51

by exercising its own leadership to
mount as concentrated and effective
an assault upon heart disease, cancer
and stroke as may be possible in terms
of the resources of the State of North
Carolina. On the basis of these prem-
ises the Regional Medical Program
of North Carolina has evolved a de-
cision-making mechanism which is
both responsible and rational, and
which will maximize the effectiveness
of the wealth of leadership which is
available. . . .

"Participating Organizations: The
North Carolina Regional Medical
Program has received the enthusiastic
support of the participating organi-
zations.  Particularly  outstanding
have been the contributions of the
North Carolina Heart Association
and the North Carolina Division of
the American Cancer Society.

"The staff of the Association for
the North Carolina Regional Medi-
cal Program has devoted much time
and energy to the orientation of
health interests throughout the region
in terms of the nature and objectives
of the Regional Medical Program,
and as it has been possible to identify
appropriate functional roles, an in-
creasing number of them have be-
come active participants. This effort
will continue to be a dominant feature
of the Program since to a large ex-
tent its success will depend upon the

degree to which the skills and man-
power represented by these interests
can be mobilized. . . .

"The Planning Division has made
good progress in assembling survey
data essential for program planning
and to provide overall baseline data
against which future impacts may be
gauged.

"One study which has been com-
pleted has explored the dimensions of
an affiliation between the Memorial
Mission Hospital at Asheville and the
Bowman Gray School of Medicine.
In addition to collecting data perti-
nent to this situation, this experience
will serve to teach us how to organize
and communicate the data needed to
provide linkages beween Medical
Schools and community hospitals.
Surveys have been made of practic-
ing physicians in Buncombe County
and of other staff members of the
Asheville Hospital aimed at securing
their ideas of the general utility of
such an affiliation and their specific
recommendations of what such an
affiliation should strive to provide,
especially in the way of continuing
education.

"A report on this study was devel-
oped by the Planning Staff for the
Association for the Regional Medi-
cal Program with the assistance and
guidance of Memorial Mission Hos-
pital, Bowman Gray School of Medi-

cine, the Buncombe County Medi-
cal Society and the State Medical
Society. It includes a description of
the characteristics of its patients and
staff. Also included arc ideas of key
hospital personnel as to the desira-
bility of developing the affiliation
with the Bowman Gray School of
Medicine, suggestions as to programs
of continuing education, and sugges-
tions as to what other elements might
be included in an affiliation between
the two facilities. It also includes the
viewpoints of the county's physicians
toward affiliation, continuing educa-
tion, diagnostic resources and needs,
and paramedical personnel needs
through an analysis of questionnaires
that were distributed to all Bun-
combc County physicians in Febru-
ary and March, 1967.

Diabetic Consultation
and Education Service

"This study was begun January 1,
1967 and participants include rep-
resentatives of Bowman Gray and
Duke Medical Schools, the Univer-
sity of North Carolina School of
Public Health, the State Board of
Health, Community Board of
Health, practicing physicians, and
public health nurses.

The feasibility of a regional consulta-
tive service and an educational pro-

gram for diabetic patients is being
tested. Scheduled clinics in COIIUDU-
nity hospital or similar settings and
also at the university medical centers
are included. These activities will be
supported by a home nursing service
to assure proper follow up and sus-
tained patient contact. The educa-
tional program will be directed to
community groups of diabetic pa-
tients and will be coordinated with
community health organizations. . . .

Continuing Education

"Data on the number and types of
continuing education programs for
professional and ancillary personnel,
their geographical outreach and the
numbers and characteristics of indi-
viduals attending is being collected
through a monitoring system involv-
ing obtaining of registration forms
from program chairmen. When this
monitoring process was first initiated,
the researchers attempted to gather
data only from those organizational
meetings with program content re-
lated to the categorical diseases. HOW-
ever, it was often difficult to draw a
line between those meetings that
either did or did not fall within this
provision. As a result an attempt has
and will continue to be made to moni-
tor all of the major medical meetings
unless the program content clearly


indicates na relevance to the RMP.
In a statewide study of this nature an
analysis of any part of the continuing
education process becomes an analy-
sis of the total on-going system. Con-
sequently, the findings will be more
relevant and meaningful if the
widest possible representation of the
education system is obtained."

Northern New England
Regional Medical Program

"The Northern New England
Regional Medical Program and core
staff have been organized along
functional lines-medical economics,
education, information systems, dis-
ease prevention, and patient care
services. All planning and program
efforts, in turn, are organized ac-
cording to a systems approach
which provides continuous feedback
of information and assessment of
progress. . . .

"We have made good progress in
determining the scope of participa-
tion of various health related groups
in Regional Medical Programs. From
the beginning we have made every
effort to include representatives from
all interested groups in our planning
effort. . . .

"A number of steps have been
taken to develop cooperative work-
ing relationships with health profes-
sions  groups,  hospitals, health

agencies, and other organizations
concerned with health and welfare
throughout the Region. . . .

"Determining the planning ap-
proach has been complex because we
have attempted to shape our program
in response to the requirements of
the systems approach to planning.
This approach provides for the appli-
cation of advanced mathematical and
computer techniques in analyzing
alternative solutions to problems. It
also includes cost-benefit studies.
Some cost estimates of the training of
allied health personnel and coronary
care training for nurses have been
made. Since there are no precedents,
some experimentation has been nec-
essary. . . .

"The development of a Model of
Patient Care is the major initial
planning effort. To develop the edu-
cational aspects of the Model, an
Education Committee has been ap-
pointed which will be concerned with
lay health education, continuing
education for all health professionals,
and basic education in the allied
health professions. . . .

"A meeting held in February 1967
with representatives of some 25 or-
ganizations which operate a variety of
health education programs was a first
step in coordinating the existing
health education programs with Re-
gional Medical Program activi-
ties. . . .

"Since continuing professional
education is an integral aspect of
Regional Medical Programs, an ad
hoc committee has been appointed
for continuing education of allied
health professionals with representa-
tives from the Vermont Division of
the American Cancer Society, the
American Red Cross, the State
Health Department, the Department
of Physical Medicine and Rehabilita-
tion of the College of Medicine, the
Vermont Heart Association, the Ver-
mont Pharmaceutical Association,
the State Mental Health Depart-
ment, the Office of Continuing Edu-
cation of the College of Medicine and
the Regional Medical Program's
staff. This group has defined, specific
objectives for continuing education
and is gathering information on exist-
ing activities and personnel needs for
carrying on these activities. . . .

"The potential  use of various
modes of communication and trans-
portation to augment continuing
education programs is being ex-
plored. Two-way television connec-
tions between the Medical Center
Hospital and community hospitals in
the Region and the use of the Uni-
versity's airplane are two possibilities
for future education program sup-
port. . . .

`<Assessing basic education needs in
the allied health professions has been
a prime concern; and surveys have

been made to determine the numbers
and types of such personnel in the
Region. . . .

"Health education for the public
has emerged as a top priority objec-
tive, and recruitment of a full-time
information specialist to be respon-
sible for this aspect of the Program
is currently underway. . . .

"Dissemination of recently ac-
quired medical information to the
practicing physician has also been a
concern of the Northern New Eng-
land Regional Medical Program and
our proposed Pilot Project in Coro-
nary Care is an illustration of how we
intend to accomplish this task.
Through cooperative arrangements
between health personnel at the Cen-
ter and their counterparts in the re-
gion which are described in our
proposal, we intend to promote ap-
plication of the latest techniques in
progressive coronary care at the local
level. . . .

"The proposed Pilot Project in
Progressive Coronary Care involves
research related to the regional as-
pects of the management of coronary
disease. One such study will be a
determination of modifications in
equipment and personnel require-
ments necessary to provide intensive
coronary care in small community
hospitals. Using the data collected
through the Heart Inventory, which
the Northern New England Regional


53

Medical Program is developing, it
will be possible to identify other
potential research projects related to
various aspects of the incidence and
treatment of heart disease. . . .

"Our planning efforts must neces-
sarily take into account how trans-
portation affects the delivery of
health care. Thus, we currently are
conducting with the State Medical
Society a survey to determine which
towns have emergency ambulance
service, how it provided, and how
effective it is."

Tennessee Mid-South
Regional Medical Program

"Understanding of what the fun-
damental concept of a Regional
Medical Program is and how to best
develop and establish it in this region
has proceeded steadily from the
earliest discussions which led to the
application for a planning grant. In-
evitably, such understanding has de-
veloped in an evolutionary fashion
since it is, in fact, a reflection of a
growing awareness of the medical
faculties of ways in which they can
serve as resource agencies for im-
proved medical care, and of practic-
ing physicians that the primary aim
of the program is to help them in
the care of patients in their own lo-
cal area. Similarly, the role of exist-

ing health agencies, public and volun-
tary, and of the wide spectrum of
health personnel on which good
health care depends so heavily has
gradually come into focus like a pic-
ture on a screen as steps have been
taken to promote discussion and
planning for specific action to deal
with real problems.

"This first progress report of the
Tennessee Mid-South Regional Med-
ical Program attempts to chronicle
the widespread growth of under-
standing about its purposes and
methods that has taken place in the
past year. The basis for most of the
achievements to date is the willing-
ness of many persons, acting on their
own behalf or that of their institu-
tions and organizations, to study new
approaches and to undertake new re-
sponsibilities to assure the continued
improvement of medical care in the
fields of heart disease, cancer and
stroke. . . .

"In developing the strategy to be
followed, the Director of the Ten-
nessee Mid-South Regional Medical
Program has sought consultation
from Dean Batson (Director, Medi-
cal Affairs, Vanderbilt University),
Mr. Kennedy, (Chairman of the Re-
gional Advisory Group), and from
Dr. Anderson (Chairman of the
Faculty Group formulating policy for
Meharry Medical College). It

seemed desirable to explore with the
faculties of the two medical schools
their interest in the general areas of
continuing education, the training of
affiliated health personnel, and vari-
ous aspects of heart disease, cancer
and stroke. Visits were made to key
communities in the region which had
given evidence that they were ready
to develop cooperative arrangements.
In addition, it was deemed essential
to establish communication with the
various voluntary and public health
agencies in Nashville and other areas
of the region. . . .

"On January 10, 1967, the Direc-
tor met with a group of approxi-
mately 12 hospital administrators
from the Nashville area. The group
was knowledgeable about the objec-
tives and procedures to be followed
in developing a Regional Medical
Program. They were greatly inter-
ested in finding out how the Regional
Advisory Group would function and
the basis for establishing priorities for
projects which might come from a
variety of sources. Questions were
raised about the establishment of
coronary care units in hospitals and
particular inquiry was made about
the eligibility of hospitals for funds
to conduct renovation for projects of
this kind. A discussion was held about
the importance of building into the

design of projects a mechanism for
evaluating their results. . . .

"On February 22, 1967, Dr. Faxon
Payne, radiologist at the Jennie
Stuart Memorial Hospital and Chair-
man of the Medical Society Commit-
tee for Regional Medical Programs
for Heart Disease, Cancer and Stroke,
arranged a meeting of the Director
with the chiefs of medicine, surgery,
pediatrics and pathology, with the
Administrator of the hospital and
several members of the Board of
Trustees. It was apparent that the
group was anxious to establish com-
munication with the Regional Medi-
cal Program and was particularly in-
terested in the field of continuing
education. The potential of televi-
sion  and other communications
media was discussed. The staff indi-
cated that it would be greatly inter-
ested in having medical school faculty
members come either for lectures or
for periods of one or two days at a
time. They expressed interest also in
the possibility that a full-time chief of
medicine might be appointed in order
to help organize an educational pro-
gram of some substance which could
serve not only  the Hopkinsville
group but the 8 or 10 smaller hospi-
tals which are located within a 10
to 15 mile radius of Hopkinsville. . . .

"A meeting was also held with the
staff of the Erlanger Hospital in


54

Chattanooga on March 8, 1967. We
discussed the problem created by the
fact that Chattanooga serves areas
not only in Tennessee but also in
Northern Georgia. The Director as-
sured the staff that the Regional
Medical Program would in no way
interfere with the relationships with
established groups. We then discussed
ways in which the hospital could
proceed to become actively engaged
in an operational project. The follow-
ing suggestions were made-that a
committee be appointed within the
hospital to coordinate suggestions
made by the various services and to
cooperate with the already appointed
committee of the medical society. The
individual chiefs should be encour-
aged to draw up a rough draft of pro-
posals relating to their own depart-
ment. The Director indicated that
the Regional Medical Program staff
would work with the various groups
to help refine the proposals, make
sure that mechanisms for evaluating
the projects were incorporated and
that specific budgets relating to per-
sonnel, supplies, equipment, etc.,
were properly drawn. It appears
likely that the Regional Medical Pro-
gram will work through this group to
establish an educational sub-center in
this area anticipating that the group
at the hospital will reach out into the
surrounding areas to establish closer
contact for the training purposes. . . .

"Similar developments are taking
place at two hospitals in Nashville,
St. Thomas, and Mid-State Baptist
and in Knoxville and the Tri-City
area. . . .

"In addition to visits with hospi-
tals, the Director has met with many
of the medical societies in the re-
spective communities and they have
now established liaison committees
to consider ways and means of foster-
ing activities under the aegis of the
Regional Medical Program for Heart
Disease, Cancer and Stroke. In most
instances, it was found that these
committees while expressing interest,
had been unable to focus their ef-
forts on specific programs. It was only
through discussion of possible opera-
tional projects for which grant funds
might be made available that the ac-
tivities began to achieve some degree
of substance. . . .

"Dr. Frank Perry, Associate Pro-
fessor of Surgery, is coordinator for
the Meharry faculty and will devote
a major share of his time to explora-
tion of continuing education pro-
grams for Negro physicians. He plans
to coordinate his activities with the
parallel efforts being made in con-
tinuing education by the faculty at
Vanderbilt University. . . .

"Dr. Leslie Falk of the University
of Pittsburgh School of Health, who
is serving as chief consultant for the
planning of a Neighborhood Health

Center sponsored by Meharry and
funded through the Office of Eco-
nomic Opportunity, believes that the
Regional Medical Program could be
of considerable value in supplement-
ing the services that Neighborhood
Health Center would ordinarily make
available. . . .

"The demands made by the Re-
gional Medical Program have focused
the attention of the professors of
medicine, surgery, and radiology at
Vanderbilt University on the need to
make a major revision in the facili-
ties  for  diagnosis  and  treating
patients with surgically correctible
cardiovascular disorders. The evident
strengths of the institution have not
been used as effectively as they might,
and the requirements for a pene-
trating assessment of the problem has
been a beneficial experience.

"Planning is underway to deter-
mine how best to develop a rehabili-
tation facility to serve the needs of the
region. A gift in the amount of
$2,000,000 from a Nashville family
has insured the funds for construc-
tion. Intensive effort is needed, how-
ever, to coordinate the project for
maximum involvement of faculty,
community agencies and state and
regional agencies. It is expected that
the institution will serve important
educational and research purpse~.
This appears to be an excellent ve-
hicle for achieving regional ob-

jectives in an area where existing fa-
cilities and personnel are desperately
needed. . . .

"Acquisition of information about
the health resources of the region is
underway and will be continued and
expanded during the year. Using the
resources of the biostatistical division
of the Department of Preventive
Medicine and Public Health of Van-
derbilt University, data has been put
on computer tape regarding physi-
cians, nurses and the hospitals. Using
this basic information, a health re-
sources profile will be developed for
each county and later certain coun-
ties will be grouped into areas to de-
termine the characteristics of these
larger areas. Demographic data will
also be used as a basis for determining
the size of the population to be served
in the respective counties and areas.
Valuable correlative data has also
been obtained from the statistical di-
vision of the Tennessee Department
of Health. . . .

"In cooperation with the Tennessee
Nurses Association and the Tennessee
League for Nursing, we are making a
study leading to the preparation of a
state-wide plan for nursing education.
Cooperating in this endeavor will be
Miss Anne Dillon, Head of the Sta-
tistical Division of the Tennessee De-
partment of Public Health. The time
seems ripe for just such a study to


55

help focus on the total problem of
nursing."

Texas
Regional Medical Program

"The Project Director in Area I has
conducted meetings with various
educational health agencies. Meet-
ings were held to determine meth-
odology and to enlist the help of ded-
icated individuals interested in the
goals of the Regional Medical Pro-
grams. Outside the Medical School
community, the Council of Medical
Society Representatives appears to be
the most significant body to reach
community physicians. Two meetings
of the Council of Medical Societies
Representatives have been attended
by 28 physicians and 12 hospital ad-
ministrators from 16 of the 44 Coun-
ty Medical Societies of Area I. There
was a favorable attitude expressed to-
ward the Regional Medical Program
and a desire expressed for the need
of the early development of an In-
tensive Care Unit Training Program
for nurses and physicians. The in-
volvement of hospital administrators,
individually or through the Hospital
Council, has been most worthwhile
since the eventual improvement of
health services must generate from
the community hospitals. . . .

"There are many facts to be un-
covered by making a survey of phy-

sicians. We need to know the future
patterns of medical practice. The
gradual shift of general practitioners
into specialties and into population
centers is leaving many areas without
younger physicians. Several counties
have no young men coming into their
communities. In order to examine
regional problems Area I has been
divided into six divisions and studies
are now uhderway to define the phy-
sician's role in each community. . . .

"Within the regular teaching pro-
gram for medical students, residents,
and interns at the University of Texas
Southwestern Medical School and
affiliated teaching hospitals there are
conferences, seminars, lectures, and
clinics that are maintained on a
regular basis and are available for
physicians interested in continuing
postgraduate education. There are
several institutional grants in both
heart disease and cancer supported
by Public Health Service grants.
These programs are ariented to CO-
operate with the Regional Medical
Programs. . . .

"Stroke : Significant programs are
being developed in the medical
school community, especially the
Presbyterian Hospital, to develop a
significant demonstration unit involv-
ing all of the disciplines of medicine
necessary to bring this program into
one cooperative effort. A total pa-
tient care program, including re-

habilitation, will have high priority
in developing an operational program
in the immediate future. . . .

`<In Area II, many physicians were
skeptical, suspicious, or hostile to the
Regional Medical Program on initial
contact. The hostile response, how-
ever, was not uniform. Many physi-
cians, and a majority of many of the:
district and county medical societies,
looked favorably and hopefully upon
the program. They saw in it an op-
portunity for continuing education
for themselves, for training of allied
health professionals, for supplemen-
tary special medical care facilities,
and other measures that may alleviate
a feeling of isolation. . . .

"Certain difficulties have been
encountered in Area III in commu-
nicating with peripheral points at
which health care services are dis-
pensed. Full-time personnel are still
being sought for the professional posi-
tions now filled on a part-time basis.
A full-time Assistant Planning Direc-
tor will concentrate his efforts on
hospitals and other health care cen-
ters. It is obvious that the circuit-
rider technique must be employed to
effect an appropriate response at the
community level. . . .

"The feasibility study for develop-
ing a School of Allied Health Sci-
ences has progressed very well. Em-
phasis will also be placed on studying
mutual  relationships that could

evolve from the collaborative efforts
with the Galveston Community Col-
lege. . . .

"The planning staff became acute-
ly aware that the health practitioner
and the hospital at the community
level had little knowledge of the exist-
ence, the intent or the potential of
Regional Medical Programs. Efforts
to establish written communication
proved less than satisfactory; there-
fore, a more direct approach was
deemed essential. On February 25,
1967, the president of each county
medical society in the Gulf Coast
Area was invited to Galveston to en-
ter into a dialogue on Regional
Medical Programs. It was hoped
that each of these individuals would
return to their respective communi-
ties and would, in turn, create addi-
tional dialogue at the local level. Rep-
resentatives from seven county socie-
ties, the Texas Medical Association
and planning staffs from each of the
several components of the Texas Re-
gional Medical Program attended.
While the physicians present repre-
sented only a small part of the geo-
graphic area, this meeting provided
considerable information that verified
the essentiality of a continuing inter-
change between a planning office and
the health practitioner. The meeting
also demonstrated the difficult task
that lay ahead in establishing such a
dialogue. . . .


56

Intensive Care Unit

"The planning director has collab-
orated with the administration of the
University of Texas Medical Branch
and the Medical Branch Hospitals
in developing a modem intensive care
training unit which will contain four
beds for postoperative care of patients
with cardiovascular disorders. The
planning director is currently arrang-
ing far partial funding through non-
federal sources. This unit will be de-
veloped in such a manner that will
permit the training of nurses and
physicians to man intensive care units
in other hospitals. . . .

"Many interested individuals and
groups are taking an active part in
gathering information and are par-
ticipating in studies, such as the
Houston Area Hospital Personnel As-
sociation and Houston Dietetic As-
sociation. They have worked with the
staff in designing questionnaires and
gathering information. . . .

"The program is serving as a cata-
lyst in encouraging dialogue and co-
operation between institutions, in-
terest groups, associations and
individuals. Progress in carrying out
planning studies and surveys is being
made. Misconceptions and erroneous
conclusions about the purposes and
goals of the program are being cor-
rected. Resistance to the program is

dissipating as further information is
provided. . . .

"In the early phases of this pro-
gram it is the primary objective of
the Division of Continuing Education
of the Graduate Medical School of
Biomedical Sciences to determine
how educational roles may be dis-
charged within the framework of in-
dividual needs and goals, while at
the same time providing practical and
applicable information which will be
both convenient and accessible to the
physician and others who deliver
health care, and which will ultimately
result in better patient care. . . .

"An attempt will be made to con-
vey the concept that the medical
school not only awards an M.D. de-
gree, but provides annual opportuni-
ties to appraise the practicing phy-
sician  of current attitudes and
techniques, to support the physician
in his need for lifelong learning. . . .

Regional Training Program
in Cardiovascular Disease

"The initial study of personnel
available within the Medical Center
for postgraduate training programs
in the area of cardiovascular disease
has been productive . . . initial con-
siderations have led to plans for re-
fresher courses lasting three to five
days and providing for the participa-
tion of practicing physicians and

other health professionals in the con-
ferences, clinics, and ward rounds of
the Medical Center. . . .

"A study of the applicability of
closed circuit television communica-
tion with one or a few local com-
munity hospitals is of considerable in-
terest. This institution will participate
with others in the region to prepare
formal postgraduate training pro-
grams for television presentation. In
addition, it is proposed to utilize this
medium for individual consultations
with patients who can then remain
in a familiar environment with their
own physicians. . . .

"A general planning study and sur-
vey has been undertaken in the allied
health professions education field to
identify needs, trends, problems, and
resources necessary to implement
grant proposals and program goals in
advancing, through education, train-
ing and demonstrations, the care of
heart-cancer-stroke patients. . . .

"In brief, findings indicate: a gen-
eral awareness that a perilous short-
age of allied health personnel exists
in both numbers and quality . . .
physicians want and need to delegate
more to allied health personnel to
free themselves to serve more pa-
tients . . . a closer liaison is evolv-
ing between educational institutions
and hospitals in the education and
training of all levels of allied health
personnel. . . .

"At the Division of Allied Health
Science at South Texas Junior Col-
lege (Houston, Texas) feasibility
studies are in process in the develop-
ment of curricula in nursing, inhala-
tion therapy, X-ray, medical records,
physical and occupational therapy as-
sistants, medical monitoring and elec-
tronics, ophthalmic assistants and die-
tary supervision. . . .

"At this writing, we have the pros-
pect of a cooperative feasibility study
for a multiphasic screening pilot proj-
ect in conjunction with the Baylor
University College of Medicine com-
puter science program and the De-
partment of Biomathematics of the
University of Texas at Houston. This
would involve a multiphasic automa-
tion and computer project in patient
diagnosis. This would also bring into
focus projects for continuing educa-
tion of physicians in outlying hospitals
and allied health education and train-
ing needs and programs. . . .

"A major introductory activity in-
volved recognition and visitation of
rehabilitation settings within the
Texas Medical Center and in
Houston community agencies. Pro-
grams in these institutions pertinent
to the development of the Program
were explored and an attempt was
made to build with these institutions
appropriate collaboration. These or-
ganizations include : the Methodist
Hospital, the Ben Taub General Has-


pita!, the Physical Medicine and Re-
habilitation Service of the Veterans
Administration Hospital, Houston,
the Visiting Nurse Association of
Houston, the American Cancer So-
ciety, Harris County Unit, and Good-
will Industries. The Texas Woman's
University, although relatively new,
has a distinctive curriculum with
early patient contact. The school is
geared to agency collaboration and is
constructively interested in Regional
Medical Program participation. . . .

"At the University of Texas Dental
Branch restorative dentistry is con-
cerned with a number of cancer pa-
tients, and there is considerable expe-
rience with restoration of the mouth,
face, nose and ears. Prostheses includ-
ing artificial eyes are fabricated.
Closed circuit television has become a
part of the teaching technique. . . .

"It is apparent that new methods
and new techniques must be utilized
to attract those who do not now par-
ticipate in continuing education. . . .

"Progress in the first year of plan-
ning at the M. D. Anderson Hospital
and Tumor Institute has been handi-
capped by lack of success in recruit-
ing a full-time Physician Coordinator
having the special combination of
qualifications deemed essential to this
important position. We have felt it
expedient to evaluate the needed
adjustments between the Texas Med-

ical Association, the various county
medical societies, specific practition-
ers, hospital administrators and this
cancer program which largely has
been designed and planned through
the University's biomedical units. It
has been considered essential that
understanding and agreement be at-
tained in an atmosphere of good will
in order to project further progress.
Therefore, time has been required to
make this adjustment and to reach a
consensus as to goals. In the case of
some existing activities, such as the
cancer registry, there have been on-
going programs under diverse aus-
pices. Before a statewide registry can
be projected, all aspects of existing
programs must be reviewed to fit into
the larger effort in an harmonious
and agreeable fashion."


I

II

III

IV

V

VI

VII

VIII

IX

X

XI

XII

XIII

XIV

Preparation of Report
Ad Hoc Advisory Committee
Planning Grants
Operational Grants
National Advisory Council
Review Committee

Consultants
Program Coordinators
Review of Operational
Grants

Division Staff
Relationships of Public Laws
89-239 and 89-749

Public Law 89-239         I

Regulations
Selected Bibliography


EXHIBITS

EXHIBIT I

Steps in
Preparation of the
Surgeon General's
Report to Congress
on Regional
Medical Programs

To assist in the preparation of the
report required by Section 908 of
Public Law 89-239, the Surgeon
General appointed a Special Ad Hoc
Committee of non-federal consult-
ants. The nucleus of the committee
was four members of the National
Advisory Council on Regional Medi-
cal Programs. Eleven other persons
with diverse backgrounds and inter-
ests in health and public affairs also
joined the group. In addition, six
other individuals with extensive ex-
perience in medical education and
governmental administration agreed
to serve as consultants to the Ad Hoc
Committee. (The members of and
consultants to the Committee are
listed in Exhibit II.)

The Committee met five times. At
the initial meetings, on September 16
and October 7, 1966, issues pertain-
ing to the development and admin-
istration of Regional Medical Pro-
grams were presented and discussed.
From these deliberations came a
series of recommendations for the

steps to be followed in preparing the
Report.

First, an outline of discussion items
was prepared and reviewed at a
meeting on November 7. From these,
the key issues relating to the three
areas specified for consideration in
Section 908 of the Act and other as-
pects of the program were identified
and analyzed.

Subsequently, a national forum
was scheduled at which these issues
were presented for consideration and
reaction from health and related in-
terests representing all sections of the
country. This forum took the form of
a Conference on Regional Medical
Programs held in Washington
(D.C.) on January 15-17, 1967.
Nearly 850 medical, health and civic
leaders were invited. This group in-
cluded persons from both regions
where planning activities were al-
ready underway and from other
areas where proposals were still un-
der development. In addition, many
others with related interests received
invitations. More than 650 persons
attended the Conference.

Faur Issue Papers were prepared
by the Division of Regional Medical
Programs and distributed in advance.
Seven papers were presented at ple-
nary sessions and two panel sessions
were conducted. These presentations
provided background for the 26 dis-

cussion groups of about 25 indi-
viduals each that met three times
during the Conference. The results
of this meeting are published in the
Proceedings: Conference on Re-
gional Medical Programs.

The wealth of information
developed by the Conference was
supplemented by letters and other ma-
terial, voluntarily submitted by par-
ticipants following the Conference.
To gather additional information, the
Division staff made a series of visits
to on-going Regional Medical Pro-
grams and held discussions with Pro-
gram Coordinators and others en-
gaged in the develapment of regiona
activities. A "14-point" survey form
was also distributed to all Program
Coordinators for their use in for-
warding up-to-date data on the status
of their activities and plans. All of
this material was analyzed and used
in the preparation of this Report.

A preliminary draft of the Report
was reviewed by the Ad Hoc Com-
mittee on March 10, 1967. It was
subsequently revised in accordance
with its recommendations and re-
submitted to them on April 14.
After consultation with the members
of the National Advisory Council on
Regional Medical Programs, the Re-
port was submitted to the Secretary
of Health, Education, and Welfare
for transmission to the President and
Congress.


EXHIBIT II

Surgeon Gcncral's Special
Ad Hoc Advisory
Committee To Devclop
the Report on Regional
Medical Programs to
the President and
the Congress

Ray E. Brown, L.H.D.
Director
Graduate Program in Hospital
Administration
Duke University Medical Center
Durham, North Carolina

Michael E. DeBakey, M.D.
Professor and Chairman
Department of Surgery
College of Medicine
Baylor University
Houston, Texas

Bruce W. Eve&t, Jr., M.D 1
Chief of Pediatrics
Green Clinic
Ruston, Louisiana

James T. Howell, M.D.'
Executive Director
Henry Ford Hospital
Detroit, Michigan

George James, M.D.
Dean
Mount Sinai School of Medicine
New York, New York

`Member, National Advisory Council
on Regional Medical Programs.

   268449 047-5

Boisfeuillet Jones
Director
Emily and Ernest Woodruff Foundation
Atlanta, Georgia

Charles E. Odegaard, Ph. D.
President
University of Washington
Seattle, Washington

Edmund D. Pellegrino, M.D.
Director
Medical Center
State University of New York
Stony Brook, New York

Carl Henry William Ruhe, M.D.
Assistant Secretary
Council on Medical Education
American Medical Association
Chicago, Illinois

Clark K. Sleeth, M.D.
Dean
School of Medicine
West Virginia University
Morgantown, West Virginia

Ray E. Trussell, M.D.
Director
School of Public Health and
Administrative Medicine
Columbia University
New York, New York

Burton Weisbrod, Ph. D.
Associate Professor
Department of Economics
University of Wisconsin
Madison, Wisconsin

Robert E. Westlake, M.D.
Syracuse, New York

Storm Whaley (Chairman)
Vice President of Health Sciences
University of Arkansas Medical Center
Little Rock, Arkansas

Paul N. Ylvisaker, Ph. D.
Commissioner
New Jersey Department of Community
Affairs
Trenton, New Jersey

Consultants to the
Surgeon General's Special
Ad Hoc Advisory
Committee To Develop
the Report on Regional
Medical Programs to
the President and
the Congress

Norman Beckman, Ph. D.
Director
Office of Intergovernmental Relations
and Urban Program Coordination
Department  of Housing  and Urban
Development
Washington, D.C.

Ward Darley, M.D.
Office of the Consultant to the Executive

Director

Association of American Medical Colleges
University of Colorado Medical Center
Denver, Colorado

Kermit Gordon
Vice President
The Brookings Institution
Washington, D.C.

Charles Kidd, Ph. D.
Executive Secretary
Federal Council for Science and
Technology
Ofice of Science and Technology
Washington, D.C.
Jack Masur, M.D.
Associate Director for Clinical Care
Administration
Office of the Director
National Institutes of Health
Bethesda, Maryland

Joseph S. Murtaugh
Chief
Office of Program Planning
Office of the Director
National Institutes of Health
Bethesda, Maryland.


62

REGIONAL DESIGNATION    ALABAMA

PRELIMINARY           Alabama
PLANNING REGION.'

POPULATION ESTIMATE    3,5oo,fr96
1965.*

COORDINATING
HEADQUARTERS.

University of Alabama
Medical Center

Same.5                   Same.5

January I, 1967          July 1, 1966

2%                      3

t318,046-1st

$373,254-1st
$384,244-2nd

ALRANY, NEW YORK        ARIZONA                ARKANSAS

Northeastern New York and
portions of Southern Vermont
and Western Massachusetts

Arizona                  Arkansas

EXHIBIT III
Planning Grants for Regional Medical Programs, June 30, 1967

Albany Medical College of
Union University, Albany
Medical Center.

GRANTEE.*

EFFECTIVE STARTING
DATE.

PROGRAM PERIOD
(YEARS).

AWARD
(AMOUNT AND YEAR).

RECOMMENDED FUTURE    $286,750-2nd             $252,4863rd
SUPPORT             $143,375-3rd
(AMOUNT' AND YEAR).

1,960,000

College of Medicine         University of Arkansas
University of Arizona         Medical Center

Same.'                   Same.5

April 1, 1967            April 1, 1967

2%                 2%

t119,045-1st            $360,174-1st

$287,00(&2nd           $421,682-2nd
$67,750-3rd            $97,30(t3rd

' fieliminav regions for planning @urj~oses as dclincated in the original applications. State designations
do not indicate they me cotnminous with State lines. `Z&se preliminary regions may be modified on
the basis of planning and exjurience.
a P+lation estimates include overlap between regions. As fieliminary regional boundaries are evaluated
and cIa$ed during the planning process, inappropriate overlap will be eliminated.

3 The Grantee defers from the Coordinating Headquarters when the Region requested this arrangemmt
or the latter agency did not have the capability to assume formal &at responsibility.
' Direct costs only.
s Indicates the Grantee Agency and the Coordinating Headquarters arc the same organization.


63

REGIONAL DESIGNATION

PRELIMINARY
PLANNING REGION.'

POPULATION ESTIMATE
1965.2

COORDINATING
HEADQUARTERS.

GRANTEE.3

EFFECTIVE STARTING
DATE.

PROGRAM PERIOD
(YEARS).

: AWARD
(AMOUNT AND YEAR).

I
RECOMMENDED FUTURE
SUPPORT
) (AMOUNT' AND YEAR).

-

_-

--

--

--

--

--

_-

B&STATE

Eastern Missouri and
Southern Illinois centered
around St. Louis

CALIFORNIA

California

4,700,000

Washington University School
of Medicine

Same.5

18,600,ooo

California Committee on
Regional Medical Programs

California Medical Education
and Research Foundation

April 1, 1967            November 1, 1966

2%                 2%

8603,965-1st            81,511,381-1st

$547,989-2nd            $2,198,452-2nd
$135,993-3rd            3961,982-3rd

-

--

--

--

--

--

_-

_-

_-

CENTRAL NEW YORK

Syracuse, N.Y., and 15
surrounding counties

1,800,OOO

Upstate Medical Center,
State University of
New York at Syracuse

Research Foundation of State
University of New York

January 1, 1967

2

$289,522-1st

$211,206-2nd

-

-.

-.

_-

__

.-

.-

.-

.-

COLORADO-WYOMING

Colorado and Wyoming

2,300,OOO

University of Colorado
Medical Center

Same.&

January 1, 1967

2312

$361,984-1st

$326,114-2nd
$170,662-3rd

                                                 I                          I

' Preliminary regionsfor filanning gur~oscs as delineated in the original applicarions. Stale dtsignalions  a The Grantee d$crs jrom the Coordinating Headquarters when the Region requested this arrangement
do not indicate they arc cotnminous with Slate lines. Thcsc preliminary regions may be mod&d on   OT the latter agency did not have Ihc capabilily LO assume formal fi(ca1 responsibility.
the basis of planning and cxpnicncc.                            ' Direcr costs only.
2 Population eslimaks include overlap between rcgioas. As preliminary regional boundaries arc evaluated  5 Indicates the Grantee Agency and the Coordinaring Hcadquarfcrs are fhc same organization.
and clarified during the planning firocess, inappropriate ovnlap will be tliminalcd.


64

-

-_

--

--

_-

_-

--

_-

_-

-

HAWAII

CONNECTICUT

REGIONAL DESIGNATION

GEORGIA                GREATER
                      DELAWARE VALLEY

Georgia

Eastern Pennsylvania and
portions of Delaware and
New Jersey

__

_-

_-

._

.-

.-

.-

.-

-

PRELIMINARY
PLANNING REGION. '

Ckmnccticut

Hawaii

POPULATION ESTIMATE
196K2

2,800,OOO

800,000

4,400,000              8,800,000

COORDINATING
HEADQUARTERS.

University of Hawaii College
of Health Sciences

Yale University Medical
School and University
of Connecticut School of
Medicine

Yale University School of
Medicine

Medical Association of Georgia

University City
Science Center

Same.5

I

Same."

Same.s

GRANTEE.3

EFFECTIVE STARTING
DATE.

July 1, 1966

July 1, 1966

January 1, 1967           April 1, 1967

PROGRAM PERIOD
(YEARS).

3

2

2%                       1

AWARD              $406,622-1st
(AMOUNT AND YEAR).     $338,513-2nd

8240,098-I st            81,531,49+1st

$108,006-1st
$119,122-2nd

RECOMMENDED FUTURE
SUPPORT
(AMOUNT' AND YEAR).

3312,761-3rd

$203,207-2nd
6 104,749-3rd

`Preliminary rqionr jar planning purposes as delineated in the original applications. State designations
do not indicate they are coterminous with State lines. Thrse preliminary regions may be modified on
the basis of planning and experience.
' Population estimates include overlap between regions. As preliminary regional boundaries are evaluated
and clarifed during the planning process, inappropriate overlap will be eliminated.

3 The Grantee d#ers from the Coordinating Headquarters when the Region requested this arranqcmcnt
or the latter agency did not have the capability to assume formal fiscal responsibility.
e Direct costs only.
J Indicates the Grantee Agency and the Coordinating Headquarters are the same orqanization.


65

REGIONAL DESIGNATION

PKELlMINAl~E
PLANNING ICEGION.'

ILLINOIS

Illinois

POPULATION ESTIMATE    10,700,000
1965."

COORDINATING
HEADQUARTERS.

Coordinating Committee of
Medical Schools and Teaching
Hospitals of Illinois

GRANTEE."

EFFECTIVE STARTING
DATE.

University of Chicago

July 1, 1967

PROGRAM PERIOD         2
(YEARS).

AWARD               8336,366-I st
I AMOUNT AND Y LAR j.

I~ECOMMENDEl~ FUTURE
SUPPORT
(AMOUNT ' AND YEAR).

$244,175-2nd

-.

_.

-.

_.

__

._

._

-

INDIANA

Indiana

4,900,000

Indiana University School      University of Utah School
of Medicine                of Medicine

Indiana University Foundation

Same.3

January 1, 1967

July 1, 1966

2%

2

5384,750-1st

$373,710-2nd
$152,295-3rd

INTERMOUNTAIN

Utah and portions of Colorado,
Idaho, Montana, Nevada, and
Wyoming

2,200,ooo

$456,415-1st
8363,52&2nd

-

--

--

--

--

--

_-

_-

.-

-

IOWA

Iowa

2,800,OOO

University of Iowa College
of Medicine

Same.5

December 1, 1966

2

5291,34&l--1st

8230,ZI 8-2nd

' Preliminary regions for planning purposes as dclincatcd in the original applications. State designations
do not indicate they arc coterminous with State lints. These preliminary regions may be mod$ed on
the basis of planning and expcrienca.
2 Population estimates include overlap between regions. As preliminary regional boundaries arc rvaluated
and clar(fied during the planning process, inappropriate overlap will be eliminated.

5 The Grantee dtxersfrom the Coordinating Hendquortcrs when the Region requested this arrangement
or the latter ogtncy did not have the capability to assume formal fiscal responsibility.
c Direct costs only.
J Indicates the Grantee Agency and the Coordinating Headquarters ore the same organization.


66

REGIONAL DESIGNATION    KANSAS

PRELIMINARY
PLANNING REGION.'

KatXis

POPULATION ESTIMATE
1965.*

--

COORDINATING
HEADQUARTERS.

2,200,000

University of Kansas
Medical Center

GRANTEE.3

Same.s

EFFECTIVE STARTING
DATE.

July 1, 1966

PROGRAM PERIOD
(YEARS).

2

AWARD
(AMOUN'J AND YJiAJl).

5197,94%1st
$293,080-2nd

RECOMMENDED FUTURE
SUPPORT
(AMOUNT' AND YEAR).

LOUISIANA

Louisiana

3,5oo,oOo

Louisiana State Department
of Hospitals.

Same. 5

January 1, 1967

2

$490,448-1st

$514,251-2nd

.-

.-

.-

.-

.-

.-

.-

.-

-

MAINE

Maine

1,000,000

Medical Care
Development, Inc.

Same.5

May 1, 1967

2

$193,909-1st

$204,709-2nd

-

--

--

--

--

--

--

_-

--

-

MARYLAND

Maryland

3,520,OOO

Steering Committee of the
Regional Medical Programs
for Maryland.

The Johns Hopkins University

January 1, 1967

2

$518,443-1st

f431,821-2nd

' Preliminary regions for planning purposes as delineated in the original applications. State designations
do not indicate they are coterminous with State lines. These preliminary regions may be modzJicd on
the basis of planning and experience.
o Population estimates include overlap between regions. As preliminary regional boundaries are evaluated
and clarified during the planning process, inuppropriatc overlap will be eliminated.

3 The Grantee dozers from the Coordinating Headquarters when the Region requested this orrangemen;
or the latter agency did not have the capability to assume form01 fiscal responsibility.
' Direct costs only.
5 Indicates the Grantee Agency and the Coordinating Headquarters ure the same organization.


67

REGIONAL DESIGNATION

PRELIMINARY
PLANNING REGION.'

POPULATION ESTIMATE
1965.s

COORDINATING
HEADQUARTERS.

GRANTEE.3

EFFECTIVE STARTING
DATE.

PROGRAM PERIOD
(YEARS).

AWARD

-

.-

.-

.-

.-

.-

.-

.-

.-

$173,119-1st

(AMOUNT AND YEAR).

RECOMMENDED FUTURE    $140,000-2nd
SUPPORT              $54,825-3rd

t (AMOUNT 4 AND YEAR).

MEMPHIS

Western Tennessee, Northern
Mississippi, and portions
of Arkansas, Kentucky,
and Missouri

2,400,OOO

Mid-South Medical Council
for Comprehensive
Health Planning, Inc.       -
University of Tennessee
College of Medicine

April 1, 1967

2%

METROPOLITAN
WASHINGTON, D.C.

District of Columbia and
2 contiguous counties in
Maryland, 2 in Virginia,
and 2 independent cities
in Virginia.

2,050,OOO

District of Columbia
Medical Society

Same.5

January 1, 1967

2%

$203,790-1st

8 169,658-2nd
884,829-3rd

-

-_

-.

--

-_

--

-_

-_

-_

MICHIGAN

Michigan

8,220,ooo

Michigan Association
for Regional Medical
Programs, Inc.

Same.s

June 1, 1967

1

$1,294,449-1st

-

--

--

--

--

--

--

--

--

-

MISSISSIPPI

Mississippi

2,320,OOO

University of Mississippi
Medical Center

Same.5

July 1, 1967

2

8322,845-ht

$295,825-2nd

r Preliminary regions for planning purposes as delineated in the original applications. State designations
do not indicate they are coterminous with State lines. These preliminary regions may be modrjied on
the basis of planning and experience.
r Population estimates include overlap between regions. As preliminary regional boundaries are evaluated
and clarified during the planning process, inappropriate ouerlap will be eliminated.

3 The Grantee dr$crs from the Coordinating Headquarters when the Region requcstcd this arrangement
or the latter agency did not have the capability to assume formal jiscal responsibility.
4 Direct costs only.
5 Indicates the Grantee Agency and the Coordinating Headquarters are the same organization.


6%

REGIONAL DESIGNATION

PRELIMINARY
PLANNING REGION.'

POPULATION ESTIMATE
1965.2

COORDINATING
HEADQUARTERS.

GRANTEE.3

EFFECTIVE STARTING
DATE.

PROGRAM PERIOD
(YEARS).

AWARD
(AMOUNT AND YEAR).

RECOMMENDED FUTURE
SUPPORT
(AMOUNT ' AND YEAR).

-

--

-_

-_

--

--

--

--

--

-

MISSOURI

Missouri

4,500,ooo

University of Missouri
School of Medicine

Same.5

July 1, 1966

3

$398,556-1st
$324,254-2nd

$368,125-3rd

-

-.

-.

-.

-_

--

-_

-_

-_

-

MOUNTAIN STATES

Idaho, Montana, Nevada
and Wyoming

2,200,000

2,200,000

Western Interstate Commission    Nebraska State Medical
for Higher Education          Association

Same.5

November 1. 1966

2

8876,855-1st

$761,983-2nd

NEBRASKA-
SOUTH DAKOTA

Nebraska and South Dakota

Same."

January 1, 1967

2

$350,339-1st

$281,450-2nd

NEW MEXICO

New Mexico

1 ,ooo,ooo

University of New Mexico
School of Medicine

University of New Mexico

October 1, 1966

2%

$449,736--1st

$729,285-2nd
$545,49 I-3rd

' Preliminary regions for planning purposes as delineated in the original applications. State designations
do not indicate they are cotcrminous with State lines. These preliminary regions may be modified on
the basis of planning and experience.
o Population estimates include overlap between regions. As preliminary regional boundaries are tvaluatcd
and clarified during the planning process, inappropriate overlap will be eliminated.

3 The Grantee d$crs from the Coordinating Headquarters when the Region requested this arrangemen
or the latter agency did not have the capability to assume formal@al responsibility.
4 Direct costs only.
o Indicates the Grantee Agency and the Coordinafing Headquarters are the same organization.


69

-

-_

--

--

--

--

--

--

--

-

-

--

--

--

--

--

--

--

--

-

NORTHERN NEW ENGLAND

NEW YORK
METROPOLITAN AREA

NORTH CAROLINA

NORTHLANDS

REGIONAL DESIGNATION

--

PRELIMINARY
PLANNING REGION.'

New York City, and Nassau,
Suffolk and Westchester
Counties.

POPULATION ESTIMATE
1965.?

11,400,ooo

COORDINATING           Associated Medical Schools
HEADQUARTERS.          of Greater New York.

GRANTEE.%

Same.5

EFFECTIVE STARTING
DATE.

June 1, 1967            July 1, 1966

PROGRAM PERIOD
(YEARS).

2

AWARD
(AMOUNT AND YEAR).

$967,010-1st

RECOMMENDED FUTURE
SUPPORT
(AMOIJNT ' AND YEAR).

$96 1,957-2nd

North Carolina

Vermont and 3 counties in
Northeastern New York.

Minnesota

4,900,ooo

550,ooo

3,600,ooo

Minnesota State Medical
Association Foundation

Association for the North Carolina
Regional Medical Program.

University of Vermont
College of Medicine.

Duke University

Same.s

Same."

July 1, 1966

January 1, 1967

2

$435,851-1st
$600,944-2nd

3

$316,186-1st
$377,701-2nd

2%

$370,904--1st

$234,872-3rd

$469,080-2nd
$234,700-3rd

1 Preliminary rqionr for planning purposes as delineated in the original applications. State designations
do not indicate they are cotnminous with State lines. These preliminary regions may be modified on
the basis of planning and experience.
1 Population estimates include overlap between regions. As preliminary regional boundaries arc evaluated
and clarified during the planning process, inappropriate overlap will be eliminated.

a The Grantee d+rs from the Coordinating Headquarters when the Region requested this arrangement
or the latter agency did not have the capability to assume formal fiscal responsibility.
4 Direct costs only.
5 Indicates the Grantee Agency and the Coordinating Htadquarters arc the same organization.


70

REGIONAL DESIGNATION

PRELIMINARY
PLANNING REGION.'

OHIO STATE

Central and Southern T$ of
Ohio (61 counties excluding
Metropolitan Cincinnati
area).

OHIO VALLEY
-
Greater part of Kentucky and
contiguous parts of Ohio,
Indiana, and West Virginia.

OKLAHOMA

Oklahoma

OREGON

Oregon

POPULATION ESTIMATE    4,500,OOo              5,900,000               2,500,OOO               1,900,000
196X*

COORDINATING
HEADQUARTERS.

GRANTEE.3

Ohio State University
College of Medicine.

Same.s

Ohio Valley Regional
Medical Program.

University of Kentucky
Research Foundation

University of Oklahoma
Medical Center.

Same.5

University of Oregon
Medical School.

Same.s

EFFECTIVE STARTING
DATE.

April 1, 1967

January 1, 1967

September 1, 1966

April 1, 1967

PROGRAM PERIOD         1                       2                       2                 2%
(YEARS).

AWARD              $109,417-1st            $346,760-1st            8177,963-1st            $219,168-1st
(AMOUNT AND YEAR).

RECOMMENDED FUTURE
SUPPORT
(AMOUNT ' AND YEAR).

$232,371-2nd            $136,168-2nd

$17 1,998-2nd
$44,078-3rd

' Beliminary regions for planning purposes as delineated in the original applications. State designations
do not indicate they are coterminous with State lines. These preliminary regions may be modified on
the basis of planning and experience.
' Population estimates include overlap between regions. As preliminary regional boundaries are evaluated
and cla$ed during the planning process, inappropriate overlap will be eliminated.

3 The Grantee dzyeers from the Coordinating Headquarters when the Region requested this arraWmf*:
or the latter agency did not have the capability to assume formal fiscal rcsponfibility.
' Direct costs only.
6 Indicates the Grantee Agency and the Coordinating Headquarters arc the same organization.


71

KI:GION;1L DESIGNATION

Pl~Ll.lhIlNARY
I'I.ANNlNC RIXION.

POPULATION ESTIMATE
1965.'

COORDINATING
HEADQUARTERS.

GRANTEE.3

EFFECTIVE STAR'1 ING
DATE.

PROGRAM PERIOD
(YEARS).

AWARD
(AMOUNT AND YEAR).

RECOMMENDED FUTURE
SUPPORT
(AMOUNT 4 AND YEAR).

ROCHESTER, NEW YORK

Rochester, N.Y., and 11
surrounding countics.

SOUTH CAROLINA

South Carolina

University of Rochester
School of Medicine and
Dentistry.

Medical College of South
Carolina.

Same.5                    Same."

October 1, 1966          January 1, 1967

$306,985--1st

$329,364-2nd
8259,900-3rd

$65,906-l&

SUSQUEHANNA VALLEY,     TENNESSEE MID4OUTI-l
PENNSYLVANIA

24 counties centered around
Harrisburg and Hershey.

Eastern and Central Tennessee
and contiguous parts of
Southern Kentucky and
Northern Alabama.

2,100,000

Pennsylvania Medical Society.

2,600,OOO

Vanderbilt University School
of Medicine and Meharry
College of Medicine.

Same.s

June 1, 1967

2

$263,530-1st

Vanderbilt University.

July 1, 1966

2

$265,841-1st
$393,458-2nd

$249,550-2nd

' Preliminary regions jor planning purposes as delineated in the original applications. State designations
do not indicate they are coterminous with State lines. These preliminary regions may be modified on
the basis of planning and experience.
2 Population estimates include overlap between regions. As preliminary regional boundaries are evaluated
and clarijied during the planning process, inappropriate overlap will be eliminated.

a The Grantee d$ers from the Coordinating Headquarters when the Region requested this arrangement
or the latter agency did not have the capability to assume formal fiscal responsibility.
4 Direct costs only.
5 Indicates the Grantee Ageruy and the Coordinating Headquarters are the same organizalion.


72

REGIONAL DESIGNATION

PRELIMINARY
PLANNING REGION.'

TEXAS

Texas

VIRGINIA

Virginia

WASHINGTON-ALASKA

Alaska and Washington

POPULATION ESTIMATE    10,500,000              4,500,000              3,200,OOO

1965.2

COORDINATING
HEADQUARTERS.

University of Texas

Medical College of Virginia and
University of Virginia School
of Medicine.

University of Washington
School of Medicine.

GRANTEE."               Same.'

University of Virginia School of
Medicine.

Same.5

EFFECTIVE STARTING
DATE.

July 1, 1966

January 1, 1967

-

September 1, 1966

AM'AKI)
(AMOUN'I' AN11 YICAIt).

$1,271,013-1st
$1,260,181--2nd

$291,454-1st            $266,248-1st

$133,987-3rd

$254,000-2nd

$230,934-2nd
$241,79%3rd

WEST VIRGINIA

West Virginia

1,800,OOO

West Virginia University
Medical Center.

Same.s

January 1, 1967

$150,798-1st

$175,250-2nd
$91,25&3rd

I

' fteliminnry regions fm Planning purposes as delineated in the original applications. State designations
do not indicate they are coterminous with State liaes. These prliminarv rcgiow may be modijed on
the basis of Planning and experience.
' Population estimates include overlap between regions. As preliminary regional boundaries are evaluated
and cf@$d during lh planning Process, inappropriate overlap will be eliminated

3 The Grantee dt@rs from the Coordinating Headquarters when the Region requested this arrangement
or the latter agency did not have the capability to assume formal fiscal responsibility.
' Direct costs only.
6 Indicates the Grantee Agency and the Coordinating Headquarters are the same organization.


73

PR~1.II\IINARY
PLANNING REGION.'

POPULATION ESTIMA'I`E
1965.2

COORDINATING
HEADQUARTERS.

GRANTEE.:'

EFFECTIVE STARTING
DATE.

PROGRAM PERIOD
(YEARS).

AWARD
(AMOUNT AND YEAR).

RECOMMENDED FUTURE SUPPORT
(AMOUNT I AND YEAR).

WESTERN NEW YORK

Buffalo, N.Y., and 7 surrounding
counties.

1,900,000

School of Medicine, State
University of New York at
Buffalo in cooperation with the
Health Organization of Western
New York.

The Research Foundation of
State University of New York

December 1, 1966

2

$149,241-1st

8 117,626-2nd

WESTERN PENNSYLVANIA

Pittsburgh, Pa., and 28
surrounding counties.

4,200,OOO

University Health Center
of Pittsburgh.

Same.5

January 1, 1967

236

$340,556-1st

$260,484-2nd
$137,618-3rd

-

-.

_.

__

_.

-.

_.

-.

-.

-

WISCONSIN

Wisconsin

4,100,000

Wisconsin Regional
Medical Program, Inc.

Same.P

September 1, 1966

2

f344,418-1st

8341,000-2nd

1 Preliminary rtgions for planning purposes as delineated in the original applications. State designations
do not indicate they arc cotnminous with State lints. These preliminary regions may be modified on
the basis of planning and cxpnitncc.

1 Pc$ulation tstimates include overlap bctwtcn rtgions. Asprtliminary rtgional boundarits arc evaluated
and clarified during the planning p~occss, inappropriate overlap will be rliminattd.

a The Granter d@rs from tht Coordinating Htadquarfns when tht Rtgion requested this arrangement
or the latter agtncy did not hnvc the capability to assume formal fiscal rcsponribility.
( Dirtct costs only.

6 Indicates tht Ganttt Agency and tht Coordinating Htadquartcrs me the samt organization.


74

EXHIBIT IV

Operational Grants for Regional Medical Programs, June 30, 1967

REGIONAL DESIGNATION

REGION.

ALBANY, NEW YORK

Northeastern New York and
portions of Southern Vermont
and Western Massachusetts.

POPULATION ESTIMATE    1,900,000
1965.

COORDINATING
HEADQUARTERS.

Albany Medical College of
Union University, Albany
Medical Center.

GRANTEE.

EFFECTIVE STARTING
DATE.

Same.'

April 1, 1967

PROGRAM PERIOD         2
(YEARS).

FIRST-YEAR AWARD.

RECOMMENDED FUTURE
SUPPORT
(AMOUNT r AND YEAR).

$914,627-1st

S750,000-2nd

-

--

_-

--

_-

--

_-

_-

-c

-

INTERMOUNTAIN

Utah and portions of Colorado,
Idaho, Montana, Nevada,
and Wyoming.

2,200,000

University of Utah School
of Medicine.

Same. *

April 1, 1967

$1,790,603-1st

8 I, 162,049-2nd
$1,036,378-3rd

-

-.

-.

_.

-.

_.

_.

__

_-

-

KANSAS

Kansas

MISSOURI

Missouri, exclusive of
Metropolitan St. Louis.

                                                -

2,200,000               2,400,OOO

University of Kansas
Medical Center.

University of Missouri
School of Medicine.

Same. l

Same.'

June 1, 1967

April 1, i967

2                        2

$1,076,600-1st           $2,887,903-l st

f I ,OOO,OOO--2nd           $2,625,0OO-2nd

1 Indicatts that tht Grantee Agency and the Coordinating Htadquartcrs are the same organization.

2 Dirtct costs only.


75

EXHIBIT V

National Advisory Council on
`, Regional Medical Programs

Leonidas H. Berry, M.D.
Professor
Cook County Graduate School of Medi-
cine
Senior Attending Physician
Michael Reese Hospital
Chicago, Illinois

Mary I. Bunting, Ph. D?
President
Radclifie College
Cambridge, Massachusetts
Gordon R. Cumming '
Administrator
Sacramento County Hospital
Sacramento, California

Michael E. DeBakey, M.D.
Professor and Chairman
Department of Surgery
School of Medicine
Baylor University
Houston, Texas

Bruce W. Everist, Jr., M.D.
Chief of Pediatrics
Green Clinic
Ruston, Louisiana

Charles J. Hitch
Vice President for Administration
University of California
Berkeley, California

John R. Hogness, M.D.
Dean
School of Medicine
University of Washington
Seattle, Washington

James T. Howell, M.D.
Executive Director
Henry Ford Hospital
Detroit, Michigan

J. Willis Hurst, M.D.'
Professor and Chairman
Department of Medicine
School of Medicine
Emory University
Atlanta, Georgia

Clark H. Millikan, M.D.
Consultant in Neurology
Mayo Clinic
Rochester, Minnesota

George E. Moore, M.D.
Director
Roswell Park Memorial Institute
Buffalo, New York

William J. Peeples, M.D.3
Commissioner
Maryland State Department of Health
Baltimore, Maryland

Edmund D. Pellegrino, M.D.
Director
Medical Center
State University of New York
Stony Brook, New York

Alfred M. Popma, M.D.
Regional Director
Mountain States Regional Medical
Program
Boise, Idaho

Mack I. Shanholtz, M.D.
State Health Commissioner
State Department of Health
Richmond, Virginia

Robert J. Slater, M.D.'
Dean
College of Medicine

University of Vermont
Burlington, Vermont
Cornelius H. Traeger, M.D.
New York, New York

ex o&i0

William H. Stewart, M.D. (Chairman)
Surgeon General
Public Health Service
Bethesda, Maryland

Liaison Members to
the National Advisory Council
on Regional Medical Programs

Liaison Member for National
Advisory Cancer Council

Sidney Farber, M.D.3
Director of Research
Children's Cancer Research Foundation
Boston, Massachusetts

Murray M. Copeland, M.D.
Associate Director
M.D. Anderson Medical Hospital
and Tumor Institute
Texas Medical Center
Houston, Texas

Liaison Member for National
Advisory General
Medical Sciences Council

Edward W. Dempsey, Ph. D.
Chairman
Department of Anatomy
College of Physicians and Surgeons
Columbia University
New York, New York

Liaison Member for National
Advisory Neurological Diseases
and Blindness Council

A. B. Baker, M.D.
Professor and Director
Division of Neurology
University of Minnesota
Minneapolis, Minnesota

A. Earl Walker, M.D.
Professor of Neurological Surgery
Johns Hopkins University
Baltimore, Maryland

Liaison Member for National
Advisory Heart Council

John B. Hickam, M.D.
Professor and Chairman
Department of Medicine
Indiana University Medical Center
Indianapolis, Indiana

Liaison Member for the
Veterans Administration

Benjamin B. Wells, M.D.
Assistant Chief Medical Director
for Research and Education in
Medicine

Department of Medicine and Surgery
Veterans Administration
Washington, D.C.

`Resigned January 1967.
f Membership terminated November
1966.

D Appointment expired September 1966.