairman:  C. Robert Ogden, President, North Coast Life
                             Insurance Company
                         2.  Composition (43 members)
                             a.   Practicing physicians                      11
                             b.   @ledical center officials                  3
                             c.   Hospital  a@,P-is+..-,-+o-s                s
                             d.   Voluntary   health   agency
                                  representatives                            2
                             e.   Other health workers                       5
                             f.   Public   health   officials                3
                             g.   Members of the public                     '12
                             h.   Other                                      2
                                                            TOTAL
                   .B.  Program   staff:  33.8 Full-time    equivalents

               IV.  PROGRAM PRIORITIES

                    A.   Improve the availability of care
                    B.   Improve the accessibility of care
                    C.   Improve the acceptability of care
                    D.   Maintain and improve the quality of care
                    E.   Assist in the containment of costs of care

                V.  OPERATIONM ACFMTIES

                    The region currently supports 20 operational activities at a level o
                    1,003,000.  These include an emphasis on the coordination of health
                    services and manpower development and training.  Kidney disease is
                    given emphasis with five components funded at a level of $125,000.









                                                    2

             VI.  SELE=-  RE-GIONA:L CHARACFERISTICS

                   A.  Population:  3.7 million -- 59% urban, 8% minority
                   B.  Health resources
                       1.   University of Washington School of Medicine
                       2.   121 short-term., non-Federal hospitals with 11,863 beds.
                            (Alaska   13 hospitals, Washington - 108 hospitals).
                       3.   Alaska   183 physicians GID's and DO's)
                            Washington 4,208 physicians (MD's and DO's)
                       4.   Alaska - 590 active registered nurses
                            Washington 11, 361 active registered nurses
                                                          C.


            VII.   ILLUSTRATIONS OF ACI'IVITY

                   One illustration of Washington/Alaska RMP's efforts to improve health
                   services coordination is  the  development  of  an  unusual  cooperative
                   arrangement between the 39-bed Willapa Harbor Hospital, located in a
                   remote lumbering community on the West coast of Washington, and the
                   300-bed Virginia Reason medical center in Seattle.

                   In 1969 the small co       ty was serviced by one physician nearing
                   retirement and a failing hospital for a population of 9,000 people.
                   Two years later, through   the aid of Washington/Alaska @,IP's Com-
                   munity Health Services Program, the town now has tivo resident
                   physicals, art elected health i)oard, d Comprehensive Health Planning
                   agency, an emergency military  elicopter service which flies patients
                   to a specialized service center,  as  well  as  a  cooperative  arrange-
                   ment between the two hospitals.  The latter has produced a "hot-
                   line" for consultation between the hospitals, air and land transpor-
                   tation, arrangements for continuity of patient care, a drug inventory
                   and formulary (resulting in a savings of $5,000 in one year), as
                   well as continuing staff education for the smaller hospital.

                   The success of this program  has  prompted  Virginia  Mason  to  request
                   Wa-shington/Alaska RMP to help in identifying other co         ties  for
                   similar arrangements.




         Job



              WEST VIRGINIA R4P: Robert  C.  Byrd  (D.)

               I. BACKGROUND

                  A.  Grantee:  West Virginia University Med ical Center
                  B.  Coordinator:  Charles D. Holland
                  C.  Boundaries:  Coterminous  with  state
                  D.  History
                      1.  Initial planning grant:  January 1967
                      2. Operational  status  achieved:  January  1970

              II. FUNDING

                  A.  Support through FY71:      $1,716,000
                  B.  FY72 award:                   609,000
                  C.  Total support to date:     $2@325,000

            III.   ORGANIZATION

                  A.  Regional Advisory Group
                      1.  Chairman:  Charles E. Andrews, M.D., Provost, WVU Medical
                          Center
                      2.  Composition (36 members)
                          a.  Practicing physicians                 9
                          b.  Medical center officials              3
                          c.  Hospital   administrators             6
                          d.  Voluntary  health  agency
                              representatives                       7
                          e.  Public  health  officials             2
                          f.  Other health workers                  3
                          g.  Members of the public                 5
                          h.  Other                                 1
                                                      TOTAL        T6-
                  B.  Program staff:  19.25 Full-time equivalents

             IV.  PROGRAM PRIORITIES

                  A.  Rural health care
                  B.  Delivery of primary health care services
                  C.  Preventive Services

              V.  OPERATIONAL ACTIVITIES

                  West Virginia @IP currently supports 5 operational activities in the
                  amount of nearly $190,000.  Only one of these programs is directed
                  toward the control of a specific disease entity (i.e., stroke); the
                  remainder a-re for the.most part broadly based in the areas of cooper-
                  ative delivery of health care services, conmnication networks,
                  emergency medical system , and general continuing education.  Over
                  half of the Region's operational funds ($100,000) go for the conduct




         AL



                                                2

                  of continuing education program for physicians, primarily in the
                  form of one project aimed at improving care through the use of
                  physicianiself-audit -review.  Another noteworthy effort (20% of
                  funds) isi,directed toward improving primary care delivery to
                  children in rural and remote areas of the State.

            VI.   SELEC7ED REGIONAL CHARACRERISTIC

                  A.  Population:  1.8 million -- 95% white, 62% rural
                  B.  Health resources
                      1.  1 medical school; 11 schools of nursing; 7 schools of medical
                          technology
                      2.  74 short-term, non-Federal hospitals with 9,286  beds.
                      3o  1,500 active @ID's, 111 active DO's; 5,001 active RN's.

           VII.  ILLUSTRATIONS OF ACRIVITY

                  A.  Rural School Health Program: This activity has been  underway  in
                      West Virginia @IP since July 1971 and has as its major objectives
                      the identification implementation and evaluation of  a  prototype
                      school health program which can be replicated in rural areas
                      throughout the Nation.
                      Program emphasis is on the prevention of health problem , particu-
                                                                         of py4
                      larly chronic diseases, and tqe more efficient use      Lmaiy
                      health care services.  Having c   leted preliminary planning
                                                    OMP
                      activities (e.g., collection of baseline data, rando  sampling of
                      health status of elementary school children, modification of
                      school health record form), the program this year will begin  the
                      development of a new type of health manpower, the "school  health
                      assistant;" test the feasibility of employing various types of
                      health personnel, including pediatric nurse practitioners and
                      physicians' assistants; and initiate screening and referral
                      services for children as well as educational programs for their
                      parents.








              WISCONSIN:  William Proxmire (D.)

               I. BACKGRDUND

                  A.   Grantee or sponsor: Wisconsin  Regional  Medical  Program,  Inc.
                  B.   Coordinator:  John S. Hirschboeck M.D.
                  C.   Boundaries:  coterminous  with  state
                  D.   History
                       1.  Initial plannina grant:  September  1966
                       2.  Operational status:  September 1967

              II. FLJNDING

                  A.  Support through FY71:       $5,115,000
                  B.  FY72 award:                  1,764,000
                  C.    TotIal support to date: TU   879,000

            III.    ORGANIZATION

                  A.  Regional Advisory Group
                       1. Chairman:  Rodney Lee Young, J.D., County Judge      Lady Smith,
                          Wisconsin
                       2. Composition (45 meffbers)
                          a.   Practicing physicians                 9
                          b.   Medical center officials              4
                          c.   Hospital  administrators              8
                          d.   Voluntary health  agency
                               representatives                       2
                          e.   Other health workers                  6
                          f.   Public health  officials              2
                          g.   Members of the public                 11
                          h.   Other                                 3
                                                  TOTAL              @5
                  B.     Program staff:  24.0 Full-time equivalents

              IV. OPERATIONAL ACRIVITIES

                  The region is currently supporting nine (9) operational activities in
                  the amount of approximately $450,000.  A majority of the funds are
                  expended in the area of training existing  health  personnel  in  new
                  skills, although significant portions of their budget are also
                  directed towards patient care delivery  and  coordination  of  health
                  services. The projects being carried out  in  the  region  are  under
                  the aegis of a variety of  institutions.  For  example,  two  smaller
                  projects are directed from the medical school, two from hospitals,
                  one from a voluntary health agency, another from a public health
                  agency,   etc.

               V. SFLECRED REGIOINAL      crERISTICS

                  A.  Population:  4.4 million -- 49% urban, 95'0 white
                  B.  Health resources
                       1.  two (2) medical schools









                                                2
                      2.  l@4 short-term, non-Federal hospitals with 22,385 beds
                      3.  4 605 physicians @,ID's and DO's); 14,084 active registered
                          nurses


             VI.  ILLUSTRATIONS OF ACFIVITY
                  A project recently funded by the Wisconsin RV  proposes  to  demonstra'te
                  the capability of the nurse associate in performing some  tasks  which
                  are now performed by physicians.  The project will ultimately prepare
                  68 physician-registered nurse team .  The initial focus will be on
                  child health care because of the amount of work already done  in  this
                  area.  Because of the rural nature of Wisconsin, the project will then
                  move into the area of family health or general practice,  followed  by
                  the application of the concept to geriatrics practice.  These te@
                  will practice in various settings (single office, group practice,
                  health center and outpatient  department-coimunity  setting).  Perfor-
                  mance, role acceptance and cost effectiveness will be continually
                  evaluated in order to anticipate problems and  suggest  modifications.
                  Another activity recently funded -- "North Central Wisconsin Outreach"--
                  will hopefully serve as a prototype to be replicated elsewhere in the
                  state.  Addressing the problem of "no doctor towns," in which there is
                  little likelihood of recruiting a physician,, this project hopes to
                  develop Satellite Clinics.  The clinics would be staffed only 2 and
                  one half days per week by a physician; the remainder of the time by  a
                  trained physician assistant.







                            GREATER DELAWARE VALLF.V @',IP:   Daniel  Flood   (D)
                                llilkes-Barre, Peniisylvi.nia  (District 11)


              1.   BACKGROUND
                   A.. Grantee or Sponsor:  University City       Science Center, Philadelphia
                   B.  Coordinator:  @lartin Ilollmann, M.D.
                   C.  Boundaries:  Region encompasses a number of counties in         'eastern
                       Pennsylvania and southern New Jersey, and the state of Delaware.
                       In  general  it  covers  the  Delaware  River  basin   area.
                   D.  History:
                       1.  Initial planning grant:  April 1967
                       2.  Operational status achieved:  April 1969

             II.   FUNDING
                   A.  Support through FY71:          $ 8  837  753
                   B.  FY72 award (projected):          2,433   217
                   C.  Total support to date:         $11,270,970

           III.    ORMIZATION
                   A.    Regional Advisory Group
                       i.. Chairman:  Leonard   Wolf,   Ph.D.;   Vice   President for Planhi.ng,
                           University   of   Scranton,   Scranton,   Pennsylvania
                       2.  Composition   (61   members)
                           a.  Practicing physicians                            14
                           b.   Medical center or'ficials                       10
                           c.   Hospital     administrators                       8
                           d.   Voluntary   health   agency
                                 representatives                                  5
                           e.   Other  health   workers                           2
                           f.   Public   health   officials                       9
                           g.   Members of tfie public                          11
                           "'h. Others,                                      .... 2
                                                              TOTAL             61
                   B.   Core staff:  46.08 full-time equivalents

            IV.    PROGRAM PRIORITIES:  Improving the quality, quantity, and accessi-
                   bility of health care.

             V.    OPERATIONAL   ACTIVITIES:   The   Region currently has  16 ongoing operational
                   activities with a total funding level of $796,667.  Approximately 19%
                   of funds are related to training of nurses for coronary care Unit ,
                   operations.  The large majority of remaining funds are devoted to man-
                   power development, including continuing education and training.
                 -Activities are being reoriented in line with changing priorities,
                   and include recruitment and reactivation      of health care personnel,
                   special training for respiratory diseqse      care, etc.









                                              2


            VI.   SELECTED REGIONAL CHARACTERISTICS.
                  A-.. Population:  6,200,000 -- 72@-. urban, 97% white
                  B.-licali@ Resources
                     I    6 medical schools
                                                                 with 40,000 beds
                     2.   165 short-term, noii-Fed- al hospitals
                                                   or
                     3.   13,300 practicing physicians (@ID's and DO's) 28.,500
                          registered nurses
           VII    ILLUSTRATIONS OF ACTIVITY
                  Ten participating hospitals have  joined in a '3 phase program of
                  improving patient care through a  deliberately planned  process of
                  pinpointing patient care deficiencies, determining the causes, and
                  then developing training processes.wliich will overcome those
                  deficiencies in the future.  This is'a group approach to self-'
                  evaluation by physicians.  Current ),ear funding is supporting
                  development and adoption of care criteria for at least throe
                  conditions.  As that progresses other conditions wil'l be assiini-
                  lated into,the process.






                      IOII.A R,\IP: Nleal. t.'Smitli (D); Altoona (Fifth District)


              1.  BACKGROU,\TD
                                                University    of Ioiqa,   College
                  A.   Grantee or sponsor:                                       of Medicine
                                       -Ir.  Cliarles  Calch@ell (Acting)
                  B.   Coordinator:
                  C.   Regional boun @ies:  coterminous        with state
                  D.   History:
                       1.  Initial   planning groAt:. Dece@er'1966
                       2.  Operational status achieved:  July 1968

             II.  FUNDING
                  A    Support through FY71:         $2    876,860
                  B.   FY72 mvard                          889,998
                  C.   Total support to date:          T3,-766,858

           III.     ORGANIZATIO-N
                  A.   Regional Advisory Group
                       I..  Chairman:  Georue Hegstrom, M.D.; practicing physician,
                            McFarland Clinic, Ames
                       2.   Composition:   (40 members)
                            a.  Practicing physicians                          8
                            b.  Medical center officials                       2
                            c.  Hospital administrators
                            d.  Other health i@orkers                          6
                            e.  Public health officials                        3
                            f.  Members of the public                          10
                            g.  Voluntary health agency
                                     res ntatives                              1
                                   rep   e
                            h.  Others                                         4
                                                             TOTAL             40
                  B.  Core staff:     17 full-time equivalents

             IV.  PROG@L P.AIORITIES
                  -A.  Assist in the development and testing        of  new  and   voluntary   ways
                       to deliver comprehensive quality care.
                  B.   Foster improved manpower utilization and distribution.
                  C.   Foster cooperative relationships, appropriate training and adequate
                       data collection.

              V.  OPERATIOI@ ACTIVITIES:  The-I@IP currently           has 7 ongoing activities
                  funded at a level of $352,76Q.  Last year a          large majority of that
                  sum was devoted to continuing education and          training.    Planning    for
                  FY72  hoivever.,  alters  that  picture  and  indicates  a  spending   level   of
                  about $210,000 for purposes.  The current application requests funds
                  for  planning  of  a  renal  care  program,   an   emergency   medical   services
                  program,  and   a   neonatal   care   program.








                                               2


          YI.    SELECTED IZE-C-IO.NAL CTIARACTERISTICS
                A.  Population:  2,825,000    57% Urban,  09% white
                B.  IJealth resources
                    1.  Universi@, of Iowa College of Medicine
                    2.  Colleae of Osteopathic Medicine and Surgery
                    3.  133 short-term, noii-Federal hospitals with 15,333 beds;
                        62% involved with RN,@
                    4.  5,900 practicing physicians
                        17,000 active registered nurses
                                        Z>

         VII.  ILLUSTRATIO'i\'S OF ACFIVITY
                In the Mason City area, emergency ambulance services  are  being  of f-eyed
                to -rural residents with acute Myocardial Inf-a-rction. Upon bein@,,.o ,i.l
                alerted, the emergency vehicle will pick up trained personnel,
                administer care enroute to the hospital where intensive care is
                available. An ancillary purpose is to reduce tlie.i-ioed for a  full
                -range of emergency cardiac care services in isolated rural hospitals.
                Less emphasis is being given to  operational  component  activities.
                Skills of core staff are bein(y increased with a view toward assisting
                in development of Health Maintenance Organizations, increasing cuality
                of care, cost reduction etc.  In brief, project activities a-re cTivinc,
                wa)r to planning and evaluation in regard to total program priorities
                and to related national priorities.







                      ILLII\'OIS:  Robert Michel (R), Peoria (District 18)


          NOTE:   Representative @lichel's district falls into both the Illinois and
                  the Bi-State RNIP'S.

            1. BACK6ROLJ,\'D
               A.  Grantee or sponsor:  Illinois Reaional Medical Proarim, Inc.
               B.  Coordinator:  Morton C. Creditor, @I.D.
               C.  Boundaries:  in general, cote-aiinous with state; some overlap with
                   Bi-State RN,]P in southern Illinois.
               D.  History
                   1.  Initial plannina grant:  July 1967
                   2.  Operational status:  February 1970

           II. FUINDINIG
                             -rough FY71:
               A.  Support th               $4,942,754
               B. =FY72 award:  -            2,000,000
               C.  -Total support to date:  $6)942,7@

         III.  ORGALNIZ-ATIO-N
               A.  Regional Advisory Group
                   1.  Chairman: Dexter Nelson, M.D.,  practicing  physician,
                   -   Princeton, Illinois
                   .2. Composition (55 m@mbers)
                       a.  Practicina  physicians                   9
                       b.  Medical center officials                12
                       c.. hospital administrators                 12
                       d.  Voluntary health agency
                            representatives                         3
                       e.  Other-health workers                     4
                       f.  Public health officials                  3
                       g.- members of the  public                  12
                                                     TOTAL         55
                   Core staff -- 22.5 full-time equivalents

          IV.  OPr-,RATIO.@ ACTIVITIES: The region is currently supporting  9
               operational activities in the amount of approximately 758  000 direct
               costs. Monies  are  fa'irly evenly divided among heart,  cancer, and
               stroke activities.  Interestinaly, no activities have continuing
               education and training as a major emphasis, while patient care
               demonstrations and coordination of healt]-i services account for almost
               3/4 of available funds.  Over 50% of the funds support activities
               sponsored by voluntary health agencies.

           V.  SELECFED REGIONAL  CHARACTERISTICS
               A.  Population:  ll'I million    83% urban, 87%  white
               B.  Health resources
                   1.  5 medical schools; I college of osteopa
                   2.  256 short-term, non-Federal hospitals with 51,267 beds; 6%
                       (161 of these are involved in T'@,!P f)'Iai-u-iii-ig and activities.
                       13,100 physicians @ID's and '])Ols)
                       35,500 active registered liui,ses.








                                                2


          VI.   ILLUSTRATION-S OF ACTIVITY
                fielpina to solve the manpower problem is a key prourain  of  the  Bi-
                Statd Re@ion.' In this connection, the Bi-State  @IP  (i@lissouri  and
                 11 nois) obtained a waiver from the \Iissouri Council on Higher
                Education so as to make it possible for non-hic,]-i scJiool  gradu@tes
                to enter junior colleaes for  training  as  aide-level  health  workers.
                                      C,
                This is a part of Bi-State's larger  effort  of  getting  all  neighbor-
                hood health personnel in the IZegion to  work  together  in  assessing
                their manpower needs and taking steps to meet them.
                In terms of direct patient care,  the  Bi-State  @IP  has  established
                an intensive care facility at St. Louis  City  Hospital  to  serve  an
                estimated 400 medically indigent stroke  victims  from  the  inner  city
                each year. There has  also  been  established,  as  an  integral  partof
                the project, a much-needed trainina unit for the purpose of     instructing
                approximately 100 nurses from the  Bi-State  Region  in  the  critical
                early management of acute stroke.  In'addition, this project has
                          C>
                created cooperative arrangements amona existina lona-term care centers
                                          C,           C,        Z>   Z>
                for stroke and set up a  practical  teachina  program  for  therapists
                                                           0
                concerned i.;ith rehabilitation and., when necessary, custodial care of
                stroke victim throughout the Bi-State area.
                The Illinois RNIP is supporting a demonstration project in Chicaao in
                                                                                   C>
                a lo-w income community area to-test the usefulness of an automated
                medical history system in a Community Health Clinic.  If the system is
                successful it will be incorporated into the re  lar funding schedule
                                                                 gu
                for the Valley Clinic.






                   KANS.,kS:  Garner E. Shrii,er (R), l@7ichita (First District)


            I.   B.,kCKGI-,',OIAID
                 A.  Grantee or Sponsor:  Uiiversity of Kansas @ledical Center-
                                                   il '%I. D.
                 B.  Coordinator:  Robert Broi,,,ii  i
                 C.  Boundaries:   coterminous   with   state
                 D . History
                     1.  Initial planning arant:  July 1966
                     2.  Operational status:  June 1967

          II.    FUNIDING
                 A.  Support through FY71,:        $51961,663
                 B.  FY72 miard:                   1,603,419
                 C. Total support to date:         7,  65,082

          III.  ORGAI\IIZATIOIN
                 A.-  Reuional Advisory Group
                     1.   Chairman:  Robert  Polson,   @I.D., practicing physician,   Great
                          Bend,   Kansas
                     2.   Composition (19 meffbers)
                          a.   Practicing   physicians                      7
                          b.' Medical tenter officials                      3
                          c.  Hospital administrators                       3
                          d.  Voluntary health agency
                                represen a ives                             1
                              Other health workers                          1
                          f.  Public health official                        1
                          g.' @ffbe-rs of  the  Public                      3
                                                          TOTAL            -19
                 B.  Core staff:  60.0 full-time equivalents

           IV.   OPERATIO,@AL ACFIVITIES:  Kansas R%,]P currently has 9    funded operational
                 activities.  The level of support for these in direct costs is about
                 $520,000 -- 85% of which supports activities in continuing education
                 and manp@@er utilization and over 10% in the coordination of health
                 services.  Most of the program do not support specific disease-Toldt-ed
                 activities but progr@ of a more general -nature, such as a medical
                 library-system, various training program (includina one designed to
                 recruit health professionals from a Model Cities neighborhood).

            V.   SELEC7ED  REGIOI\'AL   (RAMCTERISTICS
                 A.  Population:  2,250,000        66% urban, 95% white
                 B.   Health   resources
                     1.   1 medical school
                     2.   146 8hort-tem, non-Federal hospitals with 11,80S total beds;
                          14% (21) are involved with R\T planning and activities.,
                     .3.  2  333  active physicians (@ff)ls and DO's)
                          6.,895  active registered nurses (10,532   total)





                                             2



             ILLUSTRATIO,\'S OF ACRIVITY

             A unique attempt to alleviate the gliortage of health manpower is being
             carried out by the Kansas Regional ',Iedical Program. '@lany registered
                                                                          -\IP
             nurses for one reason or another were not ijorkina and the KR
             established a program to promote the re-entry of registered nurses
             into the ]Zegioii's health care system.  For the past tivo years, the
             Kansas proaram has offered six three-week training courses.
             hundred and thirty-three nurses have been trained and are employed
             in the 17 hospitals in Kansas City.  Over 100 of the 133 nurses are
             employed on a full-time basis-and 33 of this number hold supervisory
             positions.

             'nie Kansas Prouram is also supporting a project desianed to provide and
             promote employment in the health fields and entry into the healtji
             pro essiorls for model neighborhood residents.  The methodology @lo),ed
             in this project will center around the development of the health aide
             as a category of health personnel.  The general purpose of this@project
             is to raise the level of knowledge and understanding among indigent
             residents about good health practices @d to provide a means of entry
             of these citizens into health care professions.





                               KFI\TRUCKY (01-110 VULEY R\IP)        l@lilli,-an   Natclior (D)
                                        .b@o-@@ling @ecii (Second   District)


              I.     BACKGPOU,\TD
                    A.   Qrantee or Sponsor:  University ofkentucky              ResearcJi   Foundation,
                         Lexington
                    B.   Coordinator:     IVi lliam @IcBeath    M.D.   , M.P.H.
                    C.   Boundaries:      Reaion    encoir.passes the State of Kentticiw, and      parts'
                         of southern    Indiana    and    soatliivesteni Ohio
                    D.   History
                         1.   Initial   planning     grant:      January 1967
                         2.    Operational    status     achieved:     January 1969

               II.  RJNDING
                    A.   Support through     n@71        $3,594 092
                    B.   FY72 support (projected)   1,505,902
                    C.   Total support to date           $5,099,994
                               (projected)-

              III.  ORGANIZATIOIN
                    -A.     Regional Advisory Group
                         1.   Chairman:   Donald I. Loi@,ry, B.S., Technical Staff Director,
                              Proctor and Gamble, Cincinnati, Ohio
                         2.   Composition (41 members)
                              -a.  Practi'cina physicians                              9
                              b.   Medical center officials                            7
                              c.   Hospital administrators                             5
                              d.   Otlier health i@orkers                              3
                              e.   Public health officials                             2
                              f.-  @lembe-rs of the public
                              g.   Volmt@ry health acency
                                                          C,
                                    representatives                                    2
                              h.   Others                                              2
                                                                     TOTAL            41'
                    B.   Cote Staff:   18.12 full-time equivalents

               IV.  PRO@L PRIORITIES
                    A.   Development of health manpower
                    B.   Improved delivery of ambulatory            care
                                          -ITIF,S:  OVP-,@IP currently has    seven   funded activities
                V.  OPERATION,'L    ACTI@,7
                    in the amount of $76S,000.  Slialitly less than half that sum ($3Sl,OOO)
                    supports patient care demonstration activities.  A                somei%,hat smaller
                    amount ($330,000) is devoted to continuing education and training
                    type      activities.
                    Two components dealing with multiphasic screening-a'nd home health care
                    are oriented toivard control in the indigent population.







                                               2


         VI.  SETECFED REGIO.@U CL-L@CFERISTICS
              A.   Population:  5,300,000      52%,urban, 90% white
              B.   Health Resources
                   1.  3 medical schools
                   2.  157 short-term, non-Federal hospitals with 22,679 bods;
                       12% of these are involved with RNIP activities
                   3.  5i9OO physicians (,@ID's and DO's)
                       17,188 registered nurses.

        VII.  ILLUSTRATIOIN,,S OF ACFIVITY

              Witliiii the past year, the major thrust of the program has been
              delineated as "manpower development."  To that end, a project has
              been proposed for initiation in 1972 which will train a new type
              health professional, the clinical associate.  He will function under
              the general auspices of a physician and will perform specific
              activities designed to free the physician from routine duties, so he
              can concentrate oii more critical needs.  The training inclu es a
              preceptorship so the trainee can move into various semnents of the
              medical care spectrum in accord with his abilities and desires.






                                             till, Jr.
               MISSOTJRI (,\Io.R',IP):  IV. R. 11        D) , IVeston, Missouri (District  6)


            1.   BA@KGROUIND
                 A.  Grantee  or  Sponsor:   CuratQrs   of the University (if Missouti,
                     Columbia
                 B.  Coordinator:  Arthur   Pi.lli,   M.D.
                 C.  Boundaries:  cotendnous ivith-state but excluding      @e,St.     Louis
                     area
                 D.  History
                     1.  Initial planning grant:  July 1966
                     2.  Operational status achieved: Al)ril     1967

           II.  FUJ\TDING
                 A.  Support throuah FY71:        $20,916,311
                     FY72 award (projected)'        2.282,096
                 B.
                                Total             $23;198,407

          III.  ORGANIZATIO'I\T
                 A.  Regional Advisory Group
                     1.  Chairman:  Robert E. Fr@', Hospital Administrator
                     2.  Composition (12 members)
                         a.   Practicing physicians                     6
                         b.   Hospital 'administrators                  1
                         c    Members of the public                     4
                         d.   Others                                    1
                                                      TOTAL           12-
                 B.  Core staff:  48457 full-time equivalents

                                        Act
           IV.  PROGRJOI PRIORITIES:       ivities which relate to    the prouram's mission,
                 i.e., to serve  as  a  "catalyst  for  ch
                                                         anaes which will provide the best
                 health  for  residents  of  the  region."

            V.   OPERATIONAL ACRIVITIES
                 'The region  currently  has  underway  24 operational activities  with    a
                 fundina level  of  $l'i231,641.  i\learly half the funds support   activities
                 related to continuing education and/or patient services.  Strong
                 emphasis is placed on coordination-botiveen health care service
                 providers.  Last  year  40%  of  funds  were  expended  for  activities  of
                 that nature.  Under R%,IP leadership, for example, 12 hospitals in the
                 Green Hills area of imissouri'have banded together to discuss and act
                 on mutual problems, including administrative practices, personnel
                 needs and practices, etc.
           VI.   SELECTED RE-GIO,\TAJ, CHARACFERISTICS
                 A.  Population:  4,677,400  --  45%  urban,   63%   white
                 B.  Health resources:
                     1.  2 medical schools; 2 schoolsof        osteopathy
                      2.  121  short-term  non-Federal  hospitals  with  21,480  beds;   67%
                          of these are involved with RNIP.








                                                2


                  .3.   5,900 physicians (@ID's and DO's)
                       11,20o active registered nuzses

        VII.   'ILLUSTRATIO;'\TS OF ACTIVITY

               Sikeston Intensive Care      A seven bed Intensive Care lJnit has been
               established and become operational since initial ftu)dii-i- in mid-1970.
               Through June 1971, 218 patients had been admitted, half of i%,Iioiii i,:ere
               categorized as cardiacs.  During that period tijelve pacemakers ijere
               installed and 36 def-ribrillations perfoiTied.  The unit is currently
               operating at 75% capacity.  Hiah praise for the procram and its
               training coiTonent has been received from participatiiia    institutions.






                         NBV JERSEY:  Ediqard J.     Patt                            strict  l@5)


               1.  BACKGPOU,\'D
                   A.@. Grantee or Sponsor:  I\Tcii Jerse@ Joint Comittee for        @iplenientation
                   B.   Coordinator:  Alvin   A.   Florin,   M.D.                    of P.L. 89-239.
                  'C.   Boundaries:.   cote@nous    with    state
                   D.   History
                        1.  Initial plannina grant:  July 1967
                        2.   Operational   status:   April   1969

              II.  FUNIDII\'G
                   A.   S   out through FY71:          $4,684,186
                        UPI)
                   B.   FY72 x%lard (projected):       I.,400,000
                   C.   Total support to date:         $6,o84,186

           11      OR@'RIZATION
                   A.   Regional Advisory Group
                        1.  Chairman:  Richard J. Cross, M.D., Professor of Medicine,
                            Rutgers Medical School
                        2.  Coniposition (27 members)
                            a.   practicing physicians                            6
                            b.   medical center officials                         3
                            c.   hospital administrators                          5
                            d.   voluntary health aaency     representatives      2
                                                      C,
                            e.   public health officials                          3
                            f.   other health workers                             2
                            g.   members of the public                            6
                                                              TOTAL               27
                   B.. Core staff:  20.5 Full-time equivalents
              IV.  OPFRATIO.VT@ ACTIVITIES:  The -re,,lon currently has tiNTelve ongoing
                   -operational activities with direct cost funding of $814,000.            Ap-
                   proximately one half of the projects-are directed towards categorical
                   diseases (heart, cancer and stroke) and the other half are multi-
                   categorical disease progr@ .   In tei@ of p-rimar),, focus, the Neii
                   Jersey Program is directed rather evenly in three areas -- coiitinuin-
                   education, patient care delivery and coordination of health services.
                   Close to half of the NJR-W s operational monies support inner city
                   programs for blacks and spanish surname populations.
               V.  SELECFED PEGIO@,KL CHARACTERI@TICS
                   A.  Population:  7.2 million          89% urban, 89% white
                   B.  Health resources
                        1.  2 medical schools
                        2.  107 short-term,- non-Federal hospitals with 25,247 beds;
                            58% (62) of these hospitals are,involved in @ffl plannin
                                                                                             .9
                            and activities.
                        3.  9,176 physicians (@ff)ls and DO's)
                                     active nurses (42,400 total)








                                                2


          VI.   ILLUSTP,-kTIO.\!S OF ACRIVII'Y
                With more than 8S% of New Jersey cancer  patients being treated in
                conmunity or general hospitals of  500 beds or less, it  is the  aim  of
              .the New Jersey RNIP - Tumor
                                            Conference Boar& to bring the most up-to-
                date medical information to'the  practicing  physician  responsible  for
                cancer patient care. lliu's, four aoreements,of  affiliation  have  been
                executed with eigliteen'liospitals and negotiations are currently under-
                way  w.ith six additional hospitals..' More than 10,000  patients  @ave
                been brought under team review of the status of their disease,
                treatment niodes, and rehabilitation plan.  By March 1972, it is
                anticipated that 43 hospitals will be totalin(Y an  estimated  15,000
                annual admissions for cancer.
                An ob ective of the project is to establish joint tumor conf-ereiar-e
                boards for tqb or more hospitals.  In Middlesex County, a demonstration
                of a joint conference board is planned for St. Peter's General Hospital
                (ongoi ) and @,Liddlesex Hospital. The  encouraging  factor  in  support
                      nccll
                of a oint program for these two institutions  is  the  recent  procram
                amalgamation of radiation therapy services in St. Peter's Hospital to
                serve both hospitals.
                New Jersey RN-IP has-provided staff and technical assistance to
                six Federally-designated iNbdel Cities Programs  through  the  assign-
                ment of full-time Urban Health Coordinators.  In  each  city  the  Urban
                Health Coordinator helps plan and organize facilities and  manpoi,;er
                resources to increase the effectiveness of local health care delivery
                                  ject, now in its second year  of  operation,  serves
                s,ystems.  This pro
                      lation of 200,000 disadvantaged residents and  has  secured  or
                a popu                             C,
                Eipplied for more than five million dollars from sources  outside  the
                RNP for funding health proor@ in these cities.  Plans call for
                expanding the project to include 367,000 residents of the  14'neii;ly
                approved State Community Development cities.
                A project has been developed to organize providers of service and
                health care facilities into a comprehensive  care  program  especially
                directed at serving the disadvantaged and others without regular
                                                   Z>
                sources of medical care. The project,  at  Middlesex  General  Hospita
                is designed to serve a patient population of 4,000 persons with a
                program of preventive medicine and treatment  utilizing  a  full-time
                family health care team. The  project  includes  multiple  funding  from
                Medicaid, Medicare, hospital resources, and the l@IP.






                          TEXAS:  Robert R. Casey (D), I-lous    ton, (District 22)

                     1
              I.  BACKGROU.\D
                                              -University of Texas System
                  A.   Grantee   or   Sponsor:
                  B.   Coordinator:  Charles McCall, II.D.
                  C.   Boundaries:. coterminous i,.,ith state
                  D.   History
                       1.  Initial planning grant:  Januarv 1966
                       2.  (4)erational status:  July 1968

             II.  FL iND I I\'G
                  A.  support through FY71             $ 8,190,302
                  B.  FY72 aivard:                       1,650,386
                  C. -Total support to date:           $ 9 840,688

            Ill.  ORGAIN I 7-,kT I OiN
                  A.  Regional AdiTisory Group
                       -1.  Chairman:  N. C. Hightoiier, M.D., Scott and IVIiite Hospital
                            and Clinic, Temple
                       2.   Composition (50 members)
                            a.  practicing      physicians                       12
                            b.  medical center officials                         13
                            c.  hospital administrators                           9
                            d.  voluntary health agency
                                 representatives                                  3
                            -e. other health ivorkers                             2
                            f.  public health officials                           3
                            g.  members  of   the   public                        8
                                                            ,TOTAL               so
                  B.  Core staff:  24.0 Full-time equivalents
             IV.  OPERATIO,@IU ACTIVITIES:  The reaion is currently conducting 19
                  operational activities ivith $945,000 in direct costs.  Approximately
                  60% of the TR,\ffl activities are in tJie area of general continuiiia
                  education  and  30%  of   th'eir monies are directed toivards patient care
                  delivery problems.  Categorically speaking, (36%) of their projects
                  are.for-strbke-related diseases and (26%) are in the area of cancer.
                  Texas is supporting tivo projects directed tm@,ards blacks and chicanos
                  (one of iiliich is coordinated with.rlodel Cities).

              V.  SELE-MED    REGIOI%'AL    CL-@CTERISTICS
                  A.   Population:  11.2 million         80% urban, 87%     ivhite
                  B.   Health resources
                       1.   4 medical schools
                       2.   492 short-tem, nm-Federal hospitals Avith 46,149 total beds;
                            14% (67) of these are involved in the RNIP
                       3.   11,700 physicians (@U)ls and DO's)
                            20,000   active   registered   nurses.@(30,000   total)








                                               2

         VI.   ITIUSTRkTio:\Ts OF ACFIVITY
               One of the more significant projects in  the Texas region has been the
               implementation of a proaram aj-jpod at the prevention of morbidity and
               mortality from cervical cancer.  Application of exf-oliative cytology
               screening                                             ider the aegis
                         is tal,-inc, place at 109 satellite clinics w
               of the Sout]-ii,;esten-1 i%ledical School at San Antonio.  Approximately
               3,700 smears are being performed each month ivith 40,000 ivoinen tested
               each year.  Preliminary findings indicate that the program is findinc,
               more and earlier lesions with more favorable outlook than expected..






                 -STATE  R.\IP:  Silvio Conte (R) Pittsfield       Massachusetts (Distric    t 1)
             ]\IOTE-:.@Representative Conte's district Includes territory served by both
                                    he  Albaiiy@  Regional   Medical   Programs.
            ,'tlic  Tri-State  and  t

              I.   BACKGROUI\'D
                   A.  Grantee or   Sponsor:  Medical Care and Education Foundation) Inc.,
                       Boston
                   B.  Coordinator:  Leona Baumgartner, M.D.
                   C.  Boundaries:  States of Massachusetts, New Hampshire, and Rhode'
                       Island (some western counties of Massachusetts are also served
                       by the Albany R\IP).
                   D.  History
                       1.  Initial planning grant:  December 1967
                       2.  Operational status achieved:  February           1969

             II.   FLMING
                   A.  Support through FY71:      $5,459,941,
                   B.  FY72   asvard-               2,461,425
                   C.  Total support to date        7,921,366

            III.   ORGANIZATIO.'Q

                   A.  Regional Advisory Group
                            Chairman: Louis A. Leone, @I.D., Director, Department of
                            Oncolo(,,y.,  Miode  Island   Hospital,   Providence
                       2.   Composition (62 me@ers)
                            a.   Practicing physicians                       27'
                                                                               3
                            b.   Medical center officials
                            c.   Hospital administrators                       4
                            d:   Voluntary health acency
                                  representatives
                            e.   Public health officials                       4
                            f.   Other health worl,-ers                        5
                            g '  Members of the public                        10
                            h.   Others                                        4
                                                          TOTAL               62
                   B.  Core Staff:  43.0 Full time equivalents

             IV.   OPERATIOi'iAL ACTIVITIES
                   'Tri-State R@iP currently has 6 ongoina operational components with a
                   fundina level of $613,500.  About 60'- of that sum supports activities
                          0
                   in the area of intensive coronary care.  Better manpower utilization
                   is the major focus of  rogr@ AIiicli are supported by approximately
                                             p
                   half of the available funds, the remainder supporting various types
                   of patient care demonstrations.  Approximately 59% of funds ($365,000)
                   go to activities directed against health problems of the black POPU-
                   -lation in the three state area.








                                                 2


            V.  SI:LECM REGIONU CIIU,@CRMSTICS
                A.  Population:  7,374,000      82% urban, 97% i@hite
                B.  Health resources
                    1.   5 medical schools; 1 ti@o-year medical sciences  school
                    2.   188 short-term, non'Fede'Tal hospitals i@ith 33, 075 beds
                         20% of these are participating in l@ND3 planning bodies and
                         operational activities
                    3.   11,200 active physicians; 35,800 active nurses

           VI.  ILIUSTRATIOI\TS OF ACTIVITY
                The major thrust  of the Tri-State R\IP  is  undergoing change  in  accord
                       -ranging emphasis of the national proaram.  Greater emphas'
                witli cJ                                                           is  is
                beingplaced on actions i@Iiicl-i affect the delivery of healtJ-i care
                services, and cha'ngina the system, i@hile attacks  oii individual   disease
                problem are  being  de-empliasized.  Ex-isting  disease control   activities
                a-re being reoriented as the transition process indicates.
                The-re has also been an increased emphasis on'mqarding of contracts to
                meet specific needs of the program, i@,hile mvardina of grants for
                                                                    C,
                marginally related activities has been  de-einpliasized.  The  end  point
                 as been a greater reliance on proaram expertise in mee
                h                                                          ting the Regions'
                needs through priority programming.
                An intensive coronary care demonstration project of  the  Albany  RNIP  is.
                located at Bershire Medical  Center  in  Pittsfield,  Massachusetts..  To
                @date it has trained 190 Purses from 29 hospitals.  These hospitals
                account for 68% of g&neral-hospital  admissions  in  the  Albany  Region.
                During the past year the Tri-State Region instituted a program "to
                assure that no patient ijith end-stage kidney disease ivill die from
                'lack of necessary services." New England states other than those of
                the Tri-State Region are involved. .nic short--ranae objective is to
                develop a method of procuring donor organs and to identify problems
                of funding. 'Die long-range objective is to f-ui-nish  an  adequate  supply
                of cadaver organs to-satisf-y patients needs in various transplant
                units.






                                VIRGINIA RNRI:  J.   Kenneth   Robiii@oii  (R)
                                       Wil@             ITO]Ith District)



             ,I'. BACKGROUND
                 A.  @Grantee  or Sponsor:  Virginia Regional      Medical Prograin, Inc.
                 B.   Coordinator:  Euaene   R.   Perez,   @I.D.
                 C.   Boundaries:    coteminous.ivitli     state
                 D.  -History
                      1.  Initial plannina                    ary 1967
                                               grant:  Jai-iu
                      Z.  Operational status achieved:  January 1970

            II.  FLMING
                 A.   Support   through    FY71:      $2,445,7SS
                 B.   FY72 support:                      789,488
                 C.   Total support to date:          $3,235,243

          III.  ORG/\NIZATIO',\'
                 A.   Regional Advisory Group
                      1.   Chairman:  Mack  I.   Shwffioltz,   M.D., Commissioner of State
                           Health     Department
                      2.   Composition (36 members)
                           a.  Practicing      physicians                    11
                           b.  Medical center officials                       2
                           c.  Hospital administrators                        7
                               Voluntary health auency                        4
                           e.  Public health officials                        2
                           f.  Other health workers                           3
                           g.  @lembers  of  the   public                     7
                                                        TOTAL                36
                 B.   Core   staff:   20.3   full-time   equivalents
            IV.  0:PBRATIONAL ACTIVITIES:      MIP   currently   has 7 funded operational
                 activities.  The  level   of   support   for.tliese in direct costs. is about
                 $372,000, 85% of which supports activities in continuing education
                 for health professionals.  Approximately 40% of the funds are.beiii(y
                 expended in the area of heart disease, over 10% for @troke-related
                 activities and about S% in the area of cancer.

            V@-  SELECTED    REGIONAL     CHARACTERISTICS
                 A.   Population:  4,648,000 ---63% urban, 81% white
                 B.   Health resources
                      1.   2   medical   schools
                      2.   102 short-term  iion-Federal hospitals      with  16,,385 be(L; 15%
                           of these are involved in JINIP activities
                      3.   4,631  physicians  (,NID's  and  DO's)
                           11,500   active   registered   nurses

            VI.  ILLUSTRATIO,'\'S  OF   ACRIVITY
                 The VRNIP is  supporting a program     to   (1) educate    and train nurses and
                 physicians  in  the   treatment   of   patients with myocardial'infarction






                                             2


              (2)'.provide consultative assistance. to coronary care units.  Over
                                                  C,          -ils, have been trained
              50 healtli professionals, representiiiu 19 hospit,
              to date, and the project director has provided consultation to six
                        hospitals either planning or operatiiia CCU'S.
              'hie @ledical Colieoe of Virginia, under the sponsorship of the MIP,
              hasundertaken a project to demonstrate that the case of stroke
              patients in rural communities can be improved by up-grading the
              knowledge and skills of physicians mid other health perso  el throuch
              a relationship with a medical center.  I'he incidence and management
              of stroke is beina studied in five small rural communities (6)-
              general practitioners, (105) nurses and nursing.assistaiats and a
              number of family members are participating in educational programs
              related to care and rehabilitation of stroke patients.






   0













   0













    0










                                           Regional    Medical    Programs




          J.  Budget Summary




                                                        1971                   1972                   1973
                                                      Estimate               Estimate              Estimate
              Activity or Subactivity             Pos.      Amount       Pos.       Amount      Pos.       Amount

              Regional Medical Programs
                 Grants and contracts    ....     56 1/     74,735        56  1/   139,300       56       125,10C
                 Direct operations   .......      178          4,025     169         4,602      194         5,051

              Program    direction    and
                 management      services .....   67           1,394        68       1,117       68         1,13C

                                                  245       80,154       237       145,019      262       131,287


        II.     1973     Prograr     S@a=

                                        FY'72               ADD OR SUBTRACT                FY'73-

                56 RMP's                  98.-'                    0                          98.3

                CONTRACTS                 4.3                      0                          4.3

                CANCER CONSTRIJCTTON      5.0'                    -5.0                        0


                HMOS                       16.2                  -16.2                        0


                EMERGENCY MEDICAL -  -
                  SERVICE                 8.0                     +7.0                        15.0

                AHEC                      7.5                      0                          7.5




                                        139.3*                   -14.2                     125.1 Grants &
                                                                                                        Contractc


                                                                                              5.1 Direct Ops.


                                                                                                  Direction &
                                                                                                  Management
                *Smoking   and   Health   Contracts                                          131.3
                taken  out,   print   shows   140,656


                @l   Represents regions.





                                        Regional Medical Programs



            Budget Summary

                                                        (Dollars in thousands)
                                              1971               1972                1973
                                            Estimate           Estimate            Estimate
            Activity or Subactivity       Po S.  Amount     Pos.     Amount     Pos.      Amount

            Regional Medical Programs:
              Grants and contracts  ....   56 I/  74,735      56 1/  139,300     56  1/   125,100
              Direct operations  .......  178       4,025   169        4,602    194         5,051

            1973 Program Summary

                  Funds will be needed  for  programs  to  enable  existing  health  manpower  to
            provide more and  better  care  and  training  and  more  effective  utilization  of
            new kinds of health manpower.  New funds will be used to plan and develop
            Area Health Education Cent@rs, which will be major sources of manpower for
            Health Maintenance Organizations, Experimental Health Service Delivery
            Systems and other comprehensive health care systems.

                  Activities qimed at improvii   - the  accessibility,  efficiency,  and   quality
            of health care  will  provide  opportunities  to  increase  the  rate  of  implementa-
            tion  of  systems,  innovations  and  new  technology.  Rural  health  care  systems
            will be  developed  that  are  comparable  with  needs  of  rural  areas.  Development
            o  emergency healLn dare systems will bring together better transportation
            -  rvices,  communication  which  would  tie  hospitals,  transportation   facilities
            and  other  emergency  organizations  into  rapid  response  systems,  and  emergency
            medicAl centers with specially train(' doctors and nurses.  The provider-
            initiatea activities leadilLg to a gr@ater sharing of health facilities, manpower,,
            and other resources  will  provide  the  opportunity  to  show  how  scarce  resources
            can be linked together efficiently.

                  -Further Regional Medical Prugrams wil=l be strengthened so it will be
            possible for all to accomplish their objectives and goals.
                  Regional Medical Programs  particularly the weaker ones, will be provided
            the strong  leadership  required  by  the  expansion  and  redirection  of  Regional
                                          'L
            .4edical  Program   activities.
                  The  rapid  expansion  of Regional Medical Program activity and the movement
            into new areas of emphasis will require additional development of policy
            guidance and criteria for project development.

                  Increased technical assistance will.  be  needed  for  new  projects  in  areas
            involving  new  techniques  and  innovative  delivery  patterns,  mote  effective  use
            of new kiildg of health manpower, and th2 quality of care guidelines.


            1/  Represents regions.










                                       Regional Medical Programs


         J.   Budget Summary


                                                         (Dollars in thousands)
                                              1971                1972                1973
                                            Estimate            Estimate           Estimate
              Activity or Subactivity    Pos.     Am ount    Pos.    Amount     Pos.     Amount

              Program direction and
               management services ....  67        1,394     68       1,117      68      1,136


        IIi   1973 Program Summary

                   This activity provides for a central staff@needed in planning, directing,
              and evaluating the broad scope f program activities in the RMPS; maintains
              effective COUUILLinications and information links with the 56 local regional
              medical programs and the general public, and provides Administrative
              management qervices.






   0













   0













   0





                          DEPlir,,T',%i'!,,",@T OF   EDUCATIO',, AIND


                        I]EALTII Sl,-Il@%?ICES Al\'D I,IE!iTi'd, IIEALTIL AD'@',Ili\'T.STIU@TIO'i


                                     Regional 1.1cdic,-Il Progranis


                                /uDouiits Available for 01)1.j.    j-on




                                                                 J-972               1973

   Appropriation        .......................               $102,771,000      $131,287,000

   Real transfer to:


    "Operating expenses, Public
        Buildings Service," General
        Services Administration       .........                      1,000


   Comparative transfers to:

    "Departmental iianageinent," OS      ......                     27,000
    "Prevc@ntive health ser-,,.,ces   .........               2,189,,  O@O

   Sul)total, budget authority       ..........                100,554,000       131,287,000

   u           I  balance,  start   of   year..                 44,500,000

   u      gated balance, larsing       ........                    -35,000
     Total, obligations       .................               $145,019,000      $131,287,000













                                                                 ol-)].i-@ations  bv  Activity
                                                               1972                               1 9 7  3                       Inctease  or
                                                                                                                                         crc,@isc,
      Page                                                 Es t i-pll t e                     Esti.mite                              he
       Ref.                                           Pos.          Ai,,Iouiit            Pos.           A,@Tioulit            Pos.           Aipo all t


                Regional medical
                   programs:
                (a)    Grants  and
                            contracts...               ---               $139,,ob,ooo     ---                 $125,100,000     ---                 -@14,200,000
                                                                                                                                          y
                (b)     Direct                                                                                                                   @V, @ zn-C
                            operations..                 169        4        602,,OOO     .194           5             GOO     +25   +                   0 0  0


                Program  direction
                   and  m@,n,--eitient
                   services       .........              '68                1,117,000         68         I'@          '000                               @,-ooo

                Total  obligations..                     237             $145,019,000     262                 $131,287,000     +25                 -$13,732,000





                                                             I)%,   Object


                                                    1972                   1.973             Increase     or
                                                 I'stimate               E f-, t -i. 1-.li a t e. I)ecrease

   TotTl number of per@-qzineiit
     positions         ..................           237                    262             +       25

   Full-time (,(Ii.ii.v@ilent of all
     other p,o,@l'-L-i-oi)s    ............          51                      51

   Average   niiiibc2r of all
     oil loyec!s       ..................           260                    277             4-      17
        p




   Personnel coTql)ensation'.

     Permanent positions         ........          $3,465,000             .$3,788,000      +        $323,000

     Positions other than
                              ...........           309,000                B09,000
        permanent   .....

     Other personnel compeii-
        sation        ...................            57,000                  57-,OOO


          Subtotal., personnel
             compensation       .........           3,831,000            4,154,000         +         323,000

   p      nol benefits        ...........           378,000                412,000         +       34,000
    ee

   Travel and transportation of
     persons        .....................           289,000                314,000         +       25,000

   Transportation of things         .....            35,000                  35,000

   Rent, coiTh-ouni.cati.bns and
     utilities          .................           367-5000               368,000         +       .1,000

   "ri,nting   and   reproduction    ....            87,000                  87,000

   )ther servi   ,ces      ...............          634,000                716,000         +       82,000


                  -,itracts .........  .
     Project co.                                    4,300,000            4,300,000
   supplies and materials         .......            59,000                  62   000      +           3,000

   Equipment         ....................            39,000                  39,000

   .Iraiits, subsidies and
     contributions    ...........                 135,000,000             120,800,000            3.4,200,000

            al obligations by
    ect,bject          ..................        $145,019,000          $1-3-1,287,000      -$13,732,000






   0




    loestipiated obligations       ..........................................        $145,011@9,000

    1973 estimated obligations     .........................................          131,287,000

                 lqet change ... .......................................              -13,732,000


                                                          Base                 Change   from   Base
                                                    Pos.        AT--Oullt      Pos.         AntoLint


    Iiicreaseg:


    A.' Built-i.n:
        1.   lqorking capital fund                                                       t$58,000
               charges      ....................
        2.   I-.Iithiii'@grade pay increas(,...,                                         @133,000
        3 .  I-lil-itai-y Pay Bill (P@L. 92-129)                                         +    9,000

    B.  @o   r.,- m
        1.   Up,.qard mobility    ..............                                         +   28,000
        @2.  Emergency medical services      ...                               +25       +356@.000

                     Total, increases     ......                               -i-25     +578,000




    De6reases:


    A.  Built-in:

        1.   Tiqo-da7ys less pay ...........                                                -27,000

    B.  Program:

        1.   Savings realized from cuts in positions
               in 1972 and reductiop.iip.,iyc-,rage grade                                   -83,000
        2.  Grants and
               contract*  ....................           139,300,000                  -14,200,000

                     Total, decreases   .......                                       -14,310,000


     Total, net change         .................                               +25    13   7@3Z,000







                                            Sili,@@l"l,)ry Of CIII]13'c@s


   19     Udget      authority ............................................               $1-00,554',OOO

   3.973   budget    authority ...........................          ............  .        3@31-i287,000
           Net change                ...............................................        @+30,733,OOQ


                                                           Base                    ClianRe   from   Base
                                                    Pos.          Amount           Pos.        l@l-Li o u II t


   Increases:


   A,.  Biiilt-in-.
        1.  I%Iorki-n- capital f uiid
               charges      ...............                                                 +$58,000
        2.  Within-grade pay
               increase      ..............                                                    .+133,000
        3.  Ifilitary Pay Bill (!'.L. 92-129)                                               +      9,000

   B     -o r@m
        1.  Upl..,,ard liability ........                                                   + 28,000.
        2.  Einerpency medical services.                                           +25      +350,000
        3.  Grants   and   contracts   ....                  94,800,000                      +30,300,000

                Total, increases      .....                                        +25      +3.0,878,000



   Decreases:


   A.  Built-in:
        1.   'Aio-days less pay   ........                                                        27,000

   b
        1.  Savinps realized from cuts       in positions
              in 1972 and reduction in       aver                                                      0
                Total,-decr&ases     ......                                                     '145,000
        Total,   net    change ........                                            +2   +30,.733, 0








                                    Exp']..ql)zltio,,i of Cl a@,,@s



  increases:


        Bui]-t7i.n:
                                                      ng capital fund cliar-es.
          increase of $58,000 is included for i-7orki

                                            -i(le pay. increases.
        $133,000 is included for i@7i.thiii-gr,
                                iii-itary Piy bill increase. (P.L. 92-129)
        $9,000 is included for i,

  B.

        $28,000 is included for Upward nobility.
            25 positions and $350,000 are i.ncl-u-iod for the new Emergency I-ledic,-.l
        Services Prograri. These resources will be used   to provide planning and
        evaluation, profc,-ss--nal and technic ' issistance, staidard setting, project
        review, projec.t grants and contracts niiiaFcment, data systems development,
        and program direction and management services.



         se-.


   A.  Built-in-

        $27,000 is excluded for two days less pay.

   B.   P ro r@am
        $83,000 is excluded because  of savings realized from cuts in Positions in
        1972 and reduction in average grade.
            The decrease of $14,200,000 in 1-973 ref'Lects adjustments for tN,7o non-
        recx,-riiig items in 1.972 of $21,200,000 and an increase of $7,000,000 fDr a
        n                                   s for i,.,,,,,ei-gc,,nc-y medical services. These
        ex-7 program o@ grants  and  contract
        funds-i-iill t  used to support 5 projects in addition to the 5 funded   in 1972.









                                    Exl)],qnati.oii of Traiisfc,).s



                                           1972
                                                                    Pti)-I)c)se


    Real transfer to:

       Operating expenses, Public
       Buildings Servicc@," General       -$1,000                 Transfer to GSA for
       Sc-rvd-ccs Administration                             rental of space.


    Comparative transfers to:

      t'Departr.ental management"         -27,000                 Transfer of Public Affairs
                                                             function to Office of the
                                                             Secretary.


      "PreventiNye health
        services                       -2,189,000                 Traiisfer of National
                                                             Clearinghouse for Smoking and
                                                             )Iealtli.




















   0













   0








                                       S i. 11 i- f i C,! i-I '.I' t. c@ '3 )-I           t e
    I tie                                                                Action             oi- I-.o I)c@

    ]()7). ilousc,        it




                               di.r(@(-tc@Ct that  the                          Ei@!lit Pdcliqtri-c- Pul-i-.,)oniry I)roj-,
                                               be coi-i-                 e
       Pediatric                                                          cts x-7e,-e fL'T!Ciad  at  a  $1,000,  @@O
       ti.i@ued.i.n  19i2  at  not  Ic@ss  tiiin   the                   level, in .1.97)..     It i.s  -tiiticipa.teci
       1971 level.        (pa-e 16  of  Llie  re@)c)rL)  .                      tlic@. 1.@172 ai-i@  197')  levels  @-.7ill
                                                                         be                       tlic.,.saiiie.



    -1972 Senlq! Report

    Research and Oer,,onst).-ati.o@,) -@ra,,its

       1.        COIYLmi.ttee expres,,;c@cl l@f--en                     1.      Pccc,,nt    studies    liavc@ bep.Lin    to
          interest in a I.ong-r@kiic,e. @lari          to                develc)-i)                     plans for    co@'L)at-.
                                          L:,
          develop                                    pro-                LnF, eii(I-st@i-c, l@idnc--.y dicc-,ise.        There
          gra,ii,3 ai,@@-ed at proviei-1-1,@i,,,  therapy                will- be l@,Licl,. F,)--oatc-.r  eml)liisis  on
          for  the  8,000   to   10,01JO   A7!-,,cricii-is               pl..ici-ii-I       I)ro.-'Iect in the coiitcxt
          i.7)io  fell  vi.ctir-i  to  kicli-@ev   disease               of I)c)tl,@             and nitioii---il-
              oa)-ly.     (page   25    of    the    renert).            In                     e@;raiicled I)I.anF,,
                                                                         fundF,   invested    i-ii    tlics(,    activities
                                                                         i,7j-ll   increase   from   @14,t..00,000    in
                                                                         1971   to   an   e.-;ti,,.Iated   $8,500,000    in
                                                                         1972.



                                                                                Up to $1.6,200,000                be used
       2.        CoTrnittee directed that a                            2.i
          portion   of   IZ'@'LP   increases   be   used   to            to    fund    the    plaiinin,-    and    development
          prove out           programs.       (page    25                of llil-10's in 1972.
          of the    report).


                    iimittee                                                            -o2ects      ongoin
       3.        Co            coiictir3.-cd x.?itli the                3.      All pi-                     g   in    1971
          Ilouse    and    further    directed    that    all            x-7hi-cl)   have   been   included    in    their
          pediatric pulmonary projects ongoing                           applications    by    the     11,MP's     affected
          in 1971 x.,crc-. to be. funded in 1972.                        have          approved for 1.972.           At    the
          (page 26     of the report).                                   same    t.iiiia,    final    fundi.ng    decisions
                                                                         have  been   left   to   the   iiidi-,,i.(itial
                                                                         reFions               their oi.@n systems of
                                                                         pr@.Crities.





                                                                         -t,,Ll Sci)atc@
                                    Sil',I-li,f joint ft
                                                                                       (CC)Iitld)


                                                                                              be
                                                                                   ii or


                           t  (co,it' d)
                                                                                                      specific      cr-@-
                                                  and             /4       over the I)a!,t Y(,,].
       4.       Cof,,-uiiittec@ directed                                     -And  policy   have   been   (le-vc@].OPc-'l
           the Na'tioi-ii]. Advisor@, Coiii(,,il to                    teria                                            u
                @s   tliciii-,clves   to    questions                  and issued to the ]@'@1)'s.      There         has
           ii(ldrcl
                                                                                                                        L
           surrouiidiric,  Llic   fl@il)j-]-ity   and                  been  i  1-aqrl@ecl  increase   in   efforts   o"'
                                                                       staff  to  iiiec,.t  with  IZOE   oiial   Advisory
           individuality. allowed P.,
           coul-d.iiipair their effectiveness.                         Grotip@,,. In   Jantiiryl   3.972,   a   I\Iatibnal
           p a'g'c, 2 5 o fthe report).                                Coordinators    Confel-ence    was     held.     'L t
                                                                       brought togetlic-,i- il.1- coordinators,
                                                                        G             'Lroni   every   region   and
                                                                       Council rer@,bers to discuss with
                                                                       staff issues,  policy,  etc.
                 Covr,nittee directed that                         5        A    new     survey     of     cardiovascular
           Increased funds be targeted to a                            surgery     facii.ities-iii      the      District
           'review of the availabll--'-ty of and                       of  Colu,-@il)j.a   is   currently   in   progress
           access to special surgical tOa-,-IS 3-n                     @uiider  the  auspices  of   the   \!('trOI)Ol@l-,
                                                                       ta  l@Tisliii-,c,ton        A     report      will
           open-heart    -qn.d    coronary     artery                   n  ,
           surgery,  especially in r_l@ District                       be    available    before    6/30/72.     In
           of Col.ur  i-a.    (page 25 of the report).                 addition,    regional    I.-Icdi-.cal    PrograTns
                                                                       Service,   in   order   to    carry    out    Sec.
                                                                       907  of  the   Ptibl-ic   Ilealth   Service   Act,
                                                                       L.-)ntracted  with  the  Joint   Co.-.il@i-,sio-,i
                                                                       3i-i   Accreditation   of    hospitals    to
                                                                       develop the Secretary        I--,   T,ists-.   One
                                                                       of   the   cri.teri.a   which   will    be    used
                                                                       in     identifying      eligible      institutions
                                                                       for   those   lists   will   be.    their    par--
                                                                              atioii in a regional       plan         for
                                                                       ticip
                                                                       the optimal development          and     utilj.za-
                                                                       tion     of     specialized     facilities     and
                                                                       services.




             Conference Report
       !Re.searc.11   ind   demonstration    c-,rants
              Comniittee agreed that no exist-                                Al.1 r@"PIs will, where             consis-
       ing regional- riedical program is to                             tent    with    l@ational    Advisory     Council
       i
                            r amount in l,Y 1972                        ap    loved    funding    levels,    be    funded
       !receive a lesse                                                   P'
       tiian'-it received in       1971i     (page 6                    at or above the l@'Y 1971 le.-,,el..
       of the report).




















   0













    0









                                                                                 197")
                                                                                               AI)propriat4-on
            lzition                                             Autl)orj.zed                  re (I II 0 s t c,@ (I.-

     Public Ilealtli Service Act


       Title IX        ll'('.ucat:ioii, Research,
          Trainii-ii,, and Der.-.onstrzit-i-ons  in
          the Fields of ]!cart Disease,
          Cancer,   Strolc@,   !,-LCiney   Disease,
          and other F,,elated Diseases        .....             $250,000,000                     $1.20,800,000



                                          PUBLIC IIE,@LTH S)7-RVICE ACT
     'flIie Public llc-@alth Service Act, Title IX, Education, Research, Training And
     Demonstrations in tl-,c Fields of Ileart Disease, Cancer, Stroi@e, Kidney D2sease,
     and other Pelated Diseases.


     "Sec. c@100.   The purposes of this title are--
            ii(a)   tlirou-h grants and contracts, to enco@rage and assist in the establish-
     ment   of   regional   cooperative   arrangements    among    medical    schools,    research    -'@nsti-
                                                 C,
     tutioiis, and hospitals for research and training (including continuing education),
     for medical data exchanger and for demonstrations of patient care in the fields
     of   heart   disease,   cancer,   strole,   and   kidney   disease,   and   other    related    diseases;

            @ll(b)   to afford to the medical profession and the medical institutions of-the
            n   through    such    cooperative    arraneemen.ts,   the   opportunity   of    making    available
     to   their   patients   the   latest   advances   in   the   prevention,   diagnosis,    and    treatment
     and rehabilitation of persons suffering from these 64,-'-C@ise-s;

            if (c)  to  promote  and  foster   reg-Lc)nal   liii@'@ages   ar!.iong   health   care   institutions
     and providers so as to strengthen and improve primary care and the relationship
     between specialized and primary care; and

            11(d)  by these means, to improve generally           the  quality  and   eiiliancc-   the
     capacity  of   the   health   manpower   and   facilities   available   to   the   Nation   and   to
     improve health services for persons residing in areas earth limited health
     services,   and   to   accomplish   these   ends   without   interfering   with    the    patterns,    or
     the methods of financing, of patient-'care or p7-.-ofcssional practice, or with the
     adn@iiiistration'of   hospitals,    and    in    cooperation    with    practicing    physicians,
     medical    center    officials,    hospital    administrators,    and    representatives     from
     appropriate voluntary health agencies."

            See   901-(a)'   There   are   authorized   to   be   appropriated   $50,000,000   for    the
     fiscal  y;ar  ending  June   30,   3.966,   $90,000,000   for   the   fiscal   vear   ending   June   30,
     1967,   $200,000,000   for   the   fiscal   year   ending   June   30,   1968,   @65,000,C)OO   for   the
     fiscal year ending June 30- 1969   'I-20,000,000 for the nc,,-.-t fiscal ),car,
     $125,000,000 for the fiscal        vear  ending   June   30,   1.9.71,   $150,000,000   for   the
            I year ending June 30,      1972,   and   $250,000,000   for   the   fiscal    year    ending
            -')O, 1973, for           Lo  zi,D-s!-E;t  pu,@lic   or   nonprofit   private   universities,
            -il   schools,   research   institutions,   ind   otlif@r   public   or   nonprofit   private
     institutions   and   agencies   4j-ii   planning,   in   conducting   feasibility   studies,    and    in
     oi)er,itini- i)i3.ot 1)roie0ts for the establishment of i-(,i,,ional medical programs of



                         and demonstration                 for  c8ri7yjilg  out  the  purposes  of
     ,research, training                        ctivi.ties
     this title and for contracts to cii-Y), out the ptirposes-of this title.         Of the
     sums appropriated under this section for the fiscal year c@ii(Ii.iiF, June 30,' 1971,
     11   re than $159000,000 slial.1 be.               for @ictivi-tiies i.n the fiel-d of
     l@    disease     Of the siipis  a.I)propri-,ited under  this  section  for  qny  fiscal  -year
     c     after-Jiine 30, 1970, not more t--Iian $5,000,000 may be mide available in
                                   ants for new construction.       For any fiscal     car eiidiii,-,
     any such fiscal- year for gr,                                                   y           t@
     after June 30, lc,'69,  such  portions  of  the  appropriations  pursuant  to  tliis.  section
     as the Secretary may determine, but not exceeding 1 per ceiitu,.,i tl)c--i-cof,.'  sliall  be
     available to the Secretary for evaluation (directly or by grants oF t6nt'racts)
     of the program authorized by this title--."

                                        "ViULTIPROr.R@A@l SEI,',VICES
         "Sec.  910.   (a)To   facilitate   interregional   cooperation,   and   develop   improved
     national  capability  for  deli.very  of  health  services,  the  Secretary   is   authorized
     to utilize funds appropriated  under  this  title  @o  make  ,,r@-@nts  to  public  or  noii-
     profit  private  agencies  or  institutions  or  combinations   thereof   and   to   contract
     .for--
          "(1)  programs,  service@,  and  activities  of   substantial   use   to   two   or.nore
     -regional medical programs;
           (2)  development,  trial.,  or  demonstration  of  methods   for   control   of   heart
     disease, cancer,,stroke, lidney diseasii, or other related diseases;
          11(3)  the  collection  and  study  of  epideriiologic  data  related  to  any  of   the
     diseases referred to in paragraph (2);
          11(4)  development of trai-ning specifically related to the prevention,
          os-'Ls, or  treatment  of  any  of  the  diseases  referred  to  in  paragraph  (2),  or
     to the rehabilitation of persons suffering from any of such diseases; and for
     continiiin            of  sucn  training  @.7here  liortage  of  trained  personnel   wo.uld
               g programs                             s
     otherwise limit application of knowledge and skills important to the control
     of any of such diseases; and
           (5)  the conduct of cooperative clinical field trials.
     11(b)  The  Secretary  is  authorized  to  assist  in  meeting  the  costs  of   special
     projects for iir, rovina or developing new neaT)S for the delivery of health
                      p      0
     services concerned with the diseases with which this title i.s concerned.
     of (c)  The Secretary is  authorized  ti;   -support   research,   studies,   investigations,
     training,  and  demonstrations  designed  to  maximize  the   utilization   of   manpower   in
     the delivery of health services."






     0










                                                                                   Pub-lic Law 91-515
                                                                        glst Confress,  11.  R.  17570
                                                                                    October 30,  1970



                                                To ijuciid title, iii ,Iii(i       ix of tiie riii)iie ii(,ititli @'c-rviee Act f,.o I.,;        to     revise,,
                                                 traiiiii).-,   Lij(l   deiiioiistratioiis   tutlioi-iz(@0,   tljercuiiiler,   iiiid   for   oflier   I)ui,l@es.

                                                  I,,c it ell(Icle                             @ (191@l llo-,Itqe 0
                                                                      d by the @'eiz,,it                                                             of    the
                                                Vizite(I States (,f                    itz     Cully).,3,ss                                                       PubliG  Ifea,ltl-x
                                                                                                                                                                  S,ervioe Act,
                                                Tl'rllr@, I-A'-NIENI).@tENTS TO  TI'PIE IX                                   OF          TIIIE          l.'UBLIC  a eiidrents.
                                                                                                  SEPI'ICI@', ACT
                                                  Slc.    1.01.    This    title,    ii@iay    be    cited    i,;    the    "IIeirt.     I)is@ise.,     Ciiieer,  Citation      of
                                                Stroke, and ]@id)iv3@ Disease -,k-iiieiidiiiei)ts of 1970".                                                       title.
                                                  Si.,(,.  102. @Sc,-ction DOO of the Pliblic lle,,iltli                              Act.     i@     aiiiei)ded  79 Stat.     926.
                                                to read ,is folloivs:                                                                                             42 USC 299.


                                                  ((SLC. 900.  TI)e ])iirl)ose-, of this title, ,ire
                                                                    1-ii-oii('Ii @)-i@aiits ,,.,id                  to   ciicotti@ll
                                                                   t                                                               I   ,   ,i)i(I   ,issist   in
                                                      tile e.@,tiiijisl@3I)ellt of  ).(",iol),Il  cool)eritivc,,                                     tiiiong
                                                      ixiediezil selools,                       iiistiti)tioiis, and liosl.)iti-@li for
                                                      and trp@iiiiii,@                        eoiii  iiiiiiiig  c(li,,citioi)),  foi-   in(,(Iic,.il   deal   @t
                                                      excli,iii,@re, tii(I for (leiiioiistr,,itic)iis of 1),ttic@iit c;,           I-(,,  in  tile  iicl(ls   of
                                                      lie,irt  d               cancer,  sti-oke,  tii(I  l@idiiey                             tt)id       otlier
                                                      reliied diseases;                                                                                           84 STAT.  121@)7
                                                         "(b)  to til'oi-d to the III .(]Rival) ))rof(@,ssioll ',Ill(l I                  )Glen(  jet]  jilst@i-  84 STAT.  1298
                                                      tiitiolis of tl)c \'at,;oii, tlil-oii@li ,,,ilcli  cooper,,itiN-e
                                                      the ol)i-)orttiiiit3, Of                                     to their                     tile,   ]@it(@st
                                                      ndN-,til@-   Ili    the    I)revejiti0ii,    (li@1,111114DSiS)    Liid    ti-c@zttiiiciit    tnd
                                                      bilititioiiof
                                                                                                o  P-j-                  liyik:ifes       ,tiiioiig       health
                                                            (c)  to      )1'01)lot@ Ilid  f ,t  .            n
                                                        't -P            -.iojis   -            -idei-s   so   as   to    sti-eii(-,tiicit    tiid    in    rove
                                                      C, I , iiistittit            t)id ])roA                                                        Ili
                                                      I,-riiii,i.i-y care ,@,iid the i-elatioii,,Ii;.p between                                   qiid       pri-
                                                      iiiarv cit re; and
                                                            (d)     by     t)iese,     means.     to     iiiii)roi-e     g(@nerilly     the     quality      and
                                                      enhance     the     capacity      of      the      )ie:iltl),      i)lalij-)oNver      and      fi@iitic.3
                                                                       to  tli()  Natioii  and            to     iiiil)i-ove     I)eiltli     serN,ices      for
                                                      pei@,,(jn,-, recording in                      it,li   Iiiiait-e(l    lie@,tltli    services,    and    to
                                                                                                  w
                                                      accomplish                    c@iids     Nvitiloii,6     iiiterferiiiz     Nvitli      tile      patterns,
                                                      or    tll(@,    iiiet)lo(ls    of    financing,    of     I)zLti(-Il'k,     care     or     I)ra(,.ssionil
                                                                          -  'tli the
                                                      ]practice, or vi                 , "t(ifflillistr,,itioli of liosl itils, 'Ilia ill coo]-)Pr-
                                                      atioii    with     I)i-acticiiig     I)Iiysici,,tiis,     medical     @eiiter'     officials,     I)o.@pi-
                                                      tal    administrators,   ilid                  representatives        '         froiii         appropriate
                                                      voluntary  health  tge))cies."
                                                   SEc. 103.  (11          1)     'Fli@     first     se)it(@,nce     of     section     001.(a)     of     such  Appropria:bions.
                                                @A-ct is qmellded by stril@iii_7 out                             iDiiii(,di,-Itel.N-                         30,  82 Stqt.  1005.
                                                1969,",   iiid   ))Y  'ill-el-tilli   iiiiiiie(liatelv   before.                           for         gr@iiitS"  42 USC 299a.
                                                tle folio-%Vijl(,:         $12;-),Ooo,ooo    for    the    fic;@l    year     ending     JuTe     ",O,     1971,
                                                $150,f)00,000    for    the    fiscal    A.e-,ir    ciidinL,    June     30,     1.972,     and     $250,000,000
                                                for   tile   fisei   I   i-e@ir   ending   Jule   -o,    19
                                                                                                          7i,
                                                   (2)                                c;iiclifii-stsciitc-iic(,@isfut-tlierainciideclbysti,il(ingoiittliepc@riod
                                                lifter   "titl(@,"   .ind   iiiFzc!rtiii@,    in    lieu.    thereof    "'and    for    contracts    to    carry
                                                out the I)iirposes of this Jules!)
                                                   (3)  Such  st!cti(.)!i  901 (a)  is  tiyientled  by                                 out the second  @,nds,  limi-
                                                .@iitL@iiee and                       in lieti thereof tile,        - fol"oyjil@l":     "of     tit(@,     suits  te-tion.
                                                ,tl)i)ror)i-iated   uii(lei-tliis    section    fortl)c@,    fis(-,,il,),car    eiidinrr    June    @O,    1971,
                                                ]load iii-oi-e than $15,1)00,OW sliall be                               for   ICtivit,ies    in    tile    field

                                                      V-or7 o






                                                                          Pub. Law 91-515                                                                                1970
                                                                          Of )@idii(,-y dis(@:ise. Of tl'L' suilis lil)])rol)riite(I till(it@l' this sectioil for ,illy
                                                                          fiscal v@r cii(Iiiig            )itiie I()l  194-0, )lot  illo)-c  thin  $5,000,000  inay
                                                                                                                    icil fiscal 3!(,@ir ft)i- t,r@iiits fol- 'ICNV
                                                                                                          ;Illy  SI                                   a-.
                                                                                                   f .Ilcll          is fiii,tl)er ,ti))eiid(-cl     I)y  adding   It   the
                                           79  StP-t  926;                (1)) Sectioii 1)01 o .       i,11(r                  oil:
                                           82  Stet: 1006.                end t)iL@,r(,of the folloNv   .                                   :I)lt, lill(ic,.r  this  title,  the
                                           42  USC 299a.                  -'I (P-)  At the-, reclukest of ally                   of  @l 91                                    of
                                                                          ,iyin@i,ts to stic-it -  cil)iei)t niay I e                   )-)y the fair iiizlrl@et
                                                                                               re
                                                                          a                   Ul)l)lies, 01-               fiij@iii-@110(i 1).N, tilp                to       SU(@ll
                                                                                              the qiiioliiit@ of i I i(,  I)iiy,  alloxvziiiec,  tri-LN-eliii,,  L@xi)Cllses,
                                                                                              sts  in  connection   Nvitll   the   (letitil   of   all   oflicer   or   ein-
                                                                          a
                                                                                             ol-.C).Illllc@)lt  to  the,  recipient  -ivllen   stieli   ftii-)lisliiiig   or
                                           84  STAT.  1298                s                  lie (,.a,,,e, iii,,iy  lie,  is  for  t.ie  collN.el)ieiice.  of  iiid  at  the
                                           84     AT.  1299               r                   i-c@cil)ieiit    and    for    the,    I)iirl)ose    of                oitt        the
                                                                         @l   al 111(@(licill I)i-ogrtiin to NN-Iiieli tlic,, gr@iiit iiii(Ic-r this title is
                                           42  USC 299b.                        101.   Sect@oii   '1)02(a)   of    such    Act    is                    't)y    stril@ing    otit
                                                                                                       ,iii(I  ti-ct,,Itlnellt  i-clatiiig   to   heart,   disease,   cancer,
                                                                          or strolm, All(i  It the  OI)tlojl of                                     reltted        disease        or
                                                                          diseases"  and  iiisertii)(,@  in  li(!u  I-lic@reof  '@t  Y.,"Lil)illg,  I)i-evt@iitioii,  diiipiic)si,;,
                                                                          ti-e-,itiiieiit,   find   rc-Iiiibilitqtioii   i,@l,'Itiiig   to   heart    disease,    cancer,    stroke,
                                                                          or   kidney   di@is("   "I)Itl)    it    the    option    of    the    aj)plie4ii)t,    otliel,    related
                                                                          dise.t.w,s,@.
                                                                          (b)  Section  902(f)  is  ,iiiieilcl(@(I  I)y            strikiii,,,@      olit      ;'includes"      Iiid
                                                                          iii.@(-,i@ing in liell t)ic@reof "i)ieiiis new           (,oi)stj,iictiol)    of    f@icilities    for
                                                                          denioiisfr,,itiojis,    research,    -,lead    training    -,wheat     necessary     to     Carry     Olit
                                                                          regional  treasurer] pro-rtins'.
                                           42 USC 299o.-                  SFC. 105. Section                    (4-)  of sti(,li    Act       is       ainciidecl-
                                                                                (1)    1))y    -@trikiiigoitt"voltiliti,)-y)i(i@ilili    igeiicies,     ,tiid"     ,iiid     insert-
                                                                            in  - in li(!ii tl)er(@f '@vollillt"lry          Or   Offi(-iftl    lie@litli     ac,elicies,     Health
                                                                               9

                                                                                (2)
                                                                                                                                                                         of
                                                                            it    first             tll,e,l,eill, the foll'onviiig: ;'(iiicliidiiia as ,iii ex                I-icio
                                                                            inciiil)ei-  if  there  is  located   ill   .;iicli   religion   ol)(@   ()I-   i@@oi-e   hospitals   or
                                                                            other      lie5altli facilities of the                              Adiiiiiiisti-atio n,     the     indi-
                                                                            i,iduil       I oiri tl-te Adiiiiiiistr-,itor of @'et                        A
                                                                                         IV I                                              crtiiis  @ki'-.,iirs sliill
                                                                            designated to serve oil sti(-Ii advi,@,ory gi,oiii) its the
                                                                            of      the                or    other    health    ciii@c    facilities    of     SI.icli        Adiniii-
                                                                            istratioii NY'lijel)            locited in -catch                         ,iiid
                                                                                (3)  by St-i-ikiiig oiit "held for the,                             1)roN-ided      leader       the
                                                                            pro-rani"   ,tiid   iii,,ertiiia   in   lieii   thereof   "need   foi-    iii(I    fii)"Illcil)r-r    of
                                                                            tjie@services i))-ovicl(-,d        ,iiildcr the                         and      Nyllieli       advi@ory
                                                                            group   sliall   1)'c,   siifl'lcieiit   in   niiinber   to   iiisui-c    I(le(filite    coliiiiiiiiiity
                                                                            orici;tation     (,is     detei-iriiiie(I     bv      the      Seeretii-v
                                                                          SFc..   106.   That   part   of   the,   second    Eciit(@iiee    of    section    1)04(b)    of    ,iicli
                                               42 USC 299d,               Act precediiic_r 1)ai,aLri--,ipli             is  ,tiiieii(le(I     I)v     striking     oiit     @section
                                                                          903(i))   (4)         q-nd airport                            leof "   the.                      '-Section
                                                                          90,3(b) (4), if ol)l)ortiiiiitV                                de(l,   1)rior   to    -,iieli    i-ecoi-n-
                                                                          rneiid,,tt.ioii, for coii-;iderqti(                           t tioll I;v  ea(-Ii   1)iiblic   or   iloii-
                                                                          profit private i(_rejiev or or                                cli  ]la,.;  (leN-(!Iol)ed   a   coiiii)i,e-
                                                                          lieiisive r(@gioiial, iii@ti-ol)oliLiii        re    or o     liei@  local   area   i)l,,iii   r(tfei.red
                                                                          to  in  s  tioll  14 (1)) coveriii                .1             Iiieli   the    l@egion@il    )liL,(Iical
                                                                                                                  (-r  'II  v  I.erL  ill -,v
                                                                          proL-,r,,tin  for  which  tll(.  ql)])Iiciti'oii  is   Yil-,ide   Nvill   be.   located,   iild   if   the
                                                                          Rj)li]iC',Itioii".
                                               National Ad-               SFC,.   1,07.   (-,I)   Section   90.@)(it)   of   siieli   A(-t.    is    viiieiided    to    read    R-,
                                               visory               Council follows:
                                               on Regional                IISFC.    905.    (,,t)    The    Seerctii-y    inty    -,II)T)Oillt,    without    rezal-d     to     the
                                               14edioal Pro.              civil   service,   laws,   11   @N,,,itioiial    -kdi-is@)ry'Coillicil    oil    1,e(rionitl    '-Nfedical
                                               granis                                                                                                       I
                                                     0                    1'rograins.    ']'lie    ('oillicil    Shia])    coil,,-iFt    of    tli(,    Assistant    Secretary    of
                                               42 USC   299e.








                                                October 30,  1970                                       - 3                     Pub.         Law         91-515
                                                                                                                                                                         84 S'I't@T. 1300
                                                            I)L, tll('. Cllftil'l))ZLII, ill(rc-iliL@f                    T)ii-c@ctoi- Of tl)L',
                                                Adiiiiiiist),;itioii wlio sli@tll l@c., ,tii ex t)flieio                                ;iii(I tiN-e))ty i)lejii-
                                                                                                                                                             t--iiited
                                                ))el".,;, I)Ot                     ill     tile                                 ciiII)loy of tll(@
                                                                     ;II-e,              ill       tll(@,     of 111(@                                               the
                                                                             lic,,,Itli                                      r)].                        @kt, ]('@tst,
                                                tN%-o of ill(',                                         sliii)] I)c                                     oii(@ (;Iiall
                                                I)e, otitcit@liitlll.@L, ill tl)(, @@ill(ly (,I- I)e:iltll                   of'                               fi-oill
                                                            di.@i,:;@, oiie ,Iitil 1)(@ Olit@titil(lilig ill tll(@, Sill(]V (I]- ll('@litli
                                                                                                                                                             @ire, of
                                                1)(@rsolis                    fi-oill                   olie Slizill 1)(! olit.-,Itlll(lillo' ill t)@(@      ','t 11(13r
                                                ol-                         of                             l'i-oiii  sti.-()k(@,   ojie,   sli;ill   I)c   oiiist@kii(]-
                                                   z iii tli(-- stiidN@ ()I-  li(@iiltli                   of 1)                                fi,oll)
                                                                iNvo sliall lie,                          iii tile              of          i,liti(ill  ol'
                                                   ise
                                                disease,,                    sti,o)@, oi@                 dise;i-@e.            foiii- sli;tll 1)(@
                                                0       the
                                                   '(],))  Of tli(, 1)(,i-soiis fir,,t, :il)l)oiiii(@          'd               @,(,(@tioll                  of    filc@ Tenn  of
                                                I'   ililic                           Act to sc@IIN'(, Its trick ()Ill. I(I(Iitioll"ll                               of
                                                the    N,,itioiiil                    ('Oiill(,il oil
                                                                                                             .e
                                                ize(I 1)13' tile I)IICII(Iiijci:it ij-itde  li          stil)@  etioii   (it)   of   iliis   sc@ctioii--
                                                                     ()I)e sil,,Ill             foil-   t(-)-IYI of ol)(@
                                                                     Oil(- sell]]               fol.    tel,i-fi of ti@-o
                                                                     Ollf-' still]  1;(@l-ve  fol-      ,I tel-iii of                         iiid
                                                            (4) oiii-@  s])@ill                 l'o)-   it t(!i@i)i of folli,
                                                .IS  desigii:it(,(]  I)v  the                           of 11(@tiltli,                      aii(I 11'eli'iii-e  it
                                                tile,  til)]C   of
                                                                                                                                    oil
                                                   ro., aiii,; (o',Iiei- tli@iii tli(,@  @iii-          eoll Geliei-:@l )  ill                Oil Ill('  (I;tte  of
                                                eilactiiickiit ol.' this Act .-,Iiall coi-itillll(,' ill ol'ill('i! ill
                                                tei-iii of oili(,e  foi,                 they were I:ist :tlil)oitit(,d to the
                                                   SF,C.   108.   @@ectif)ii   !)07   of                Act is al))Cll(l(,(l l)-v                         olit  @'@Or    79 St@it.  930.
                                                                Ill(]                 ill                      ;SI:).oke,  ol-                                           42 USC  299g.
                                                                             oil t)O(                                                                                    42  USC  299i,
                                                   Src.   109.    se(,ti               )(,i) ol' sii@li Act i,,                            ))y iii@(@i-tiii        "o,
                                                (,Oiitr,tet"' -,ift(,r "gi-aiit"                             it                 tlici-eiii.
                                                   SFC. 110. (,-,) Sceiioii 910 of sll(-Il @k.ct is                                    to    I-eil(I    @'S    folioNvS: 82  Sta.t.  1006.
                                                                                                                                                                         42 USC  299J.



                                                il)li)i,oved  ii:ltioil@il  cal):il)ility  for                         (if )Milli
                                                t:it,yis,itit'i-ioi,iv(,dto   1-itiliz(@                                                                 to )airline,
                                                @'ji,ilits to I)III)Iic ol- iloill)l-ofit                                       ol, ilis@ittitiolis 01'  COIII-
                                                I)i)i,ttioiis tli(@,t@(-@of ziii(I to cotitj,:tct for-
                                                                     prog                               'Liid  activities  of  stibst,,iiiti-,il  iise   to
                                                                             r;lllls,   sej,%,)(,e",    ,
                                                       two oi- illoi@e I-egioll.11 I]lC(l i(-,l I PI-o(-,I.Ztlll",;
                                                            "(2)                                        ol. (](@illolisti.litioii of iiictl)ocls foi.- Coll-
                                                       .'trol of  lie;trt                               sti-oiie, l@idiiev dise:ise, oi- ol,lici, i@(-@l;lted
                                                       d iie@, i.@ s
                                                            11(3)     ilie                      @iii(I ,ttt(lv Of (-I)ideniiolo,,@ic  (Izita  related  to
                                                       aiiy 6f t)ie disel@ises ilclfei@-i-ed to iii
                                                            -"(4)  de%-elol)iiteiit of ti-,iiiiiii,, SI)eeifi,,,-:Illy                             to fl)(@  I)]'C-
                                                       ventioii, di;tgiiosis, or ti-ezttjiieiit                 of  iii3,  of  tile  (liseits(@s  )-ofeiired
                                                       to   ill                                 ol- to tl)e ),-el),Lbilitit ioii of I)ersoii-,
                                                       f-roiii                                  @-es; ;iiid foi- coiiiiiitiiiig 1)1.0(,rl.llllls of siicii
                                                       tr-,iiii                                 g(@,  of  traiii(-,d                      NN-oitid          otliei-Nvise
                                                       limit                                    NN-le   "re   lilid   siiills   iiiil)ol-t-,iiit   to   tile    coiitrol
                                                       of     Ill                               aiid
                                                            It (,t                             of coolieriitive cli)iieil lie](]  trials.
                                                   "(b)  Tile @cei-t@ttti-y is iiitlioi-iz-,d to ts@ist. iii                                       tile   costs   of
                                                s    eci,,tl    projects    foi-    iiiil)roviiig    or    dcvclol)iii,_,    iiew    Ilicillis    l'or    the    (leliv-
                                                   p
                                                @.ry   of   fl(@altit   @er%,j(,es   (,f)iicei,iic@(I   witli   tile-   (li'seas(ks   Nvitli   iN-Iiieli   this    title








                                                                   Pub. LaV91-515                                    4                    October    30,     1970
                                        64 STAT. 1301
                                                                                                                                                                     dies,
                                                                      11(c) 'ilic Seci-c-tai-y i.,;.,tiitlioi.-izecl to SuP])Ol't research, ,II
                                                                                           ti-ztiniiig,                (1@@lioll@trittio]ISI           -to       iliaxiiiiiz(@
                                                                   the titilizatioii of                      air  tjie   doliN7c@i- y of health
                                                                             111. (,i) 'riie                   to title ]-\, Of silc@ll @%ct is @iiiiei)de(l by
                                                                   stril,ii@L, out                      AN])                                               tiid iiisert-
                                                                                                                                                          D      OT]       IER
                                        42 IJSC 299b-                                                                                             904:(])),            905(b),
                                                                   -VOU         906, 90-t, iiid ()09(,t) of sii(.-Ii Act                          I)y    the     I)i-occ@diiig
                                        299g, 299i.
                                                                   I)t-oN-isioii,;  'of   t)@i@s   Act)  ii-e               further                1)3,      striking      out
                                                                      tirgeoji                   e,.icl)         it.  al)l)c@ii-s  therein  Lil.d  ilisortill(r   iii   li(@,u
                                                                   tliereof
                                                                      ITIE II-A!iIEXD@lE@NTS TO 'FI'FI,E III OF TI-IF, PU
                                                                                                 lll,,'.N-LTII SEIZVICE ACT
                                                                                                                                                               H
                                                                      IZT A-R)r-Sl@:A)-,Cll  ANI)                                         II!-,),ATING TO         1,
                                                                                                   li'Acil,ITILS A-.\I) Sl;ilvi@cils  -                                                                       .
                                                                                     (,q)  (1)  Sectioii   304   (,,t)   of   tli(,,   Ptil)l@le,   Ifealt@li   9'ervice   Act
                                        81 Stat. 534.
                                        42 IISC 242b.                           (!d-
                                                                                                                    lliiiiic,.(Iilt(!Il,  after            301.   (a)";
                                                                                                                                                               (A)       ,tiid
                                                                          (B                          Laid ig claii-,(,.s  (A),  (11),               (C)     as     cl,,Illses
                                                                      (2)                                      Act     is     aiiitiid(@,d-
                                                                             (A            ri   ii,- out     (b)  "  iiid  iiisci-tiii(/iii   lieu,   thereof   11   (9,)
                                                                                   by St
                                                                          all(I
                                                                             (B)      b@?      str @i.ii-                                                            tliereiii
                                                                          fLDd                   ii)    thereof ';I@li;s sii])F;O"ctioii".
                                                                             Secti-ii  3c)-l.   (c)   of.\siieli   Act   is   :i)iie3iiied--
                                                                                                 ii (, out "4t Iiis section"'             lilice, it, al)l)


                                                                                                                                          (r 11
                                                                             (A)  b), striiiiil(,y ot@        (c      alid       i@i@erLiii  i    lieu    tl)ereof     '1(3)";
                                                                          all(I
                                                                             (13)  ])Y,Stl-@]@i@g OIILI                                   J)IlC(',   it   ip],)etrs   theraiii
                                                                          aiid                   ii iicii the) c@Qlf        slil-)Sectioii@'.
                                                                      (b)  Sectioll 36-1 of such Act                 ftirtl,.cr                I-ly   i(lliiig   :tfter    the
                                                                      Oi,i@;ioji         tlicrc@of                                             (6)       by       siib-ectioii
                                                                          (3) (A) of tl is scct;oii the        fo "I"I-Illl-  neiv siil),(@ctioli:
                                                                                "Systclii,3 Aiialysis, of \"tti\oll,,Il  J-fc-,,tltli  Care, Plalis
                                                                          (b)    (I)    (A)    The    S(!C@etirv    sliall     (i@elo     ,     through     utilization     of
                                                                                                 i     t,      ..,                '       p
                                                                   the systeinc                  s   ii)o'liod,    plaiis    for    livtltli    care    s),steiiis    designed
                                                                   lideq@t,.itely   to   meet   t,'.(,,   health    iiec,,(Is    of       Aiiic@rica)l     i)eoi)le,.      For
                                                                   pur@oses  of  tl)e  1)rccedi)ig  seiitejice,  the  qyFteins                                       i-nc-thod
                                                                   means   the   ,iilill),tie'lil   method   I)y    Nvliicli    vario@IQ    iiie,tjis    of    obtiiiiiii    EL
                                                                   desired result or @o:il is issociated with                                     benefits          invoIN-ed.
                                                                      "(B)  The Se@@tii-y sli,,ill complete the (leN,el                      i)l)iiieiit   of    the    plaiis
                                                                   r(-.f@rr@d to iii                          (A),      witlii)i      -much         ,is i)i,.iy  be  ii(,ce-s-
                                         Report to
                                                                          to   enable   Iiiiii   to   S11I)nlit   t6    the    COII,(@res.; ilot        tllaii        sel)tem-
                                         Congress.                 her    30,    19TI,    a     report     tliercon     ivliieli     sliall dose                            so
                                                                      eveloi)ed i@ terms of-
                                                                                     the iiiiiiil)er of r,  ol)le -%,who Nvoiild be                                     the
                                                                                      the Iii)id Iii(I type of lie,-tltli care -,vliiel                                 red
                                                                                    lie   1)1,111;
                                                                                       the, cost in%-olN-(!d iii carrying out the                                          cli
                                                                                     ould be financed;






   0













   0













   0












                                    Regional I-ledical Programs






                      Bud-et
                          LI
                      Esti.niatc,,       liou@@e         Senate
       Yc@ar        to Congres   s     Al.l.o@.7,ince   Alloiqance       ApprQi-)ri.,ition
       1966         $25,000,000          N.C. I/        $.25,000,000      $25$000,000
       1967           45,024,000          $45$004,000    45,004,000          45,004,000
       1968           64,314,000         54,314,000      64,31-4  000        58,814,000
       1969           68,922,000          N.C. 1/        68,922,000          61,907,000
       1970   2/    1 .00,000,000        76,000,000     1.00,000,000      100,000,000
           1  2/      96,502sOOO         96,502,000     115,000,000       116,99OsOOO
          72  2/      52,771,000         82,771,000     122,77lsOOO       102,771,000

       1973   2/    131,287,000



       1/ Not considered.,
       2/ Includ                  viously supported under the appropriation "ChTonic
                 es programs   pre
             diseases," for comparability.




                                                                                                     February 28, 1972



                                                              Budget  History  -   Grants
                                                                   (In   Thousands)


                                     FY   1966   FY   1967    FY   1968   FY   1969    FY   1970   FY   1971    FY   1972   FY 1973
      Authorization  ............      $50,000     $90,000     $200,000     $65,000     $120,000    $125,000     $150,000     $250,000
      Appropriation  ............       24,000     43,000      53,900       56,200      73,500       99,500        90,500      120,800

      Add:
        Balance   brought   forward
        from previous year    .....     ---        21,934 b/   25,900       36,165      20,000       15,298        44,500

      Less:
        Amounts  helif in
        reserve  by BOB   .........                21,000      30,900       20,000      15,000       44,500        ---

      Amount available for
        obligation  .........           24,000     43,934      48,900       72,365      78,500       70,298       135,000      120,800

      Less,.
        Amount obligated....             2,066     27,052      43,635       72,365      78,202       70,298       135,000      120,800
      Lapse    ....................     ---        11,982 c/     ---          ---         ---          ---         ---


      Balance   carried   forward..    21,.934       4,900        5,265                      298       ---




      a/  Appropriation request.

      b/  Available through December 31, 1966.
      c/  These funds were appropriated for fiscal year 1966, available for obligation
           until December.31, 1966.  They lapsed on that date.





                                                            DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

                                                                                             h Administration
                                                          Health Services and Mental Healt

                                                                       History of 1973 Estimate


                                                                                                  Department       OMB reduction
                                                   Estimate        Depar@ment                       reduction         from
                                  1972                 to           Estimate      Presidentis     frcm agency       Department
                              Appropriation       Department         to OMB         Budget           request         Submission                               Posi-
                                                                                                                                      Exi)lanation              ons Amount
        Appropriation


         egional Medical
          Programs            $100,554,000        $152,815,000     $140,616,000    $131,287,000     $12,199,000      $9,329,000     Department Reductions:
                                                                                                                                    Grants:
                                                                                                                                      Construction            ---    $5,000    000
                                                                                                                                      Regional medical'
                                                                                                                                                                         5,813,000
                                                                                                                                        programs,

                                                                                                                                    Direct operations:
                                                                                                                                      Technical assistance
                                                                                                                                        and disease control      48      656,000
                                                                                                                                      Program direction and
                                                                                                                                          nagement services      62      730   000
                                                                                                                                        ma

                                                                                                                                    Total, Department
                                                                                                                                     Reduction ............   110     12 199   000


                                                                                                                                    OMB Reduction:
                                                                                                                                    Grants:
                                                                                                                                      Health maintenance
                                                                                                                                        organizations         ---       16,200,000
                                                                                                                                      Emergency medical
                                                                                                                                        services                        +7,000,000

                                                                                                                                    Direct operations:
                                                                                                                                      Employment reduction        8      129   000
                                                                                                                                                                  8    9 329-000
                                                                                                                                    Total, OMB,reduction      -