lmilil$APIIIII


                                                                I







                                              CONTENTS


                   REGION                                                       Page

                   *ALABANM    ..................................                  1

                    ALASKA, see Washington -Alaska

                   -@ALBANY   ...................................                  5

                    AMERICAN SAMOA, see Hawaii

                    ARIZONA    ..................................                  10

                   *ARKANSAS
                      see  also   Memphis ............................             11

                    BI-STATE   ..................................                  17

                   -CALIFORNIA                   ................................  19

                   *CENTRAL NEW YORK                    .........................  25

                   *COLORADO - WYOMING                   ........................  31

                   *CONNECTICUT                    ..............................  37

                    DELAWARE, see Greater Delaware Valley

                   *FLORIDA    ..................................                  42

                   *GEORGIA    ..................................                  47

                   *GREATER DELAWARE VALLEY                   ...................  53

                    GUAM, see Hawaii

                   *HAWAII    ...................................                  56

                    IDAHO, see Intermountain; Mountain States

                    ILLINOIS
                      see also Bi-State ............................               61

                   --INDIANA
                      see also Ohio Valley             ..........................  63

                   *INTERMOUNTAIN       .............................              67

                   -@IOWA                   .....................................  74

                   *KANSAS    ...................................                  77


                   *Includes operational projects
                                                      I




               REGION                                                  Page

                KENTUCKY, see Memphis; Ohio Valley;
                   Tennessee Nfid-South


                LOUISIANA              ................................. 86

               *NMINE               .................................... 88

               *MARYLAND                ................................ 93

                MASSACHUSETTS,   see   Tri-State

               *NMMPHIS               .................................. 98

               *METROPOLITAN WASHINGTON,       D. C.      .............. 104

                MICRONESIA, see Hawaii

               *MICHIGAN               ................................. 109

                MINNESOTA, see Northlands

                MISSISSIPPI, see also Memphis  ...................      114

               *MISSOURI, see also Bi-State; Memphis . . . . . . . . . . . . .  .116

                MONTANA, see Intermountain; Mountain States

               *MOUNTAIN     STATES           ........................... 125

                NASSAU-SUFFOLK    ............................          129

                NEBRASKA-SOUTH DAKOTA              ..................... 130

                NEVADA, see California; Intermountain

                NEW  HAMPSHIRE,  see   Tri-State

               *NEW JERSEY, see also Greater Delaware Valley    ........ 132

               *NEW MEXICO               ............................... 136

                NEW YORK, see Albany; Central New York;
                   Nassau-Suffolk; New York Metropolitan;
                   Rochester; Western  New  York

                NEW YORK METROPOLITAN              ..................... 140

               *NORTH CAROLINA    ............................          141

                NORTH DAKOTA               ............................. 148

                NORTHEAST OHIO    ............................          149

               *NORTHERN NEW ENGLAND               ..................... 151

               *Includes operational projects
                                             if




                  REGION                                                 P   @e

                  *NORTHLANDS    ..............................            154

                   NORTHWESTERN OHIO              ........................ 159

                  *OHIO STATE, see also Northeast Ohio;
                      Northweste n@bhi-o, Ohio Valley       ................ 160

                  *OHIO VALLEY   ..............................            162

                  *OKLAHOMA                ............................... 165

                  @OREGON                ................................. 170

                   PENNSYLVANIA, see Greater Delaware Valley;
                      Susquehanna Valley; Western Pennsylvania

                   PUERTO RICO   ..............................            174

                   RHODE ISLAND, see Tri-State

                  *ROCHESTER     ..............................            176

                  *SOUTH CAROLINA              ........................... 182

                   SOUTH DAKOTA, see Nebraska-South Dakota

                  *SUSQUEHANNA VALLEY     .......................          188

                  *TENNESSEE      MID-SOUTH
                      see also Memphis           ......................... 192
                  *TEXAS               ................................... 20,

                  *TRI-STATE              ................................ 210

                   UTAH, see  Intermountain

                   VERMONT, see Northern New England

                   VIRGINIA              ................................. 213

                  *WASHINGTON-ALASKA              ........................ 215

                   WASHINGTON, D. C.,
                      see Metropolitan Washington, D. C.

                   WEST   VIRGINIA
                      see also Ohio Valley .......................         zzi

                   WESTERN INTERSTATE COMMISSION FOR
                      HIGHER EDUCATION (WICHE),
                      see Mountain States

                  *Includes operational projects





             REGION                                             Page

             *WESTERN NEW YORK          ......................... 222


              WESTERN PENNSYLVANIA         ...................... 227


             *WISCONSIN          ................................ Z29

              WYOMING, see Colorado-Wyoming; Intermountain;
                 Mountain States


              INDEX          .................................... 234

















































              *Includes operational projects
                                          rv






                                                          ALABAMA - I


          NAUE OF PROGRAM              Alabama Regional Medical Program

          GEOGRAPHICAL REGION          State of Alabama


          ESTIMATED POPULATION         3, 558, 000

          COORDINATING HEADQUARTERS    Alabama Regional Medical Program
                                       1917 Fifth Avenue. South
                                       Birmingham, Alabama 35233
                                       (Tel.: 205/325-5394)

          GRANTEE ORGANIZATION         University of Alabama Medical Center

          EFFECTIVE STARTING DATE      January 1, 1967
          OF PLANNING ACTIVITIES

          EFFECTIVE STARTING DATE      April 1, 1969
          OF OPERATIONAL ACTIVITIES

          TOTAL FUNDING TO DATE        $1, 885,955

          FUNDING FOR CURRENT          $903, 105
          YEARIS ACTIVITIES

          CHAIRMAN, REGIONAL           T. JosephReeves, M.D.
          ADVISORY GROUP               Professor and Chairman of Medicine
                                       University of Alabama Medical Center
                                       1919 Seventh Avenue, South
                                       Birmingham, Alabama 35233
                                       (Tel.: 205/325-4651)

          PROGRAM COORDINATOR          *Benjamin B. Wells, M.D., Ph.D.

          STAFF                        DIRECTOR
                                       John M. Packard, M.D.

                                       ASSOCIATE DIRECTORS


                                          FOR PROFESSIONAL LIAISON
                                          J.0. Finney, M.D.

                                          FOR CANCER
                                          John R. Durant, M.D.


                                          FOR ADMINISTRATION
                                          Joseph J. Mason, Jr.

                                          FOR HEART AND STROKE
                                          Harold W. Schnaper, M.D.








          *Chief Executive Officer






                                                                      ALABAMA - 11


          STAFF (Continued)                     ASSOCIATE DIRECTORS (Continued)

                                                   FOR MOBILE AREA
                                                   IvL L. Campbell, M.D.
                                                   Mobile General Hospital
                                                   2451 Fillingim Street
                                                   Mobile, Alabama 36617
                                                   (Tel.: Z05/473-0341, ext. 250)

                                                ASS TSTANT DIRECTOR FOR PROGRAM
                                                DEVELOPMENT
                                                Paul K. Kennedy

                                                   NURSE SPECLALIST
                                                   Sue Weathington, R.N.

                                                   COORDINATOR FOR HEALTH
                                                   INSTITUTIONS
                                                   M.  D.  Plowden


                                                ASSISTANT DIRECTOR FOR RE-
                                                SEARCH AND EVALUATION
                                                Charles L. Joiner, Ph.D.

                                                   HEALTH PLANNER
                                                   Richard W. Thompson, Ph.D.

                                                   SYSTE@ ENGINEER
                                                   David  R.  Shaw


                                                OPERATIONS STAFF CHIEF
                                                John W.  Gillespie

                                                   ADMINISTRATIVE ASSISTANTS
                                                   Robert J.  Shaw
                                                   Catherine Crooks


                                                   STAFF ASSISTANT
                                                   Virginia  Buryn

                                                OFFICE OF COMMUNICATIONS AND
                                                PUBLIC INFORMATION
                                                Jane Davis (Visual Arts Specialist)

                                                HEALTH PLANNING LIAISON OFFICE


                                                   DIRECTOR, APPALACHIAN RE-
                                                   GIONAL COMMISSION
                                                   .Dennis Q. Opheim
                                                   Tri-County Regional Health Planning
                                                   Commission
                                                   P. 0. Box  1347
                                                   Decatur, Alabama 35601
                                                   (Tel.: 205/353-3800)






                                                                      ALABAMA - III

             STAFF (Continued)                     PLANNING OFFICE, COMPREHEN-
                                                   SIVE HEALTH PLANNING
                                                   Loren C. Nfiller
                                                   State Department of Public Health
                                                   State Office Building
                                                   Montgomery, Alabama 36104
                                                   (Tel.: 205/365-2341, ext. 3435)











































                                           -3-






                                                                         ALABAMA       IV


           APPROVED OPERATIONAL PIROJECTS




           HEALTH MANPOWER PROGRANO IN THE JUNIOR COLLEGE

           Objectives:   Pilot project at Jefferson State Jr. College to attempt to demon-
                         strate feasibility of health service manpower training in junior
                         colleges and vocational schools throughout the state. Immediate
                         aim is double size of existing nursing and medical records pro-
                         grarn.  Region intends to support this institution until the Allied
                         Health Professions Act funding is picked up.  Funds requested
                         primarily to support salaries of instructors.


           TRAINING PROGRAM IN REALITY ORIENTATION TECHNIQUE

           Objectives:   To improve care and rehabilitation of older patients with cere-
                         brovascular disease and stroke.  Training will be directed
                         toward a broad spectrum of health service personnel, with
                         special attention to lower echelon personnel in nursing homes
                         that therapeutic patient environment will replace custodial en-
                         vironment.  Methods  developed  by  Dr.  James  C.  Folsom  of
                         Veterans Administration Hospital in  Tuscaloosa  will  be  em-
                         ployed in order to orient patient to reality.


           NURSING EDUCATION IN CORONARY CARE

           Objectives:   A coordinated approach between registered and licensed prac-
                         tical nurses in care of coronary patients.  Birmingham Baptist
                         Hospital will hold five classes of 15 Registered Nurses and 15
                         Licensed Practical Nurses each, and seeks support largely for
                         personnel, office supplies, alterations and  renovations,  and
                         stipends.


           A RADIOISOTOPE SERVICE IN A COMMUNITY HOSPITAL

           Objectives: Decatur General Hospital staff proposes  to  establish  a  basic
                         service for the use of radioisotopes in diagnosis and treatment.
                         Principal objectives will be improvement of patient care and
                         teaching by demonstration.













                                             -4-





                                                                           ALBANY

               NAME OF PROGRAM                     Albany Regional Medical Program
               GEOGRAPHICAL REGION                 Northeastern New York and portions of
                                                   Southern Vermont and Western @ssa-
                                                   chusetts

               ESTIMATED POPULATION                2, 090, 000
               COORDINATING HEADQUARTERS           Albany Regional Medical Program
                                                   Albany Medical College of  Union
                                                   University
                                                   47 New Scotland Avenue
                                                   Albany, New York 12208
                                                   (Tel.: 518/462-75Zl)
               GRANTEF, ORGANIZATION               Albany Medical College of  Union
                                                   University

               EFFECTIVE STARTING DATE             July 1, 1966
               OF PLANNING ACTIVITIES

               EFFECTIVE STARTING DATE             April 1, 1967
               OF OPERATIONAL ACTIVITIES

               TOTAL FUNDING TO DATE               $2, 761, 675

               FUNDING FOR CURRENT                 $1,110,679
               YEARIS ACTIVITIES
               CHAIRMAN, REGIONAL                  I-larold C. Wiggers, Ph.D.
               ADVISORY GROUP                      Dean, Albany Medical College of
                                                   Union University
                                                   47 New Scotland Avenue
                                                   Albany, New York 12208
               PROGRAM COORDINATOR                 -@Frank M.  Woolsey,  Jr.,  M.D.
                                                   Associate Dean and Professor
                                                   Chairman, Department of Postgraduate
                                                     Medicine
                                                   Albany Medical College of Union
                                                     University
               STAFF                               (ASSISTANT) COORDINATORS

                                                       NORTHERN DIVISION
                                                       Girard J. Craft, M.D.

                                                       ALBANY-VERMONT INTERFACE
                                                       DIV IS ION
                                                       William P. Nelson 111,  M.D.

                                                       CENTRAL DIVISION
                                                       Ward L. Oliver, M.D.


               *Chief Executive Officer        -5-





                                                               ALBANY - 11

         STAFF (Continued)              (ASSTSTANT) COORDINATORS (Cont'd)

                                           SOUTHF,RN DIVISION
                                           John B. Phillips, M.D.

                                           EASTERN DIVISION
                                           Arnold W. Pohl, M.D.

                                           WESTERN DRVISION
                                           William T. Strauss, M.D.

                                        DIRECTOR OF INFORMATION
                                        James P. Mc@hon






                                                                            ALBANY  -;   III


               APPROVED OPERATIONAL PROJECTS




               TWO-WAY    RADIO     COMMUNICATION     SYSTEM     -     NETWORK     EXPANSION

               Objectives:   To  enlarge  the  already  established  communications  network
                             to include an additional 57 hospitals, 24 high schools, and
                             an unstated number of headquarters of voluntary health
                             agencies and meeting places for  medical  societies;  to  expand
                             the program beyond practicing physicians to include allied
                             medical personnel, administrators, members of boards of
                             trustees, voluntary health agencies,  adult  education  classes,
                             and selected civic groups.


               TWO-WAY RADIO COMMUNICATION SYSTEM - PROGRAM PRODUCTION

               Objectives:   To  enlarge  the  already  established  communications  network
                             to include an additional 57 hospitals, Z4 high schools, and
                             an unstated number of headquarters of voluntary health
                             agencies and meeting places for  medical  societies;  to  expand
                             the program beyond practicing physicians to include allied
                             medical personnel, administrators, members of boards of
                             trustees, voluntary health agencies,  adult  education  classes,
                             and selected civic groups.


               COMMUNITY INFORMATION COORDINATORS

               Objectives:   To provide effective liaison, evaluate prevailing attitudes,
                             and promote effective personal contacts with the medical
                             and lay individuals and groups who have a role in the de-
                             veloping regional medical program.  Four former phar-
                             maceutical representatives will be employed as coordinators.


               POSTGRADUATE INSTRUCTION DEVELOPMENT

               Objective:    To identify professional educational needs  of  the  physicians
                             in the region and to satisfy these needs through programs
                             of continuing education. A  random  group  of  physicians  will
                             attend sessions at the Medical College and by radio.  Pre
                             and post testing will be used to evaluate the effectiveness  of
                             the project.











                                                  -7-





                                                                       ALBANY - IV


           APPROVED OPERATIONAL PROJECTS (Continued)



           COMMUNITY HOSPITAL LEARNING CENTERS

           Objectives:   To establish learning centers in hospitals to accelerate the
                         dissemination of new medical knowledge and, as a broader
                         aim, to enhance the concept of the community hospital as a
                         focus for continuing medical education.  Automated audio-
                         visual aids will be installed in the initial 8 hospitals. Evalua-
                         tion will be based on use of the facilities.


           CORONARY CARE TRAINING AND DEMONSTRATION PROGRANO
           ALBANY MEDICAL CENTER

           Objectives:   To serve as a prototype of the best care available for  the
                         patient with an acute myocardial infarction; and to provide
                         training for physicians and nurses interested in establishing
                         facilities in their own communities.  This project would
                         augment the existing Coronary Intensive Care  Unit  at  the
                         Albany Medical Center.


           COMMUNITY    HOSPITAL    CORONARY    CARE     TRAINING     AND     DEMON-
           STRATION PROGRAM - VASSAR BROTHERS HOSPITAL, POUGHKEEP-
           SIE

           Objectives:   To establish a coronary care unit at Pittsfield and expand an
                         existing one at Poughkeepsie as a demonstration and educa-
                         tional project for other hospitals in the region.  A con-
                         tinuing educational program will serve the permanent Unit
                         Staff and staffs from smaller hospitals.


           COMMUNITY    HOSPITAL    CORONARY    CARE     TRAINING     AND     DEMON-
           STRATION PROGRAM - AFFILIATED HOSPITALS, PITTSFIELD,
           MASSACHUSETTS

           Objectives:   To establish a coronary care unit at Pittsfield and expand an
                         existing one at Poughkeepsie as a demonstration and educa-
                         tional project for other hospitals in the region.  A continuing
                         educational program will serve the permanent Unit Staff and
                         staffs from smaller hospitals.


           COMMUNITY    HOSPITAL    CORONARY    CARE     TRAINING     AND     DEMON-
           STRATION PROGRAM - HERKIMER MEMORIAL HOSPITAL, HERKIMER,
           NEW YORK

           Objectives:   To establish a coronary care unit in a small community
                         hospital without house staff and train selected nurses and
                         physicians to use the equipment.





                                                                            ALBANY - V
              APPROVED OPERATIONAL PROJECTS (Continued)


              COORDINATOR FOR CANCER IN SCHENECTADY AREA
              Objectives:   To establish a coordinator for cancer to implement and
                            expedite more effective professional and lay education,
                            assure better clinical care, organize more complete follow-
                            up of cancer patients, and provide coordination in evaluating
                            effectiveness of all oncol.ogy activities in the area.


              CORE PROGRAM
              Objectives:  To support administrative and planning functions.






                                                        ARIZONA - I

        NAUE OF PROGRAM             Arizona Regional Medical Program

        GEOGRAPHICAL REGION         State of Arizona

        ESTIMATED POPULATION        1, 663, 000

        COORDINATING HEADQUARTERS   Arizona Regional Medical Program
                                    University of Arizona College of Medi-
                                    cine
                                    Tucson, Arizona 857ZI
                                    (Tel.: 6OZ/884-2701)

        GRANTEE ORGANIZATION        University of Arizona College of Medi-
                                    cine

        EFFECTIVE STARTING DATE     April 1, 1967
        OF PLANNING ACTIVITIES

        TOTAL FUNDING TO DATE       $563,865

        FUNDING FOR CURRENT         $138, 095
        YEARIS ACTIVITIES

        CHAIRMAN, REGIONAL          Richard 0. Flynn, M.D.
        ADVISORY GROUP              Z210 South Nfill Avenue
                                    Tempe, Arizona 85281

        PROGRAM COORDINATOR         *Dermont W. Melick, M.D.

        STAFF                       DEPUTY COORDINATOR
                                    James R. Shaw, M.D.

                                    CHIEF OF OPERATIONS
                                    John F. Flynn

                                    INFORMATION AND PUBLIC RELA-
                                    TIONS
                                    Frank L. Riggs

                                    APPLICANT ADVTSOR
                                    Kenneth L. Brown


                                    ASSISTANT COORDINATOR
                                    Myron L. Miller, M.D.

                                    CHIEF NURSE
                                    (Miss) Margaret F. Knapp

                                    CHIE.F-SOCIAL WORKER
                                    (Mrs.) Greta AUnn






        *Chief Executive Off icer  -10-





                                                         ARKANSAS

           NAME OF PROGRAM              Arkansas Regional Medical Program

           GEOGRAPHICAL REGION          State of Arkansas

           ESTIMATED POPULATION         1, 986, 000
           COORDINATING HEADQUARTERS    Arkansas Regional Medical Program
                                        500 University Tower Building
                                        12th at University
                                        Little Rock, Arkansas 72204
                                        (Tel.: 501/664-5?53)
           GRANTEE ORGANIZATION         University of Arkansas Medical Center
           EFFECTIVE STARTING DATE      April 1, 1967
           OF PLANNING ACTIVITIES
           EFFECTRVE STARTING DATE      February 1, 1969
           OF OPERATIONAL ACTIVLTIES
           TOTAL FUNDING TO DATE        $1,05?.,599

           FUNDING FOR CURRENT          $7?.9. 9?.4
           YEARIS ACTIVITIES
           CHAIRMAN, REGIONAL           Thomas H. Wortham, M.D.
           ADVISORY GROUP               813 Marshall Road
                                        Jacksonville, Arkansas 72076
           PROGRAM COORDINATOR          *Roger B. Bost, M.D.

           STAFF                        ASSISTANT PROGRAM COORDINATOR
                                        W. Richard Ellis


                                        DIRECTOR OF HEART DISEASE
                                        Malcolm B. Pearce, M.D.
                                        NURSIND COORDINATOR
                                        (Mrs.) Jacqueolyn S. Walter

                                        DIRECTOR OF CARDIOPULMONARY
                                        EDUCATION FOR NURSES
                                        (Mrs.) Dorothy B. McPhail

                                        LIBRARIAN
                                        (Mrs.) Sally Kasalko

                                        DIRECTOR OF INFORMATION
                                        (Mrs.) Carol V. Adams

                                        BIOMETRIST
                                        John M. Long, Ph.D.
                                        DIRECTOR OF EVALUATION (ACTING)
                                        Ferris Baker



            *Chief Executive Officer  -11-






                                                                 ARKANSAS


         STAFF (Continued)                  DIRECTOR OF AUDIO-VISUAL
                                            COMMUNICATIONS
                                            Robert C. Donaldson


                                            ADMINISTRATIVE ASSISTANT
                                            (Mrs.) Jeane Moore

                                            COMPUTER PROGRAMMER TECH-
                                            NICIAN
                                            (Mrs.) Norma Haughay

                                            ARTIST-DRAFTSMAN
                                            Ronald M. Tribell






                                                                           ARKANSAS - III

                APPROVED OPERATIONAL PROJECTS




                CORESUPPORT

                Objectives:  This project would continue the support of core staff and
                              central administrative expenses after the planning grant
                              expires.


                CORONARY CARE AND SUPPORTING DIAGNOSTIC UNIT FOR POST-
                GRADUATE TRAINING OF PHYSICIANS

                Objectives:   This project would provide two-week courses for physicians
                              and the opportunity for medical students,  interns,  residents,
                              and fellows to learn about the operation of Coronary Care
                              Units.  A portion of the project involves the development of
                              a computer module to simulate patients  in  various  conditions
                              that will be encountered in coronary care units.  The sys-
                              tems design will be provided from programs already de-
                              veloped by the Intermountain Regional Medical Program.


                NURSES CORONARY CARE COURSE - ARKANSAS BAPTIST MEDICAL
                CENTER

                Objectives:   This program provides four-week courses to be offered
                              six times a year with eight  trainees  per  course.  Preference
                              in selection of trainees will be given to clinical supervisors
                              or head nurses and staff nurses in hospitals which have
                              existing or planned Coronary Care Units.


                CARDIOPULMONARY RESUSCITATION PROGRAM

                Objectives:   This project will expand a Cardiopulmonary Resuscitation
                              program initiated by the Arkansas Heart Association.  The
                              Region has been divided into 14 subregions.  Each will be
                              provided with an adequate corps of physician and lay in-
                              structors and necessary training aids in order to conduct an
                              adequate  Cardiopulmonary  Resuscitation  program  in   accord-
                              ance with the priorities established by the Cardiopulmonary
                              Resuscitation Committee  of  the  American  Heart  Association.















                                                  -13-

                    356-998 0-69-2





                                                                       ARKANSAS   -   IV


          APPROVED OPERATIONAL PROJECTS (Continued)



          COMPUTERIZED    TUMOR    REGISTRY     FOR     ARKANSAS     (BASIC     PROGRANO
          Objectives:   The purposes of this project are to collect diagnostic,
                        therapeutic and survival data on all  patients  with  neoplastic
                        diseases  in  Arkansas;  stimulate  systematic  follow-up;   im-
                        prove patient care; provide feedback  to  the  patient's  doctor
                        and to the hospital medical staff for clinical conferences;
                        and  computerize  the  existing  registry.  The  Central  Cancer
                        Registry now located at the University of Arkansas and
                        operated by the State Cancer Commission will become the
                        nucleus of the Regional registry.  District registries will
                        participate and receive services of the Commission.


          NORTHWEST ARKANSAS REGIONAL CANCER PROGRAM

          Objectives:   No large medical center is located close  to  this  remote  area
                        of Arkansas and Oklahoma.  This project will fulfill some
                        of the services generally supplied  by  such  centers.  It  will
                        establish a cancer registry at the nine hospitals in  the  area,
                        send the data to Little  Rock  to  be  computerized  and  inform
                        area physicians of the results of the patients in the  registry.
                        Cancer conferences and clinics will be held  in  the  hospitals.
                        A speakers bureau will be established and programs of
                        public education will be presented.


          HEALTH CAREERS RECRUITMENT

          Objectives:   This project is designed to coordinate programs in the
                        health field directed at solving the manpower shortage.  A
                        climate for the recruitment will be created  through  an  inten-
                        sive advertising  and  public  relations  campaign.  The  actual
                        job of recruitment will be done by the  various  schools  offer-
                        ing training and the  career  related  organizations.  The  pre-
                        college student will be the prime target.
















                                              -14-






                                                                            ARKANSAS - V


                 APPROVED,OPERATIONAL PROJECTS (Continued)



                 REGIONAL HOSPITAL MEDICAL LIBRAKY SYSTEM

                 Objectives:  This is a three-year program designed to upgrade the
                              Region's medical library resources.  During the first year,
                              local con-ununity hospitals will be assisted in building
                              library collections, and librarians from community hos-
                              pitals will be trained through workshops at the University
                              of Arkansas Medical Center Library and follow-up in the
                              local hospital setting. Physicians and other health per-
                              sonnel will be oriented to use local libraries and the Uni-
                              versity of Arkansas Medical Center library reference
                              service, the latter by a toll-free communication system.
                              During the second year, a medical library network will be
                              developed and a computerized union list of serials and
                              catalog monographs will be distributed to each library.


                 NUCLEAR MEDICINE TECHNOLOGY TRAINING PROGRAM

                 Objectives:  Arkansas currently has one nuclear medicine technologist,
                              no training programs, and six hospitals with nuclear
                              medicine equipment but no trained personnel to operate it.
                              This project would train four students per year in Little
                              Rock at the St. Vincent Infirmary where nuclear equipment
                              and the nuclear medicine technologist are now available.
                              The course will last one year.  Students will be full-time.
                              Annual seminars will be offered as a continuing education
                              program.



                 WESTERN ARKANSAS CANCER STUDY - ST. EDWARD MERCY
                 HOSPITAL OF FORT SMITH

                 Objectives:  This project has several elements designed to meet needs
                              of seven counties in western Arkansas and three counties in
                              eastern Oklahoma.  It involves a local cancer registry,
                              which will be included in the Regionwide registry; a tumor
                              board and clinics, seminars for nurses, physicians, and
                              dentists; and a lay education.  A standing committee on
                              cancer will oversee the operation of the project.













                                                   -15-





                                                                    ARKANSAS - VI
         APPROVED OPERATIONAL PROJECTS (Continued)



         CONTINUING EDUCATION FOR NURSING PERSONNEL AND CITIZENS
         ARKANSAS LEAGUE FOR NURSING

         Objectives:   To take continuing education programs to the Region's
                       registered nurses, licensed practical nurses, and concerned
                       citizens.  The project will be developed over a three-year
                       period.  The first year will be devoted to planning and
                       organization, and two sessions will be held for professional
                       nurses in leadership positions throughout the state.  By the
                       next year, the project will involve a minimum of 500 nurses
                       and 450 citizens.






                                                                                 BI-STATE - I


                NAME OF PROGRAM                         Bi-State Regional Medical Program

                GEOGRAPHICAL REGION                     Southern Illinois and Eastern Missouri

                ESTIMATED POPULATION                    4, 800, 000
                COORDINATING HEADQUARTERS               Bi-State Regional Medical Program
                                                        607 North Grand Boulevard
                                                        Saint Louis,  Missouri  63103
                                                        (Tel.:    314/535-9755)
                GRANTEE ORGANIZATION                    Washington University School of
                                                         Medicine

                EFFECTIVE STARTING DATE                 April 1, 1967
                OF PLANNING ACTIVITUES

                TOTAL FUNDING TO DATE                   $935,587

                FUNDING FOR CURRENT                     $644,922
                YEARIS ACTIVITIES


                CHAIRMAN, REGIONAL                      G. Duncan Bauman
                ADVISORY GROUP                          Publisher
                                                        Saint  Louis   Globe-Democrat
                                                        12th Street  at  Delmar
                                                        Saint Louis,  Missouri  63101

                PROGRAM COORDINATOR                     *William Stoneman 111, M.D.

                STAFF                                   ASSOCIATE DIRECTORS

                                                          I-IEART
                                                          Kenneth C. Price, M.D. (Washington
                                                            University)
                                                          Edwin E. Westura, M.D. (Saint
                                                            Louis   University)

                                                          CANCER
                                                          E. James Potchen, M.D. (Wash-
                                                            ington  University)
                                                          Donald R. Judd, M.D. (Saint Louis
                                                            University)

                                                          STROKE
                                                          William B. Hardin, Jr., M.D.
                                                            (Washington   University)
                                                          Edward L. Eyerman, M.D. (St.
                                                            Louis   University)

                                                          ALLIED HEALTH @NPOWER
                                                          Harry E. Davis



                                                 -17-






                                                                  BI-STATE - if


         STAFF (Continued)                     ADMINISTRATION
                                               @tthew J. Costello


                                            FIELD COORDINATORS


                                               REGIONAL
                                               Donald K. Young

                                               METROPOLITAN
                                               Clarice Murphy

                                            COMMUNICATIONS SPECIALIST AND
                                            DIRECTOR OF PUBLIC RELATIONS
                                            Edna Carroll


                                            RESEARCH ASSISTANTS


                                               MEDICAL PLANNING
                                               Aleene K. Schneider


                                               EDUCATION AND MANPOWER
                                               Ruth D. Dodge






































                                       -18-





                                                         CALIFORNTA - I

            NAME OF PROGRAM              California Regional Medical Program
            GEOGRAPHICAL REGION          State of California, plus Reno-Sparks
                                          and Clark County (Las Vegas), Nevada
            ESTIMATED POPULATION         19, 782, 000
            COORDINATING HEADQUARTERS    California Committee on Regional
                                          Medical Programs
                                         655 Sutter Street, Room 600
                                         San Francisco, California 94120
                                         (Tel.: 415/771-5432)

            GRANTEE ORGANIZATION         California Medical Education and
                                         Research Foundation

            EFFECTIVE STARTING DATE      November 1, 1966
            OF P LANN ING AC T rV IT IES

            EFFECTIVE STARTING DATE      July 1, 1968
            OF OPERATIONAL ACTIVITIES

            TOTAL FUNDING TO DATE        $7,589,482

            FUNDING FOR CURRENT          $3,399,924
            YEARIS ACTIVITTES

            CHAIRMAN, REGIONAL           Roger 0. Egeberg, M.D.
            ADVISORY GROUP               Dean, School of Medicine
                                         University of Southern California
                                         2025 Zonal Avenue
                                         Los Angeles, California 90033

            PROGRAM COORDINATOR          *Paul D. Ward

            STAFF                        ASSOCTATE DIRECTORS
                                         Acton Barnes
                                         William Boquist
                                         Richard Sasuly

                                         COORDINATOR OF EVALUATION
                                         Jack E. Thomson (cq), Ed. D.

                                         COORDINATOR OF ADMINISTRATION
                                         (Mrs.) Chris Roberts

                                         AREA COORDINATORS


                                          AREA I
                                          Elliot Rapaport, M.D.
                                          San Francisco General Hospital
                                          22nd and Potrero Avenue
                                          San Francisco, California 94110

            *Chief Executive Officer
                                   -19-






                                                               CALIFORNIA     11


         STAFF (Continued)                     AREA 11
                                               Reed M. Nesbit, M.D.
                                               University of California - Davis
                                               School of Medicine
                                               Davis, California 95616

                                               AREA III
                                               John L. Wilson, M.D.
                                               Stanford University
                                               703 Welch Road - Suite G-1
                                               Palo Alto, California 94304

                                               AREA IV
                                               Donald Brayton, NL D.
                                               15-39 UCLA Rehabilitation Center
                                               West Medical Campus
                                               Los Angeles, California 90024

                                               AREA V
                                               Donald W. Petit, M.D.
                                               USC School of Medicine
                                               1 West Bay State Street
                                               Alhambra, California 91801

                                               AREA VI
                                               John P ete r s on, M. D.
                                               Lon-ia Linda University School of
                                                Medicine
                                               Loma Linda, California 92354

                                               AREA V 11
                                               Joseph Stokes III, M.D.
                                               7816 Ivanhoe Avenue
                                               La Jolla, California 92307

                                               AREA V III
                                               Robert C. Combs, M.D.
                                               University of California - Irvine
                                               California College of Medicine
                                               Irvine, California 92664


















                                       -20-






                                                                        CALIFORNIA   -   III


               APPROVED OPERATIONAL PROJECTS




               CORONARY CARE TRAINING - AREA I (UCSF)

               Objectives:   Will develop and establish a  confederation  of  Coronary  Care
                             Units throughout northwestern California.  Training will be
                             provided for nurses and physicians in patient care and for
                             nurse  educators  and  nurse  administrators.  Supportive  pro-
                             grams will be coronary care conferences; a reference in-
                             formation center andnewsletter; and  consultation  on  unit
                             design, management, and specific care problems.


               ROSEVILLE PILOT PROGRAM - AREA 11 (U. C. Davis)

               Objectives:   Will be a living laboratory for development of programs in
                             continuing physician education, inservice training for
                             paramedical personnel, multiphasic screening, community
                             information and education, tumor'board consultation, and
                             cerebrovascular disease and CNS malignancy diagnosis and
                             evaluation.  Applicable to entire Area.


               A   TRAINING   PROGRAM   FOR   PHYSICIANS   IN   CORONARY   CARE    -    AREA
               IV (UCLA) (Cedars-Sinai Medical Center)

               Objectives:   To provide training programs for physicians who will occupy
                             positions as directors or associate directors of Coronary
                             Care Units in community hospitals and who will ultimately
                             provide leadership in cardiology at  the  community  level.
                             A basic training course will be given, followed  by  continuing
                             education and consultative services, and seminars and
                             workshops for continuing liaison  between  the  medical  center
                             and community hospitals.


               WATTS-WILLOWBROOK POST-GRADUATE EDUCATION - AREA IV
               (UCLA) AND AREA V (USC)

               Objectives:   Joint proposal of University of California at  Los  Angeles
                             and University of Southern California Medical Schools, the
                             County of Los Angeles, the Charles Drew Medical Society,
                             and the Community of Watts-Willowbrook.  A combination
                             planning-operational proposal.  This  project  will  coordinate
                             the establishment of a Watts-Willowbrook district Regional
                             Medical Program with  the  development  of  a  postgraduate
                             medical school.





                                                                  CALIFORNIA - IV

           APPROVED OPERATIONAL PROJECTS (Continued)



           RMP MEDICAL TV NETWORK - A CENTER FOR THE CONTINUING
           EDUCATION OF HEALTH CARE PROFESSIONALS USING TELEVISION.
           AND OTHER AUDIO-VISUAL MATERIALS - AREA IV (UCLA)

           Objectives:  Based on the UCLA campus and ETV Station KCET, Los
                        Angeles, the project will support production of programs
                        and their broadcast over closed-circuit television to more
                        than 70 Southern California hospitals via the Medical Tele-
                        vision Network (MrN).  The best of these programs then
                        are recorded on videotape for distribution by mail to sub-
                        scribing hospitals wherever located (in ZO states). Partially
                        funded by a Public Health Service contract (expired June
                        30, 1968), MTN began as a cooperative educational venture
                        by six medical institutions. Now to produce and establish
                        programs through an expanded arrangement within the
                        California Region and with other Regions, the MTN will
                        continue as a community educational endeavor; all programs
                        are approved for credit by the American Academy of
                        General Practice.



           PROGRAM FOR TRAINING PHYSICIANS AND NURSES IN CORONARY
           CARE TECHNIQUES - AREA V (USC)

           Objectives:  The program will begin with a central training center at the
                        Los Angeles County-USC Medical Center and three coopera-
                        ting hospitals (Good Samaritan, St. Joseph's and St. Vin-
                        cent's).  This central program will provide a base to
                        initiate training for the entire region and will be expanded to
                        include six additional hospitals in the second year. Physi-
                        cians and nurses selected for training will represent their
                        hospitals and will share common training backgrounds in
                        coronary care unit techniques and management.


           TRAINING OF PHYSICIANS IN INTENSIVE CARE FOR SMALL
           HOSPITALS    - AREA I (USC) (Pilot Program - Pacific Medical Center)

           Objectives:  A pilot project (one year only) designed to train physicians
                        in skills, as applicable in a small general hospital, in order
                        to provide intensive care to patients with acute myocardial
                        infarction.  (Designed for hospitals not covered under the
                        Coronary Care Training - Area I project.)


           HYPERTENSION - AREA I (UCSF)

           Objectives:  Demonstrationtrainingprogramformedicalandalliedhealth
                        personnelintencommunityhospitalsforreferralandfollow-
                        up of hypertensive patients. Includes computerized registries.

                                            -22-






                                                                        CALIFORNIA    -    V

                APPROVED OPERATIONAL PROJECTS'(Continued)



                PEDIATRIC PULMONARY -AREA VIII (U. C. Irvine)

                Objectives:   Irvine  Pediatric  Pulmonary  Demonstration   Center.   Center
                              will demonstrate the proper diagnosis and treatment of
                              children with respiratory problems; to investigate the
                              relation of pediatric pulmonary disease to chronic condi-
                              tions of later life.



                A REGIONAL CANCER PROGRAM-'

                Objectives:   Expand modern techniques in cancer diagnosis and treat-
                              ment.  Coordinated  by  Committee   including   members   from
                              both sponsoring centers, University of California Medical
                              Center and Mt. Zion Saroni Tumor Institute.  Basic
                              philosophy is to provide assistance to-peripheral medical
                              groups, building on their existing  strengths  and  resources,
                              and to assist these groups in  developing  capacity  for  com-
                              plete  cancer  management.  Has  3  components:  (1)  clinical
                              oncology, (?.) data retrieval service, and (3) educational
                              services.



                CHRONIC RESPIRATORY DISEASE*

                Objectives:   Will offer formal seminars and comprehensive consultations
                              as teaching aids for the development in practicing  physicians
                              of early detection and management abilities for chronic
                              obstructive respiratory disease.  The "Breathmobile"
                              screening program will be utilized.


                SAN FERNANDO VALLEY AND PACOIMA HEALTH PLANNING PROJECT

                Objectives:   The program is designed to alleviate difficulties of health
                              care in this suburban area for low income and indigent
                              families (approximately 800, 000). All  segments  of  the  six
                              communities of the Northeast San Fernando valley will he
                              involved in determining the  nat'ure and degree of their
                              health problems, planning solutions and establishing the
                              basis for developing service.










                *Approved but not funded         -23-





                                                                   CALIFORNIA - VI

          APPROVED OPERATIONAL PROJECTS (Continued)




          A PROPOSAL FOR REHABILITATION AND CONTINUITY OF CARE
          SERVICES*


          Objectives:   Develop role of "Liaison Nurse" (nurse with Public Health
                        training who coordinates "discharge planning services").
                        Proposal has 3 components, involving 7 counties (1) Ala-
                        meda-Contra Costa Project, (2) Humboldt-Del Norte Area,
                        (3) Sonoma-Mendocino-Lake Counties.  Each of the three
                        areas differs somewhat in its methodology and objectives.
                        Each area has a nurse coordinator and secretary with a
                        nurse project director and staff to administer the grant
                        located in San Francisco.  Workshops proposed to promote
                        understanding of "discharge planning services".


          INTENSIVE TRAINING COURSE IN CARDIOPULMONARY RESUSCITA-
          TION FOR EMERGENCY RESCUE PERSONNEL*

          Objectives:   Training Courses in Cardiopulmonary Resuscitation would be
                        conducted for representatives of rescue and emergency
                        personnel in a 7-county area in Northern California. Courses
                        would be developed by California Heart Association and fully
                        supported by the Association after two years. Faculty would
                        include internists, inhalation therapists, ambulance and
                        rescue instructors, and a legal counsel.


          UNIVERSITY MEDICAL CENTER - RURAL COMMUNITY HOSPITAL
          DEMONSTRATION COOPERATIVE PROGRAM IN PRIMARY PHYSICIAN
          TRAINING AND CONTINUING EDUCATION*

          Objectives:  Support involvement of Division of Ambulatory and Com-
                        munity Medicine of University of California San Francisco
                        Medical Center in an ongoing general practice residency
                        program at the Sonoma Community Hospital.


          A COMPREHENSIVE STROKE PROGRAM*

          Objectives:   Based on Orange County and Long Beach (Area V III, UCI-
                        CCAO.  Would encompass prevention, diagnosis, treatment
                        rehabilitation, and long term care of stroke patients through-
                        out the area.  Besides enhancing patient care, project seeks
                        to assist in the process of regionalization.  Every acute
                        care hospital in area was contacted, as were representatives
                        from extended area facilities, and many health service
                        agencies, with "unanimous" support from all.  The com-
                        munity would support the program at some unspecified future
                        time.



          *Approved but not funded          -24-





                                                  CENTRAL NEW YORK - I

           NAME OF PROGRAM              Central New York Regional Medical
                                         Program
           GEOGRAPHICAL REGION          Syracuse, New York and 15 surroimd-
                                         ing counties

           ESTIMATED POPULATION         1,848,811
           COORDINATING H]EADQUARTERS   Central New York Regional Medical
                                         Program
                                        Upstate Medical Center
                                        State University of New York
                                        750 East Adams Street
                                        Syracuse, New York 13210
                                        (Tel.: 315/473-5600)
           GRANTEE ORGANIZATION         Research Foundation of State University
                                         of New York
           EFFECTIVE STARTING DATE      January 1, 1967
           OF PLANNING ACTIVITIES

           EFFECTIVE STARTING DATE      July 1, 1968
           OF OPERATIONAL ACTIVITIES

           TOTAL FUNDING TO DATE        $1,061,356
           FUNDING FOR CURRENT          $460, 314
           Y EAR IS ACT IV IT IES

           CHAIRMAN, REGIONAL           Clarke T. Case, M.D.
           ADVISORY GROUP               1402 Genesee Street
                                        Utica, New York 13502
                                        (Tel.: 315/RA4-462.6)
           PROGRAM COORDINATOR          *Richard H. Lyons, M.D.
           STAFF                        ASSOCLATE PROGRAMCOORDINATOR
                                        Thomas W. Mou, M.D.

                                        ASSISTANT PROGRAMCOORDINATOR
                                        John Murray

                                        TEACHING COORDINATOR
                                        Walter Curry

                                        NURSING COORDINATOR
                                        (@s.) Margaret Sovie
                                        DIRECTOR OF PUBLIC RELATIONS
                                        (Mrs.) Sandra Anglund
                                        968 James Street
                                        Syracuse, New York 13203
                                        (Tel.: 315/GRg-6644)
           *Chief Executive Officer
                                   -25-






                                                          CENTRAL NEW YORK - 11

          STAFF (Continued)                    PROJECT DIRECTORS

                                                  MOBILE REHABILITATION UNIT
                                                  Leo Jivoff, M.D.

                                                  FAMILY PRACTICE PROGRAM
                                                  Francis S. Caliva, M.D.
                                                  301 Prospect Avenue
                                                  Syracuse, New York 13203

                                                  ONEIDA COUNTY TUMOR CONFER-
                                                  ENCE
                                                  Isio  Wasserman,   M.D.
                                                  264 Genesee Street
                                                  Utica, New  York  13502

                                                  MEDICAL BRIEFS BY TELEPHONE
                                                  W.S. Gibbs, M.D.
                                                  Robert Packer  Hospital
                                                  Sayre, Pennsylvania 18840

                                                  THE NEW YORK STATE SIGMOIDO-
                                                  SCOPIC DEMONSTRATION
                                                  TEACHING        PROGRAM
                                                  John  H.  Powers,  M.D.
                                                  Cooperstown, New York 13326

                                                  NURSING CORONARY CARE TRAIN-
                                                  ING PROGRAM (ST. LUKEIS;
                                                  HOSPITAL)
                                                  Willard H. Willis, M.D.
                                                  430 Court Street
                                                  Utica, New  York  13502

                                                  NURSING CORONARY CARE TRAIN-
                                                  ING PROGRAM (ST. ELIZABETH
                                                  HOSPITAL)
                                                  Vincent  deLalla,  M.D.
                                                  291 Genesee Street
                                                  Utica, New  York  13502

                                                  REGIONAL LEARNING RESOURCES
                                                  CENTER
                                                  Richard L. Muller
                                                  Department of Instructional Com-
                                                   munications
                                                  State University of New York
                                                  Upstate Medical  Center
                                                  766 Irving Avenue
                                                  Syracuse, New York 13210






                                          -26-





                                                       CENTRAL NEW YORK - III


            STAFF (Continued)                 CATEGORICAL COMMITTEE CHAIR-6
                                              MEN


                                                 HEART DISEASE
                                                 George S. Sturtz, M.D.
                                                 199 Pratt Street
                                                 Watertown, New York 13601

                                                 STROKE
                                                 Herbert K. Ensworth, M.D.
                                                 1301 Trumansburg Road
                                                 Ithaca, New York 14851


                                                 CANCER
                                                 Daniel Burdick, M.D.
                                                 713 East Genesee Street
                                                 Syracuse, New York 13210










































                                          -27-






                                                          CENTRAL NEW YORK - IV


           APPROVED OPERATIONAL PROJECTS




           CONTINUING NURSING EDUCATION

           Objectives:   To update local nursing skills.  Programs will be offered in
                         several ways: in-c.enter programs and remote presentations
                         via telecommunications, both followed by on-site visits;
                         programs at sub-regional centers; and programs designed
                         to train additional teachers in the region.  There will be
                         continuous planning and monitoring to identify needs, re-
                         sources, and the like.



           REHABILITATION CONSULTATION SERVICE

           Objectives:   This project would focus on stroke using a mobile team
                         which would provide consultation, service, and educational
                         programs in peripheral hospitals and other health care
                         facilities in the region.  The proposed team would be under
                         the direction of a physician and be composed of physical
                         and occupational therapists, speech pathologists, and
                         orthotists.  Additional consultative services would be avail-
                         able from other Departments of the Upstate Medical Center
                         which has an established rehabilitation program and is
                         designated as a primary rehabilitation facility by the state.


           ONEIDA COUNTY TUMOR CONFERENCE

           Objectives:   The proposed series of teaching conferences would build
                         upon a previously conducted cancer clinic program.  It
                         would initially involve seven cooperating hospitals in Oneida
                         County, each of which already has appointed a Cancer Com-
                         mittee.  The purpose of this project is physician and nurse
                         education.  Ten monthly conferences would be presented
                         under the direction of the participating hospitals on a rotating
                         basis.  Outside consultant-lecturers would be used and the
                         conferences would be open to the entire medical community.
                         It is anticipated that the conference program might be ex-
                         tended to four additional counties in the future.



           FAMILY PRACTICE PROGRAM - ST. JOSEPHIS HOSPITAL

           Objectives:  To provide consultants and lecture services in the areas of
                         heart disease, cancer, stroke, and related diseases.









                                             -28-





                                                                CENTRAL   NEW   YORK   -    V

               APPROVED OPERATIONAL PROJECTS (Continued)



               NURSING CORONARY CARE TRAINING PROGRAM AT ST. LUKE'S AND
               ST. ELIZABETH'S HOSPITALS, UTICA, NEW YORK

               Objectives:   Twenty nurses in Utica area will each receive 20 days of
                             clinical and didactic training in coronary care each year.
                             Because both hospitals are presently  supporting  their  own
                             coronary care units, this request is primarily for  the  ad-
                             ditional efforts the nursing supervisors and physicians will
                             spend in this training program.


               HOME DIALYSIS TRAINING PROGRAM*

               Objectives:   Establishment of home care  dialysis  training  program  at  the
                             Upstate Medical Center in Syracuse for training patients in
                             home dialysis and serving as functional unit in care of patients
                             for training of public health nurses, other  nurses,  physicians
                             and medical students.



               THE    NEW    YORK     STATE     SIGMOIDOSCOPIC     DEMONSTRATION     TEACHING
               PROGRAM

               Objectives:   To acquaint  physicians  with  incidence,  symptoms  and  recog-
                             nition of common tumors of the rectum; to teach correct
                             methods  for  the  performance  of  proctosigmoidoscopic  exami-
                             nations; to keep adequate records of utilization and value of
                             the course to the physician;and, to assist  previous  physician-
                             students in their offices if help is desired. Has  been  planned
                             by advisory group of physicians and pilot program has been
                             funded through the Division of Chronic Disease.


               MEDICAL   BRIEFS    BY    TELEPHONE    AT    ROBERT    PACKER    HOSPITAL,
               SAYRE, PENNSYLVANIA

               Objectives:   Provide local physicians  specific  and  up-to-date  information
                             on tape recordings available  by  toll-free  telephone.  Current
                             information on heart disease, cancer and stroke will be
                             supplied twenty-four hours a day.


               EQUIPMENT     GRANT     REQUEST      FOR      COMMUNITY-GENERAL      HOSPITAL,
               SYRACUSE, NEW YORK*

               Objectives: Purchase of equipment to be  used  in  educational  activities
                             at the Community-General Hospital in Syracuse.




               *Approved but not funded          -29-

                   356-998 0-69-R





                                                            CENTRAL NEW YORK - VI

           APPROVED OPERATIONAL PROJECTS (Continued)



           REGIONAL LEARNING RESOURCES CENTER FOR NURSING CONTINUING
           EDUCATION

           Objectives:   To show, in a pilot program, the effectiveness of educational
                         technology in producing behavioral changes in the professional
                         activities of health science practitioners.  To develop teaching
                         materials for independent and small group use, to test these
                         for effectiveness and to make them available to practitioners
                         in the Region.  These materials will relate to the fields of
                         heart disease, cancer, stroke, and related diseases.














































                                               -30-





                                                               COLORADO-WYOMING - I

              NAME OF PROGRAM                     Colorado-Wyoming Regional Medical
                                                  Program
              GEOGRAPHICAL REGION                 States of Colorado and Wyoming

              ESTIMATED POPULATION                2,358,000

              COORDINATING HEADQUARTERS           Colorado-Wyoming Regional Medical
                                                   Program
                                                  University of Colorado Medical Center
                                                  4200 East Ninth Avenue
                                                  Denver,  Colorado   80220
                                                  (Tel.: 303/394-7506)
              GRANTEE ORGANIZATION                University 'of Colorado Medical Center

              EFFECTRVE STARTING DATE             January 1, 1967
              OF PLANNING ACTIVITIES

              EFFECTIVE STARTING DATE             January 1, 1969
              OF OPERATIONAL ACTIVITIES

              TOTAL FUNDING TO DATE               $1, 568,994

              FUNDING FOR CURRENT                 $1,003,902
              YEARIS ACTIVITIES

              CHAIRMAN, REGIONAL                  John J. Conger, Ph.D.
              ADVISORY GROUP                      Vice President for Medical Affairs
                                                  University of Colorado Medical Center
                                                  4200 East Ninth Avenue
                                                  Denver,  Colorado  802?.O

              VICE-CHAIRMAN, REGIONAL             Thomas   Nicholas,   M.D.
              ADVISORY GROUP                      500 West Lott
                                                  Buffalo,  Wyoming   82834

              PROGRAM COORDINATOR                 Paul R. Hildebrand, M.D.

              STAFF                               PROGRAM DIRECTOR
                                                  *Howard  W.  Doan,   M.D.

                                                  EXECUTIVE       ASSISTANT
                                                  Rex D. Stubblefield


                                                  PROJECT ADMINISTRATION & HEALTH
                                                  INFORMATION SYSTENS DRVTSION
                                                  James C. Syner, M.D., Associate
                                                   Director
                                                  Warren C. Morse, Ph. D.
                                                  Douglas R. Currin, "D.
                                                  William 0. Hastings
                                                  Arthur E. Lagace, Jr., M.H.A.
                                                  Nancy A. McGuire, R. R. L.
                                                  Alan Weinstein, IvL  B.A.


              *Chief Executive Officer          -31-





                                                       COLORADO-WYOMING - II
         STAFF (Continued)                 PROFESSIONAL ACTIVITIES DIVISION
                                           Richard E. Boyle, M.D., Associate
                                             Director
                                           James E. Dyson, Ph.D.
                                           Anne M. Gough, M.P. H., R.N.

                                           CARDIOLOGY    DIVISION
                                           Robert C. Jones, M.D., Associate
                                             Director
                                           F. R. Normile, M.S.P.H., M.A.D.

                                           COMMUNICATIONS AND INFORMATION
                                           OFFICE
                                           James P. Smith, Chief
                                           Phyllis Record, Staff Assistant















































                                         -32-





                                        COLORADO-WYOMING - III


        APPROVED OPERATIONAL PROJECTS




          CORESTAFF

         Objectives: This project is to support core planning and evaluation
                  activities of the Colorado-Wyoming Regional Medical Pro-
                  gram. Staff is divided into four offices and three divisions.
                  Full-time equivalent staff are requested as follows: Office
                  of Coordinator, Office of Director, Office of Division of
                  Professional Activities, Division of Planning and Operations,
                  and Division of Health Data and Program Evaluation. Costs
                  include a subcontract with the System Development Corpora-
                  tion to complete the development and collection of com-
                  munity health profile data and for PAS/MAP participation
                  charges for 15 hospitals.


         COLORADO STATE CANCER REGISTRY

         Objectives: The basic objective of this project is to develop a computer-
                  ized statewide cancer registry to improve follow-up to as
                  near as 1000/o as possible and through utilization of registry
                  data, to provide the cancer patients of Colorado with the best
                  care and earliest diagnosis possible. Improved follow-up of
                  (1) treatment failure, (2) second primaries in Kansas Cancer
                  patients, and (3) determination of need for treatment changes
                  in those patients known to have cancer. Extension of regis-
                  tries to all hospitals, improved continuing education and
                  constant evaluation are also goals. This project relates to
                  the third National Cancer Institute Survey of Cancer Incidence
                  and Prevalence and a proposed six-state Rocky Mountain
                  Tumor Registry. The Colorado Department of Public Health
                  will be the headquarters for this activity.


         MULTI-MEDIA EDUCATION

         Objectives: This continuing education project will develop a prototype
                  system for videotape exchange and closed-circuit TV involving
                  first, the Denver Medical Society, the University of Colorado
                  Medical Center, Presbyterian Hospital and St. Joseph's
                  Hospital of Denver, and later, seven other Denver hospitals.
                  The TV system will be converted to color later and if CCTV
                  is extended throughout Colorado and Wyoming, (1) will be
                  extended to hospitals throughout the Region, (Z) produce and
                  distribute videotapes to hospitals in the Region (3) produce
                  and distribute a single concept films, slides and filmstrips
                  to Regional hospitals.





                                 -33-





                                                           COLORADO-WYOMING - IV


            APPROVED OPERATIONAL PROJECTS (Continued)




            HOME DIALYSIS TRAINING PROGRAM


            Objectives:   This project is to improve understanding of health personnel
                          and the public in the treatment of kidney disease and of the
                          problems experienced by renal patients, to enhance com-
                          munity involvement in the rehabilitation of patients  under-
                          going home dialysis, to provide  consultation  to  community
                          health personnel, to provide highly  specialized  laboratory
                          services when required, and to develop the capability to
                          provide emergency services for home dialysis patients.
                          Training plans include (1) three-day orientation for 30
                          physicians and 25 public health nurses; (2) five-day orienta-
                          tion for five physicians; (3) ten-day training for five physi-
                          cians from hospitals planning home dialysis service; (4) two-
                          week training session for seven nurses and  for  technicians
                          from hospitals planning a service program, three-day
                          training for ten dieticians; (5) one-three day conference of
                          20 social workers and rehabilitation personnel; (6) one-three
                          day orientation for five clergy,  welfare  workers,  pharma-
                          cists and community leaders; (7) five one-two day conferences
                          for 50 health related and community-oriented individuals;
                          and (8) six-week training for family members of patients.
                          Travel and per them is requested for all these groups.


            TRAINING AND APPLIED RESEARCH FOR INTENSRVE AND RE-
            HABILITATRVE RESPIRATORY CARE

            Objectives:   To (1) familiarize physicians and paramedical personnel of
                          the magnitude of the emphysema-chronic bronchitis problem;
                          (2) disseminate knowledge on the latest advances in the
                          treatment of the problem; (3) to promote and assist in the
                          establishment of respiratory care  programs  in  local  com-
                          rnunities; (4) obtain greater knowledge on the effectiveness
                          of home oxygen for both hypoxemia and nonhypoxernia
                          individuals and (5) increase the effectiveness of the therapy
                          through the development of improved ventilators and nebuli-
                          zation devices as well as the addition of humidification de-
                          vices to existing ox gen equipment.
                                             y
















                                              -34-






                                                               COLORADO-WYOMING     -      V


               APPROVED OPERATIONAL PROJECTS (Continued)




               RADIATION THERAPY AND NUCLEAR MEDICINE

               Objectives:  'Technology Training.  To reduce the acute shortage of well-
                            trained radiation therapy and nuclear medicine technologists
                            by establishing  Associate  Degree  two-year  training  programs
                            in radiation therapy and nuclear medicine technology. The
                            programs will be offered by the Denver Community College
                            in conjunction with nine hospitals in the Denver area: (1)
                            Colorado General, (2) Denver General (3) Fitzsimmons
                            General, (4) Lutheran, (5) Mercy,  (6) Presbyterian
                            Medical Center, (7) St. Anthony's, (8) St. Lukels, and
                            (9) General Rose Memorial.  It is expected that at least
                            seventy students per year will graduate from the training
                            programs.



               COLORADO INTERAGENCY COUNCIL ON SMOKING AND HEALTH
               PROGRAM

               Objectives:  To continue support of an Interagency  Council  on  Smoking  and
                            Health.  The prime source of funding for the Council (which
                            paid the salary of a coordinator and a secretary) has been
                            through a Special Project Grant from the Public Health
                            Service. This source of funding is no longer  available  due  to
                            budget limitations.  The general objectives of this proposal
                            are:  (1) coordination of Council member activities per-
                            taining to smoking and health and promotion  of  more  efficient
                            communication between Council  agencies;  and  (3)  continuation
                            of efforts on a long-range program aimed at permanent
                            financing of the Council within the State of Colorado.


               CONTINUING EDUCATION CORE PROGRAM FOR NURSES*

               Objectives: Based at University of  Colorado  School  of  Nursing,would  pro-
                            vide integrated training in intensive nursing care.


               CONTINUING EDUCATION STAFF*

               Objectives:  Develop continuing education staff in Colorado-Wyoming
                            Regional Medical Program to counsel with communities
                            interested in developing local  continuing  education  programs.
                            Staff teams would provide consultation to local hospitals.
                            Development of local consultation teams would also be en-
                            couraged, with Regional Medical Program staff assistance
                            provided to fill gaps in local expertise.



               *Approved but not funded           -35-





                                                          COLORADO-WYOMING - VI
           APPROVED OPERATIONAL PROJECTS (Continued)



           PEDIATRIC CHRONIC PULMONARY DISEASE
           Objectives:   Workshops to acquaint physicians of the Rocky Mountain
                         Region with the facilities of the University of Colorado
                         Medical Center will be held, and a means of communicating
                         new information to those medical groups which do not attend
                         postgraduate lectures will be achieved through this project.
                         On the local level, the project will strive to stimulate physi-
                         cian interest  in cardiopulmonary disease, increase the
                         willingness to care for more patients with this disease on
                         the local level, evaluate and improve the home management
                         of cardiopulmonary cases and interest physicians in seeking
                         training in pediatric chest disease.









































                                              -36-





                                                      CONNECTICUT - I


           NAME OF PROGRAM             Connecticut Regional Medical Program

           GEOGRAPHICAL REGION         State of Connecticut

           ESTIMATED POPULATION        3, 017, 000

           COORDINATING HEADQUARTERS   Connecticut Regional Medical Program
                                       272 George Street
                                       New Haven, Connecticut 06510
                                       (Tel.: 203/772-0860)

           GRANTEE ORGANIZATION        Yale University School of Medicine

           EFFECTIVE STARTING DATE     July 1, 1966
           OF PLANNING ACTRVITIES

           EFFECTIVE STARTING DATE     January 1, 1969
           OF OPERATIONAL ACT rV IT IES

           TOTAL FUNDING TO DATE       $1, 968, 189

           FUNDING FOR CURRENT         $1, 548, 257
           YEARIS ACTIVITIES

           CHAIRMAN, REGIONAL          Arthur M. Rogers
           ADVISORY GROUP              Scovill Manufacturing Company
                                       99 @ll Street
                                       Waterbury, Connecticut 06720

           PROGRAM COORDINATOR AND     @'Henry T. Clark, Jr., M.D.
           DIRECTOR

           STAFF                       ASSOCIATE DIRECTOR
                                       Edward F. Morrissey, M. S. W.
                                       EDUCATION SECTION
                                       Lester Evans, M. D., Coordinator
                                       Eleanor E. McGuire, M.A., Associate
                                        Coordinator
                                       RESEARCH AND EVALUATION SECTION
                                       John Glasgow, Ph. D.
                                       Associate Coordinator, HealthEconomics
                                       PLANNING SECTION
                                       Albert Snoke, M.D.
                                       Consultant, Health Service
                                       Area Program Assistance
                                       OFFICE OF REGIONAL ACTRVITIES
                                       David Pearson, M.P. H.
                                       Acting Coordinator, Yale-New Haven
                                       Medical Center
                                       ADMINISTRATIVE ASSISTANT
                                       Marcelle McKeon


           -@Chief Executive Officer  -37-





                                                                      CONNECTICUT - 11


           ,APPROVED OPERATIONAL PROJECTS



           CONNECTICUT UTILIZATION AND PATIENT INFORMATION STATISTICAL
           SYSTEM (CUPISS)

           Objectives:   The development of a program for routine assembly of hospital
                         patient care information to (1) serve as central registry for
                         summaries of patients' institutional medical histories as guide
                         for subsequent treatment, (2) generate indices of institutional
                         performance and effectiveness, (3) provide data base for a
                         two-stage Utilization Review Screening System, (4) provide
                         data for additional planning, (5) serve as a basis for evaluation
                         of institutional operational programs, and (6) serve as a data
                         bank for research in delivery of care.


           HEALTH SERVICE AREA PLANNING

           Objectives:   This project would provide financial and technical assistance
                         for local long-range planning within each of the ten health
                         service areas of the Region, to delineate each community
                         hospital's relationship to.the other and to strengthen cooperative
                         arrangements among all the institutions involved in continuum
                         of care: general hospitals, special hospitals, extended care
                         facilities and public health nursing and home health programs.


           SOUTH CENTRAL HEALTH SERVICE AREA CONTINUING CARE PROGRAM
           Objectives:   A patient care demonstration program for a continuum of long-
                         term care will be developed in South Central Health Service
                         Area using the unique resources of the Yale-New Haven Hospital,
                         chronic disease institutions, extended care facilities, rehabi.1-
                         itation centers, nursing homes, boarding homes, home health
                         agencies, and ambulatory services either in the physician's
                         offices or the hospital out-patient departments.  It will also
                         serve as a continuing education and consultation resource in
                         continuing care for the entire Region, with special emphasis  on
                         assisting other hospitals to develop comparable programs in
                         other health service areas.

















                                               -38-





                                                                        CONNECTICUT   -    III


               APPROVED OPERATIONAL PROJECTS (Continued)




               PATIENT CARE WORKSHOPS*

               Objectives:   Five two-day workshops on patient care will be held each year
                             in five different settings; acute,  general  hospital,  extended
                             carefacilityand/ornursinghome, home health agency, chronic
                             disease institution and rehabilitation center.  The  full  range
                             of administrative, organizational and professional service re-
                             lationships in the health service area, as  well  as  activities
                             of the health professions, will be studied in  the  workshops  to
                             help  determine  measures  to  strengthen  cooperative   arrange-
                             ments among local providers of care.


               THIRD FACULTY - COMMUNITY BASED

               Objectives:   Joint appointments are proposed for 24 full-time chiefs of
                             service the first  year,  inc'reasing to 72 by the fifth year,
                             by selected local  hospitals  and  the  medical  schools.  Goals
                             of the "third faculty" are  to  improve  undergraduate  instruc-
                             tion opportunities, intern and  residency  training,  continuing
                             education, patient management, patient care study, local
                             specialized medical  services,  patient  referral  services  and
                             planning for disadvantaged patients.


               THIRD FACULTY - UNIVERSITY BASED

               Objectives:   As the second part of the "third  faculty"  development,  it  is
                             proposed to augment the clinical faculty at the university
                             medical centers to provide counterparts to the full-time
                             community hospital appointees, and to serve as focus for
                             Regional  Medical  Programs  development  within   the   univer-
                             sities' clinical services. It is expected  that  the  university
                             third faculty will assist  in  recruting  community-based  third
                             faculty, and will then assist the communities in their pro-
                             grams to improve education, patient care and health services
                             research.



               REGIONAL CORONARY CARE TRAINING AND CONSULTATION PROGRAM

               Objectives:   This program consists of two parts: (1) a training program for
                             community physicians  at  St.  Raphael  Hospital  in  New  Haven
                             and (2)  a  Connecticut  Regional  Medical  Program  consultation
                             and education program offering: (a)consultationteams to advise
                             hospitals  on  coronary  program  development,  (b)   cooperative
                             educational programs for hospital staffs,  and  (c)  feasibility
                             studies on communications systems between hospitals and ex-
                             ploratory studies of mobile coronary care units.

                 Approved but not funded
                                                       -39-





                                                                    CONNECTICUT -IV

           APPROVED OPERATIONAL PROJECTS (Continued)


           REGIONAL CLINICAL REFERENCE LABORATORY DEVELOPMENT*
           Objectives:   It is proposed to develop a reference laboratory to (1) conduct
                         clinical tests which are too complex and limited volume for
                         any single health care institution; (2) provide 24-hour, 7  days
                         a week analysis and consultation for tests which are not  of  an
                         emergency nature or necessary for immediate patient care:
                         and (3) serve as a center for continuing education in the labor-
                         atory specialties.


           CONTINUING EDUCATION OF PHYSICIANS AND DENTISTS
           Objectives:   (1) An agency for continuing education is planned to coordinate
                         planning among the  many  agencies  sponsoring  continuing  edu-
                         cation and to develop a long range approach that will provide
                         comprehensive  continuing  education.  (2)  @dical   Information
                         Centers will be established to provide physicians, via tele-
                         phone, withimmediateanswerstotheirquestions;toassemble
                         and distribute study kits for physicians; and to assemble and
                         distribute audiovisual reference materials to hospitals, phy-
                         sicians and organizations. (3)  A  Regional  Television  Network
                         for Continuing Education will be developed  to  connect  medical
                         centers with the major hospitals.  (4) Refresher fellowships
                         will be provided physicians and dentists in rural areas for
                         1-4 months of intensive training at Medical Centers.

           CONTINUING   EDUCATION    FOR    NURSES    AND    ALLIED    HEALTH    PRO.FES-
           SIONS

           Objectives:   (1) An inventory of health  profession  education  programs  and
                         facilities, emphasizing qualitative surveillance and assess-
                         ment rather than quantitative data collections will be devel-
                         oped; (2) expert advisory committees will be organized to
                         analyze current practices in the areas of  counseling,  recruit-
                         ment, licensing, accreditation, etc., to relate educational
                         programing to health care needs; (3) program development
                         funds and technical assistance will be provided to existing
                         institutions for expanded and experimental programs in re-
                         cruitment, career counseling, curriculum design and train-
                         ing; (4) C. R. M. P. plans to aid in planning, organization and
                         development of regional and  sub-regional  continuing  education
                         programs; and, (5) a Health Profession Education Council is
                         proposed to provide technical assistance and coordination in
                         health technology education.




            Approved-but not funded                -40-





                                                                     CONNECTICUT - V

              APPROVED OPERATIONAL PROJECTS (Continued)



              DEVELOPING OPTIMUM LIBRARY SERVICES
              Objectives:   (1) Providing the two University Medical Center libraries
                            with additional personnel, machine facilities, and a com-
                            munications linkage to health institutions and practitioners
                            so that medical literature resources and library resources
                            can be made available upon request and with dispatch; and
                            (2) inaugurating extensive field consultation, basic training
                            and technical assistance to help local libraries upgrade serv-
                            ices and facilitate their involvement in a region-wide system
                            of interlibrary borrowing and loan of medical literature.


              CONTINUING INVENTORY OF HEALTH RESOURCES AND SERVICES
              Objectives:   This is a request primarily to employ a professional to
                            devote full time to assembling, organizing and preparing
                            monographs and reports on demographic, socioeconomic
                            and related characteristics of the Region's population, exist-
                            ing health facilities and specific differences among the ten
                            health service areas.



              RESEARCH PROGRAM PLANNING
              Objectives:   (1) Providing support for field research activities related to
                            planning and program development; (2) assisting in continued
                            evaluation of operational programs; (3) conducting feasibility
                            studies related to design of long range evaluation.


              SPECIAL CONSIDERATIONS IN FINANCING HEALTH CARE
              Objectives:   Selected studies will be cooperatively undertaken on the fi-
                            nancing of institutional medical care, principally in the acute,
                            general hospitals.  Special attention will be given to items of
                            ,direct and indirect administrative control and expenses pre-
                            viously controlled by physician practices.  Analyses of capital
                            funding, cash flow, reimbursement formulae of third-party
                            agents and the rate of self-pay patients will be parts of the
                            study.


              CORE      STAFF
              Objectives:  This project will continue and greatly augment core staff per-
                            sonnel for continued planning and over-all direction of opera-
                            tions of the Connecticut Regional Medical Program.



                                                   -41-





                                                                               FLORIDA     I


            NAME OF PROGRAM                        Florida Regional Medical Program

            GEOGRAPHICAL REGION                    State of Florida

            ESTIMATED POPULATION                   6, 154, 000

            COORDINATING HEADQUARTERS              Florida Regional Medical Program
                                                   1 Davis Boulevard, Suite 309
                                                   Tampa, Florida 33606
                                                   (Tel.:  813/?.53-0931)

            GRANTEE ORGANIZATION                   Florida Advisory Council, Inc.

            EFFECTIVE STARTING DATE                November 1, 1967
            OF PLANNING ACTIVITIES

            EFFECTIVE STARTING DATE                March 1, 1969
            OF OPERATIONAL GRANT

            TOTAL FUNDING TO DATE                  $1, 590,179

            FUNDING FOR CURRENT                    $1,376,251
            YEARIS ACTIVITIES

            CHAIRMAN, REGIONAL                     Coyle F. Moore, Ph. D.
            ADVISORY GROUP                         Florida State University
                                                   Tallahassee, Florida 32306
                                                   (Tel.:   904/599-2525)

            PROGRAM COORDINATOR                    *Granville W. Larimore, M.D.

            STAFF                                  DEPUTY        DIRECTOR
                                                   Robert Ausn-ian, M.D.

                                                   ASSISTANT DIRECTOR FOR COMMUNI-
                                                   CATIONS
                                                   Harold A. Tyler

            AREA COORDINATORS                      SOUTH FLORIDA AREA
                                                   George C. Adie, M. D.
                                                   Four Ambassadors, Suite 1411
                                                   801 South Bayshore Drive
                                                   Miami, Florida 33131
                                                        -  305/350-65?.3)
                                                   (Tel..

                                                   MID-FLORIDA AREA
                                                   1 Davis Boulevard, Suite 507
                                                   Tampa, Florida 33606






              Chief Executive Officer           -42-





                                                                    FLORIDA


            AREA COORDINATORS (Continued)


                                             NORTH FLORIDA AREA
                                             Lamar Crevasse, M.D.
                                             Lakeshore Towers, Suite 808
                                             2306 S. W. 13th Street
                                             Gainesville, Florida 32601
                                             Tel.: 904/39Z/3181)
















































                                            -43-






                                                                         FLORIDA   -   III


           APPROVED OPERATIONAL PROJECTS



           A COMMUNITY MULTITEST HEALTH SCREENING CENTER

           Objectives:   Develop a computerized  multitest  screening  facility  whichwill
                         serve four major, functions --health screening, education,
                         research, and coordination  between  public  and  private  health
                         programs in  the  community.  Provide  low  cost  health  screen-
                         ing to major sectors of the population of area, both  public  and
                         private patients, and contribute to continuing education of
                         practicing physicians and training of students  in  medicine  and
                         the health related professions.


           CORONARY CARE UNIT PROGRAM FOR NORTH FLORIDA

           Objectives:   (1) The institution of coronary care unit facilities  in  4  com-
                         munities currently lacking such units; (2) the initiation and
                         continuation of educational programs for local community
                         physicians and nurses who will specialize in the  care  of  acute
                         myocardial infarction; (3) the development of coronary care
                         unit facilities in communities having less  than  100  myocardial
                         infarctions per year; and (4) the coordination of other  regional
                         programs at community hospitals on  the  subject  of  heart  dis-
                         ease.



           REGIONAL COMPUTERIZED EKG PROCESSING CENTER

           Objectives:   Establishment of Center at Medical  School  to:  test  and  eval-
                         uate  hardware  and  software  components  in  an  automated  EKG
                         system; further its validation as a diagnostic tool;  design  and
                         implement a data  acquisition  system  for  processing  of  EKG's
                         transmitted over telephone lines; and evaluate and plan a
                         mass screening  program  for  prevention  of  heart  disease  and
                         for accumulation of epidemiological data.


           POSTGRADUATE     INTENSIVE     INSERVICE     EDUCATION      FOR      PHYSICIANS

           Objectives:   Brings the physician into the training institution, gives him
                         status as a staff member, responsibility for  patient  care,  and
                         makes him a temporary member of a well organized Datient
                         care team. The  program  includes  adult  cardiology,  'pediatric
                         cardiology, and cardiac radiology.










                                              -44-






                                                                                   FLORIDA   -   IV

                 APPROVED OPERATIONAL PROJECTS (Continued)


                 COMPUTERIZATION OF CORONARY CARE UNITS (JACKSONVILLE)
                 Objectives:    Jacksonville   Enter-Hospital   Coronary   Care    Committee    has
                                been successful in standardizing all of the equipment put into
                                these units, as well as the care of patients and training of the
                                personnel on  the  units.  Project  will  expand  to  include  sur-
                                rounding   communities   providing   feed-backs   of   computerized
                                information concerning coronary care tooutlying communities
                                and will  eventually  become  a  statewide  project  providing  in-
                                formation on a larger population in a morestatisticallymean-
                                ingful manner.


                 DIABETES PROPOSAL*

                 Objectives.-   (1)  Training  physicians,  nurses,  and  nutritionists   as   spe-
                                cialists in diabetes mellitus; (2) form effective group of
                                physicians  in  the  community  to  improve  detection   and   care
                                programs  and  to  extend  their  ongoing  activities  for  greater
                                effectiveness;  and  (3)  evaluate  objectively  the   achievements
                                of the program.


                 CARDIOVASCULAR     SCREENING     PROGRAM      IN      FOUR      RURAL      FLORIDA
                 COUNTIES

                 Objectives:    For  continued  support  of  a  long-term  plan  already   approved
                                by  the  Florida  Medical  Association,  Florida   Heart   Associa-
                                tion, State Board of Health,  and  the  4  county  health  officers
                                and  the  respective  medical  societies.  To  provide   the   nec-
                                essary  skeletal  screening  teams,   the   necessary   statistical
                                services  to  allow  for  adequate  evaluation,  and  the   minimum
                                amount of supplies needed for their operation.


                 COMPUTERIZED EKG SCREENING PROGRAM
                 Objectives:    To cooperate  with  the  University  of  Florida  in  the  computer
                                analysis of EKG tracings recorded in cardiovascular screen-
                                ing centers, which will be conducted by county health depart-
                                ments under the supervision of the Florida State Board of
                                Health.











                  Approved but not funded             -45-

                     356-998 0 -69  -4





                                                      FLORIDA  V


       APPROVED OPERATIONAL PROJECTS (Continued)


       PEDIATRIC PULMONARY DISEASE CENTER*

       Objectives: Coordinate the "patchwork" inpatient and outpatient services
                 currently available throughout the South Florida area. In ad-
                 dition to improved care and follow up of the children under
                 treatment, proposes to train physicians and allied health per-
                 sonnel and will utilize the facilities and staff of the University
                 of Miami - Jackson Memorial )Hospital Complex.


       SUPERVISION OF PARAMEDICAL PERSONNEL VIA TELEMETRY

       Objectives: Provide an advanced communications system between rescue
                 and ambulance personnel in the field and medical personnel in
                 the hospital. Systemwouldprovideforthetelemetrytransmis-
                 sion of physiological data (electrocardiogram) and two way
                 voice communication.



       FLORIDA CORONARY CARE NURSE TRAINING PROGRAM

       Objectives:  The Florida Heart Association plans to provide training
                 courses for coronary care unit nurses in four hospitals. Ap-
                 proximately 150nursesfromallover the statewill be trained
                 in the four-week course.






























        Approved but not funded   -46-





                                                            GEORGIA   I

            NAME OF PROGRAM             Georgia Regional Medical Program
            GEOGRAPHICAL REGION         State of Georgia

            ESTIMATED POPULATION        4, 568, 000

            COORDINATING HEADQUARTERS   Georgia Regional Medical Program
                                        Medical Association of Georgia
                                        938 Peachtree Street, Northeast
                                        Atlanta, Georgia 30309
                                        (Tel.: 404/875-0701)
            GRANTEE ORGANIZATION        Medical Association of Georgia
            EFFECTIVE STARTING DATE     January 1, 1967
            OF PLANNING ACTIVITIES

            EFFECTIVE STARTING DATE     July 1, 1968
            OF OPERATIONAL ACTIVITIES

            TOTAL FUNDING TO DATE       $3, 089, 681

            FUNDING FOR CURRENT         $2,324,0?-8
            YEARIS ACTIVITIES

            CHAIR@N. REGIONAL           ArthurP. Richardson, M.D.,
            ADVISORY GROUP              Dean, Emory University School of Medicine
                                        Woodruff Memorial Building -
                                         Emory Campus
                                        Atlanta, Georgia 30322
                                        (Tel.: 404/377-2411 or 522-6116)
            CHAIRNMN. STEERING COMMIT-  J. Willis Hurst, M.D.
            TEE                         Department of Medicine
                                        Emory University School of Medicine
                                        69 Butler Street, Southeast
                                        Atlanta, Georgia 30303
                                        (Tel.: 404/525-0738)

            PROGRAM COORDINATOR         J. W. Chambers, M. D.

            STAFF                       PROGRAM DIRECTOR
                                        *J. Gordon Barrow, M.D.

                                        ASSOCIATE DIRECTOR
                                        Robert R. Smith, M.D.

                                        DIVISION CF ADMINISTRATION
                                        James E. Baker, Director

                                        ADMINISTRATIVE ASSISTANT
                                        Elsie P. Brown



             Chief Executive Officer  -47-





                                                                 GEORGIA - 11


        STAFF (Continued)                 FISCAL OFFICER
                                          George W. Adams, Jr.

                                          COMMUNICATIONS AND INFORMATION
                                          OFFICER
                                          (Mrs.) Anne Roberts (Acting)

                                          DIVISION OF PLANNING AND PRO-
                                          GRAM DEVELOPMENT
                                          Morris M. Bradley, Director

                                          CANCER SECTION
                                          William B. Wilkins (Acting)

                                          CARDIOVASCULAR DISEASES AND
                                          STROKE SECTION
                                          Morris M. Bradley (Acting)

                                          RELATED DISEASES SECTION
                                          Harry J. Usher

                                          FACILITIES AND SERVICES SECTION
                                          James R. Griffith


                                          EDUCATION AND TRAINING COOR-
                                          DINATOR PROFESSIONAL EDUCA-
                                          TION, TRAINING AND HEALTH
                                          M"POWER SECTION
                                          Harold E. Henninger

                                          NURSE AND ALLIED HEALTH PRO-
                                          ,FESSIONS COORDINATOR
                                          Lucile Dismukes


                                          EVALUATION COORDINATOR
                                          M. Sue Pritchett


                                          ,CHIEF FIELD REPRESENTATIVE
                                          'Nfills Drury, Acting

                                          EPIDEMIOLOGY AND BIOSTATISTICS
                                          SECTION
                                          Warren Gullen, M. D.
                                          Richard Pogue, Ph. D.
                                          Medical College of Georgia
                                          Augusta Georgia 30902
                                          (Tel.: 4@4/724-7111)







                                         -48-





                                                                             GEORGIA   -   III


                APPROVED OPERATIONAL PROJECTS


                SHORT-TERM TRAINEESHUPS FOR PHYSICIANS

                Objectives:  Emory University and the Medical College of Georgia will
                             offer postgraduate training programs in the categorical dis-
                             eases of 12 weeks duration, one day a week.  These are en-
                             tirely new courses; Emory  would  offer  five  of  them  and  MCG
                             would offer four. Travel expenses  would  be  paid  to  physician
                             trainees.



                HYPERTENSION-RENAL DISEASE CLINICAL FELLOWSHIP

                Objectives:  A one-year fellowship to develop specialists  in  diagnostic  and
                             therapeutic techniques in the field of hypertension and renal
                             disease will provide financial assistance to  practicing  phy-
                             sicians. Stipends  are  provided  by  RUP.  The  medical  schools
                             provide all teaching personnel to the program.


                VISITING CONSULTANT PROGRAM TO COMMUNITY HOSPITALS

                Objectives:  Consultants from the medical schools would be provided for
                             continuing education of physicians and allied  health  profes-
                             sionals in area heart and area cancer facilities  which  will  be
                             developed as a  part  of  the  Regional  Medical  Program.  These
                             consultants would also be available for any program of con-
                             tinuing education of physicians and other  health  professionals.


                INTERLIBRARY COPYING SERVICE

                Objectives:  The two medical school libraries  will  provide  expanded  clear-
                             inghouse services for photocopies and  interlibrary  loans  to
                             participating institutions in the  Regional  Medical  Program.
                             Half the cost of a union list of serials will be supported by
                             the Regional Medical Program.


                COLUMBUS MEDICAL CENTER - EMORY UNIVERSITY TEACHING AF-
                FILIATION

                Objectives: A teaching program at the  Medical  Center  in  Columbus  will  be
                             organized and administered by Emory University.  A faculty
                             of qualified local physicians will be appointed and will  receive
                             training (12 days each) in current teaching methods.







                                                   -49-





                                                                         GEORGIA - IV

          APPROVED OPERATIONAL PROJECTS (Continued)


          COMMUNICATIONS NETWORK FOR THE REGION

          Objectives:  A medical education television network would be established
                        to include 41 community hospitals. Programs, designed to
                        meet specific health personnel needs, would be prepared by
                        Emory University and the Medical College of Georgia.


          CANCER VISITING CONSULTANT PROGRAM AND WORKSHOPS

          Objectives:   Through efforts of Area Cancer Directors, teaching consulta-
                        tion sessions will be planned for individual scheduled hospital
                        staff meetings.  "Cancer workshops" will provide the oppor-
                        tunity to attend workshops and benefit from various learning
                        experiences in order to keep current with latest developments.


          IMPROVEMENT AND COORDINATION OF FACILITIES FOR CARDIOVAS-
          CULAR DIAGNOSTIC SERVICES

          Objectives:   The project will assist in the improvement and coordination of
                        existing facilities currently providing cardiac catheterization,
                        angiocardiography and coronary angiography.  A major por-
                        tion of support would be toward strengthening the centers to
                        handle increasing case loads, and to train more medical and
                        paramedical personnel in the field in order that these services
                        can be provided to other hospitals in the Region.


          CARDIOPULMONARY RESUSCITATION

          Objectives:   The project will determine the need and resources for CPR in
                        Georgia, will develop a cadre of instructors, and will create
                        an organizational structure to permit them to carry on train-
                        ing activities in their respective communities.  Financial sup-
                        port will also be provided by the Georgia Heart Association
                        and by the State Department of Public Health.


          CORONARY INTENSIVE CARE DEVELOPMENT IN SMALL HOSPITALS
          (FEASIBILITY STUDY)

          Objectives:   The study employs the use of monitoring units in small hos-
                        pitals directly connected to an operative coronary intensive
                        care unit in a medical center.  The transmission (by special
                        telephone line) from the small hospital will be monitored by
                        trained personnel twenty-four hours a day.  This will enable
                        immediate consultation to the small hospitals.





                                               -50-





                                                                                GEORGIA   -   V

                APPROVED OPERATIONAL PROJECTS (Continued)



                STATEWIDE CANCER PROGRAM

                Objectives:   Through a system of Area Cancer Facilities, programs of
                              continuing education,  professional  workshops,  and  appropriate
                              consultation will be encouraged. A  state  registry  composed  of
                              hospital registries will be service-oriented  to  allow  compar-
                              ative evaluation of cancer therapy. Emphasis will  be  given  to
                              biostatistical support and- to training in biometry.


                PEDIATRIC CHRONIC PULMONARY DISEASE CENTER
                Objectives:   The respiratory center program  of  the  Department  of  Pediat-
                              rics of the Medical College of Georgia will be expanded  to  pro-
                              vide comprehensive regional care teaching and research in
                              chronic respiratory diseases of  children.  Support  would  also
                              be extended by the National  Cystic  Fibrosis  Research  Founda-
                              tion, the Augusta Area T. B.  and  Respiratory  Association,  and
                              other programs sponsored by  the  United  States  Public  Health
                              Service.


                TRAINING PROGRAM FOR MEDICAL SPECIALIST ASSISTANTS (CORO-
                NARY      CARE)

                Objectives:   Emory University  and  Grady  Memorial  Hospital  will  continue
                              a two-year training program for a new occupation - Medical
                              Specialist Assistant (Coronary Care).   The project  was  estab-
                              lished originally as a pilot project and, after a year, shows
                              promising results.  The new specialty concerns the delivery
                              of special skills to patients undergoing coronary care.  The
                              coronary care unit of Grady Hospital is the  principal  teaching
                              resource.


                ATLANTA    AREAWIDE    PLANNING    FOR    PROGRANZ    OF    HEART,     CANCER,
                AND      STROKE

                Objectives:   This project represents support for the final year of an ap-
                              proved three-year  program  for  area  planning.  The  applicant
                              has been informed that its Community Health Services grant
                              should be assumed in the final year by  either  R@  or  by  com-
                              prehensive health planning. The purpose is to  plan  and  imple-
                              ment out-of-hospital services for heart, cancer, and stroke
                              patients in the Atlanta area.








                                                      -51-





                                                                 GEORGIA - VI


         APPROVED OPERATIONAL PROJECTS (Continued)



         COMMUNICATION AND PUBLIC INFORMATION PROGRAM

         Objectives:  As a function of the central administrative staff, attention of
                      interested groups and the public at large will be sought through
                      a newsletter, radio programs, and an audiovisual program
                      for use of public speakers, and a system of press releases.


















































                                           -52-






                                                      GREATER DELAWARE VALLEY - I

              NAME OF PROGRAM                      Greater Delaware Valley Regional Med-
                                                     ical Program
              GEOGRAPHICAL REGION                  Eastern Pennsylvania, the southern part
                                                     of New Jersey, and the entire State'
                                                     of  Delaware

              ESTIMATED POPULATION                 8, 200, 000

              COORDINATING HEADQUARTERS            Greater Delaware Valley Regional Med-
                                                     ical Program
                                                   Wynnewood House
                                                   300 East Lancaster Avenue
                                                   Wynnewood, Pennsylvania 19096
                                                   (Tel.: 215-649-4100)
              PRANTEE ORGANIZATION                 University City Science Center

              EFFECTIVE STARTING DATE              April 1,  1967
              OF PLANNING ACTIVITIES

              EFFECTIVE STARTING DATE              April 1,  1969
              OF OPERATIONAL ACT  ITIES

              TOTAL FUNDING TO DATE                $4,802,342

              FUNDING FOR CURRENT                  $2,862,484
              YEAR'S ACTIVITIES

              CHAIRMAN, REGIONAL                   WilliamF. Kellow, M.D.
              ADVISORY GROUP                       Dean and Vice President
                                                   Jefferson Medical College
                                                   1025 Walnut Street
                                                   Philadelphia, Pennsylvania 19107
              PROGRAM COORDINATOR                  *George R. Clammer, M. D.

              STAFF                                ASSOCIATE DIRECTOR FOR PROJECTS
                                                   Earl S. Barker, M.D.

                                                   ASSISTANT DIRECTOR
                                                   Roderick G. Happel

                                                   CHIEF, AREA LIAISON
                                                   Ward   Bentley

                                                   DIRECTOR OF INFORMATION
                                                   Pierre C. Fraley

                                                   DIRECTOR OF PUBLIC RELATIONS
                                                   C. Allan Lafferty




                Chief Executive Officer          -53-





                                             GREATER DELAWARE VALLEY


         STAFF (Continued)                 AREA LIAISON OFFICERS

                                           Homer B. Glover
                                           Edgar Hare, Jr.
                                           William E. White
                                           Joseph B. Mullin
























































                                         -54-





                                                     GREATER    DELAWARE    VALLEY    -    III

                APPROVED OPERATIONAL PROJECTS



                CORONARY CARE TRAINING COURSE AT WILKES-BARRE GENERAL
                HOSPITAL

                Objectives:   Offers a course in acute coronary care  for  eight  to  tennurs-
                              es to be given four times a year.  Instruction in pulmonary
                              problems will be  included.  Workshops  for  hospitals  develop-
                              ing coronary care may also be developed.


                CORONARY CARE TRAINING COURSE AT READING HOSPITAL
                Objectives:  A four-week course will be given four times a year for the
                              training of nurses in the area of acute  coronary  care.  Staffs
                              of three Reading hospitals will participate in the  instruction.


                GENERAL INTENSIVE CARE COURSES AT ALLENTOWN HOSPITAL
                Objectives:   An 11-week course to be given twice a year will be offered
                              to nurses in the care of. acute  medical  problems.  The  course
                              will provide training in intensive care and in the following
                              areas:  acute myocardial infarction, acute stroke and head
                              trauma, acute cardio-respiratory disease and acute renal
                              failure.  Major goal is to provide a panel of nurses capable
                              of serving any one of these areas.


                PHILADELPHIA REGIONAL CHRONIC PEDIATRIC PULMONARY DIS-
                EASE PROGRAM
                Objectives:   Goals include increase of knowledge in pathophysiology of
                              chest diseases, development of acute diagnostic program
                              and satellite clinics, and training of physicians and other
                              health personnel.  A uniform history and physical form and
                              a case registry will be developed.


                RETRAINING    PROGRAM    FOR    WOMEN    PHYSICIANS    AT    WOMANIS     MEDI-
                CAL COLLEGE OF PENNSYLVANIA
                Objectives:  To provide retraining for women physicians who wish to
                              return to the practice of  medicine.  The  Macy  foundation  has
                              funded planning for the program.








                                                  -55-





                                                                          HAWAII - I


          NAME OF PROGRAM                     Hawaii Regional Medical Program

          GEOGRAPHICAL REGION                 State of Hawaii, plus American Samoa,
                                               Guam, and the Trust Territory of the
                                               Pacific (Micronesia)

          ESTIMATED POPULATION                Trust Territory, 91, 448
                                              Guam, 101, 000
                                              American Samoa, 26, 000
                                              Hawaii, 778, 300

          COORDINATING HEADQUARTERS           Regional Medical Program of Hawaii
                                              Harkness Pavilion
                                              1301 Punchbowl Street
                                              Honolulu, Hawaii 96813
                                              (Tel.:  808/531-6525)

          GRANTEE ORGANIZATION                University of  Hawaii

          EFFECTIVE STARTING DATE             July 1, 1966
          OF PLANNING ACTIVITIES

          EFFECTIVE STARTING DATE             September 1, 1968
          OF OPERATIONAL ACTIVITIES

          TOTAL FUNDING TO DATE               $1, 133, 604

          FUNDING FOR CURRENT                 $903, 301
          YEARIS ACTIVITIES

          CHAIRMAN, REGIONAL                  WilsonP. Cannon, Jr.
          ADVISORY GROUP                      Bank of Hawaii
                                              Post Office Box  2900
                                              Honolulu, Hawaii 96802

          PROGRAM COORDINATOR                 *@sato M. Hasegawa, M.D.

          STAFF                               CHIEF OF FACULTY STAFF
                                              Richard T. A&miya, M.D.

                                              CHIEF OF OPERATIONS
                                              Omar A. Tunks, M. B. A.

                                              CHIEF OF PLANNINGAND OPERATIONS
                                                OF AMERICAN SAMOA, GUAM,, AND
                                                TRUST TERRITORY
                                              Satoru Izutsu,  Ph.D.

                                              CHIEF OF ALLIED HEALTH SERVICES
                                                  s.) Rosie K. Chang, R. N., B. S.,
                                              M. S.





          *Chief Executive Officer          -56-






                                                                           HAWAII - 11


              STAFF (Continued)                    CHIEF OF COOPERATRVE COM-
                                                    MUNITY HEALTH SERVICES
                                                   Andrew 1. T. Chang, M. S. W.

                                                   MEDICAL EDUCATIONIST
                                                   Richard H. Akiyama, B.A., M.S.

                                                   ASSOCIATE CHIEF OF RESEARCH
                                                   SERVICES
                                                   (Mrs.) Nancy C. Fowler, B. A.

                                                   MEDICAL REFERENCE LIBRARIAN
                                                   Clyde J. Winters, M.S. L. S.

                                                   PUBLIC INFORMATION OFFICER
                                                   Ted T. Kurrus


                                                   COMPTROLLER
                                                   Nornian S. Kuwahara, C. P.A.

                                                   ADMINISTRATIVE OFFICER
                                                      s. Grace NL Fujitani

                                                   ONCOLOGIST
                                                   John Keenan, M.D.

                                                   PEDIATRIC PULMONARY PROGRAM
                                                    CONSULTANT
                                                   Herbert Nakata, M. D.































                                                -57-






                                                                          HAWAII - III


           APPROVED OPERATIONAL PROJECTS




           ORGANIZATION AND OPERATION OF CENTRAL REGIONAL MEDICAL
           PROGRAM - HAWAII

           Objectives:   Staff functions for the Hawaii R@ are divided into two
                         categories:  (1) central staff to implement overall program
                         direction, to provide consultation  to  communities  central
                         data collection and evaluation services, and to assist in
                         the development of cooperative arrangements and (2) staff
                         faculty to direct project operations, assist in technical
                         review, teach, draft applications and provide consultation.


           TRAINING IN REHABILITATION IN CATASTROPHIC DISEASES

           Objectives:   The Rehabilitation Center in Honolulu  will  collaborate
                         with the Hawaii Regional Medical Program in providing
                         training for medical and paramedical  personnel  in  the
                         execution of planned rehabilitation programs.  Formal
                         courses will be held in Honolulu everV three months.  Lec-
                         tures and demonstrations will be hefd at already identified
                         auxiliary centers on each of the neighboring islands, at
                         monthly or quarterly intervals.


           HONOLULU HOME CARE SERVICE

           Objectives:   This project will utilize St. Francis Hospital to provide
                         rehabilitation and palliation for terminal patients  through
                         consultation and continuing education by the Honolulu Home
                         Care Service, as well as training on  the  concepts  and
                         administrative aspects of home care.


           CONTINUING EDUCATION FOR NURSES IN PATIENT SETTINGS

           Objectives:   (a) Development and description of a nurse specialist's
                         role in a general hospital setting, Kusakini Hospital;
                         (b) development of data instruments (check lists, rating
                         scales that measure improved patient care in this setting);
                         (c) translation of new methods and techniques  in  the  care
                         of patients with  cardiovascular  problems,  stroke  and
                         cancer of the thorax and of the liver  and  gastrointestinal
                         tract; (d) improved ability to apply a team nursing approach
                         to meet needs of patients  suffering  from  catastrophic
                         diseases, and to communicate  with  patients  and  their
                         families; and, (e) definition of the role of in-service edu-
                         cation to meet needs of nursing department in cooperation
                         with the personnel department.  This is a University School
                         of Nursing-Community hospital  attempt  to  bridge  the  gap
                         between formal and in-service education.


                                             -58-




                                                                              @WAII      IV


               APPROVED OPERATIONAL PROJECTS (Continued)



               CARDIOPULMONARY RESUSCITATION TRAINING

               Objectives:  This is a three year request to train 50, 000 professional
                            and lay persons in cardiopulmonary resuscitation.  The
                            program will be based in Queen's @dical Center; nine
                            secondary centers will be established in hospitals  to  train
                            trainers, and twenty CPR teams will be established in
                            additional affiliated hospitals.  The program will be directed
                            by an anaesthesiologist assisted by two cardiologists, four
                            nurses, volunteers and  Heart  Association  staff.  The  pro-
                            gram will be sponsored by the Hawaii Heart Association
                            which has had a role in coordinating CPRT since 1965.
                            Program objectives include development of a teaching
                            faculty, provision of qualified instructors and operators
                            in every community, and establishment of a retaining
                            program.  Outlines for training courses are provided.


               CORONARY CARE TRAINING PROJECT (Queen's Medical Center)
               Objectives:  A three year program to train physicians and nurses in the
                            organization and delivery of coronary care.  It is estimated
                            that 260 physicians and 310 nurses could participate.  Initial
                            emphasis would be  given  programs  for  nurses  followed  by
                            training programs designed for physicians.  A part-time
                            cardiologist would be retained as training director.  The
                            facilities of three participating hospitals would be used
                            including those of the sponsoring institution.  Previously
                            used course outlines are used as basis for developing
                            teaching programs.  The aims of the proposal include.-
                            training of trainers, training of providers of care,
                            identification of sites for coronary care services, establish
                            methods of evaluation, development of appropriate linkages
                            between CCU training and service units, and develop
                            supportive systems.


               CORONARY CARE UNIT (Hilo Hospital)
               Objectives:  A one-year program to activate a four bed coronary care
                            unit.  Slightly more than half of this support would be for
                            equipment; the balance would  be  used  to  sponsor  coronary
                            care training for 28 nurses and 8 physicians who will travel
                            from Hilo on the Island of Hawaii to Honolulu on  the  Island
                            of Oahu.







                                                -59-





                                                                          HAWAII - V


          APPROVED OPERATIONAL PROJECTS (Continued)



          CORONARY CARE UNIT (Wilcox Memorial Hospital)

          Objectives:   One-year funds are requested to activate a four bed coronary
                        care unit.  Slightly less than half of this support would be
                        for equipment; the balance would be used to sponsor coronary
                        care training for 32 nurses and 9 physicians who will travel
                        from the Island of Kauai to Honolulu.


          REGIONAL PEDIATRIC PULMONARY PROGRAM

          Objectives:   Three years of support is requested for this program which
                        would be based in Kauikeolani Children's Hospital, Honolulu.
                        A program of service, professional training, and research
                        has been presented.  Four, additional hospitals will partici-
                        pate initially, and emphasis will be given the early identi-
                        fication and referral of high risk.cases to the program.



































                                            -60-






                                                           ILLINOIS - I


           NAME OF PROGRAM                Illinois Regional Medical Program

           GEOGRAPHICAL REGION            State of Illinois


           ESTIMATED POPULATION           10, 991, 000

           COORDINATING HEADQUARTERS      Illinois Regional Medical Program,
                                           Inc.
                                          122 South Michigan Avenue,
                                          Suite 939
                                          Chicago, Illinois 60603
                                          (Tel. : 312/939-7307)
           GRANTEE ORGANIZATION           Illinois Regional Medical Program,
                                           Inc.

           EFFECTIVE STARTING DATE        July 1, 1967
           OF PLANNING ACTIVITIES

           TOTAL FUNDING TO DATE          $1, 056, 626

           FUNDING FOR CURRENT            $944, 013
           YF-ARIS ACTIVITIES

           CHAIRMAN, REGIONAL             Oglesby Paul, M.D.
           ADVISORY GROUP                 Professor of Medicine
                                          Northwestern University School of
                                           Medicine
                                          Passavant Hospital
                                          303 East Superior Street
                                          Chicago, Illinois 60611
                                          (Tel.: 312/WH 4-4ZOO)

           PROGRAM COORDINATOR           -@WrightAdams, M.D.

           STAFF                          ASSISTANT EXECUTIVE DIRECTOR
                                          GeorgeA. Lindsley, M.P. .

                                          ASSISTANT EXECUTIVE DIRECTOR
                                          BryanLovelace, Jr., M.A.

                                          PLANNING ASSOCIATE
                                          Robert J. Rom, M.A.
                                          Lois H. Binkley, IvL S. Ed.

                                          PUBLIC INFORMATION ASSISTANT
                                          Marilyn J. V os s, M.S. J.

                                          COORDINATOR, CHICAGO
                                           MEDICAL SCHOOL
                                          Martin E. Bruetn-ian, M.D.




           *Chief Executive Officer   -61-

              356-998 0-69-5






                                                                 ILLINOIS - II


          STAFF (Continued)                   COORDINATOR, UNIVERSITY O.F
                                                HICAGO PRITZKER SCHOOL
                                               OF MEDICINE
                                              Ann M. Lawrence, M.D., Ph.D.

                                              COORDINATOR, LOYOLA UNIVFR-
                                               SITY STRITCH SCHOOL OF
                                               MEDICINE
                                              Isaac Lewin, M.D.

                                              COORDINATOR, UNIVERSITY OF
                                               ILLINOIS COLLEGE OF MEDICINE
                                              Nat E. Smith, NL D.

                                              COORDINATOR, NORTHWESTERN
                                               UNIVERSITY SCHOOL OF
                                               MEDICINE
                                              Jacob Suker, M.D.

                                              COORDINATOR, CHICAGO
                                               COLLEGE OF OSTEOPATHY
                                              Paul Vandervort, D. O.

                                              SUBREGIONAL COORDINATOR
                                              Sheldon S. Waldstein, M. D.
                                              North Suburban Association for
                                               Health Resources
                                              Northbrook, Illinois


                                              L. R. Brosi
                                              Springfield-Central Illinois Health
                                               Care Planning Council
                                              Springfield, Illinois

                                              BUSINESS MANAGER
                                              Joseph J. Gallagher






                                                         INDIANA - I


          NAME OF PROGRAM               Indiana Regional Medical Program

          GEOGRAPHICAL REGION           State of Indiana

          ESTIMATED POPULATION          5, 061, 000

          COORDINATING HEADQUARTERS     Indiana Regional Medical Program
                                        Indiana University School of
                                         Medicine
                                        1300 West Michigan Street
                                        Indianapolis, Indiana 46202
                                        (Tel.: 317/639-8492)

          GRANTEE ORGANIZATION          Indiana University Foundation

          EFFECTIVE STARTING DATE       January 1, 1967
          OF PLANNING ACTIVITIES

          EFFECTIVE STARTING DATE       January 1, 1969
          OF OPERATIONAL ACTIVITIES

          TOTAL FUNDING TO DATE         $2,366,824

          FUNDING FOR CURRENT           $1, 644, 429
          YEAR'S ACTIVITIES

          CHAIRMAN, REGIONAL            Joseph B. Davis, M.D.
          ADVISORY GROUP                The Davis Clinic
                                        131 North Washington Street
                                        Marion, Indiana 46952

          PROGRAM COORDINATOR          *Robert B. Stonehill, M.D.

          STAFF                         DIRECTOR OF PROJECT EVAL-
                                         UATION
                                        Douglas Talbott, M. D.

                                        DIRECTOR OF ADMINISTRATIVE
                                         SERVICES
                                        Charles R. Brown

                                        DIRECTOR OF PROGRAM MAN-
                                         AGEMENT
                                        Roy A. Hagstrom
                                        DIRECTOR OF ALLIED HEALTH
                                         SCIENCES ACTIVITIES
                                        H. Carl Smith

                                        DIRECTOR OF INSTRUCTIONAL
                                         MEDIA
                                        Robert M. Davis
                                        DIRECTOR OF COMMUNITY
                                         RELATIONS
                                        George F. Leamnson


          -Chief Executive Officer -63-






                                                                             INDIANA   -   11


            APPROVED OPERATIONAL PROJECTS




            OFFICE OF COORDINATOR -- CORE PROGRAM

            Objectives: This project will  continue  support  of  the  core  planning  activ-
                          ities.



            MULTI-PHASIC         HEALTH         SCREENING--METROPOLITAN          INDIANAPOLTS

            Objectives:   This project is  based  on  a  feasiblity  study  conducted  during
                          the planning  period.  The  study  provided  health  screening  for
                          1, 360 persons living in the  inner-city.  The  tests  were  admin-
                          istered  by  persons   previously   unemployed   or   underemployed
                          who were  specially  trained  for  this  program.  The  operational
                          project will screen  30,  000  within  three  years.  The  cost  is
                          $26. 43 per tested  individual.  Testing  centers  will  be  placed
                          in  two  geographical  areas  which  are  optimally  accessible  to
                          the residents.



            REGIONAL STROKE PROGRAM

            Objectives:   This program  will  answer  the  need  for  physical  therapy,  oc-
                          cupational therapy,  and  language  therapy  in  aphasia  by  plac-
                          ing  three-man  teams,  representing  each  discipline,   in   five
                          geographical  areas  to  serve  the  entire  Region.  These   teams
                          will visit hospitals on a weekly or biweekly basis to  help  avail-
                          able  hospital  personnel  develop  treatment  programs   for   pa-
                          tients.  Secondly,  a   three-bed   demonstration   treatment   and
                          training center will  be  established  at  the  Indiana  University
                          Medical Center.  Personnel from the entire Region in all
                          medical  and  paramedical  areas  will  receive  training  and  re-
                          training in  this  center.  Third,  educational  programs  will  be
                          developed for the staffs in community hospitals.  Finally,
                          neurological consultation  will  be  made  available  to  the  var-
                          ious communities in the Region.

            NETWORK OF CORONARY CARE UNITS

            Objectives:   This project will assist in  the  establishment  of  coronary  care
                          units  or  other  appropriate  monitoring   facilities   throughout
                          the Region, in conjunction  with  local  medical  and  lay  groups.
                          It will offer physicians training  in  coronary  care  in  a  model
                          demonstration and  training  coronary  care  unit  located  at  the
                          Marion County  General  Hospital,  Indianapolis.  It  will  provide
                          professional consultation  in  operating  coronary  care  units  in
                          outlying hospitals.  Project personnel will cooperate with
                          other institutions in giving  coronary  care  unit  instruction  to
                          nurses.




                                               -64-






                                                                              INDIANA  -   III


               APPROVED OPERATIONAL PROJECTS (Continued)



               HEALTH MANPOWER RECRUITMENT*

               Objectives:   This is a  proposal  to  expand  a  statewide  health  manpower
                             recruitment program by  (1)  extending  local  recruitment  ef-
                             forts, (2) providing additional staff consultation to  guidance
                             personnel  and  students  through  in-school  recruitment  pro-
                             grams, (3)  establishing  a  summer  intern  program,  (4)  de'
                             veloping and  maintaining  a  loose-leaf  Health  Careers  Direc-
                             tory as a regional resource, (5)  operating  a  clearing  house
                             of information for all approved  educational  opportunities,  and
                             (6) revising, publishing, and distributing  gratis  the  career
                             guidebook   entitled   OPPORTUNITIES   UNLIMITED.    This    pro-
                             'ject would utilize a wide range of  informational  and  communi-
                             cations techniques and media.


               EDUCATION AND PRACTICE CF PROSPECTRVE,MEDICINE*

               Objectives-   This  project  proposes  to  extend  the  cooperative  arrange-
                             ments for continuing education in  the  practice  of  prospective
                             (preventive) medicine among primary physicians over a
                             wider geographical area and for a  larger  patient  population.
                             It will link Indiana University School  of  Medicine  with  the
                             medical staffs  in  more  than  a  dozen  community  hospitals.
                             Continuing education for  improvement  of  diagnosis  and  treat-
                             ment will involve medical  and  graduate  students,  practicing
                             physicians,  and  nurse  liprogrammers"  as   physicians'   as-
                             sistants.  The  Health  Hazard  Appraisal  Program   is   based
                             upon the patient's risk of death from  major  specific  causes,
                             according to age, sex and race; it  keynotes  both  a  prospec-
                             tive and a continuing approach to patient  care  by  the  primary
                             physician.  The  coordinating  devices  for  this  program  in-
                             clude the  clinico-prospective  conferences  conducted  by  the
                             Methodist Hospital via  the  Indiana  Higher  Education  Telecom-
                             munications System,  the  application  of  computer  technology
                             to the health data bank for information retrieval,  the  estab-
                             lishment of a health care research  unit,  and  the  evaluation
                             of this approach for both the patient and the physician.


               COMMUNITY HEALTH CENTERS FEASIBILITY STUDY

               Objectives:   Make high quality, continuing medical  care  accessible  to  dis-
                             advantaged  segment  of  Indianapolis  population.  Major  thrust
                             will  be  preventive  medicine  and  health  education.  Health
                             Centers are a potential provider of the followup services
                             needed  to  make  the  Multi-Phasic  screening  program  worth-
                             while. Part of the study will be to  investigate  the  possible
                             use in the health centers of technicians trained in the  Multi-
                             Phasic screening program.

               *Approv@e  but not funded            -65-






                                                                          INDIANA  -  rV

            APPROVED OPERATIONAL PROJECTS (Continued)



            INDIANA CANCER REGISTRY PROGRAM

            Objectives:  To study feasibility of establishing a regional network of
                         tumor registries to evaluate the cancer experience  within  the
                         Region; to study techniques whereby such information could
                         be processed to relay to appropriate individuals  and  agencies
                         in the Region the problems and needs of cancer patients. Can-
                         cer Committees will be established in  strategically  placed
                         population centers and will form tumor registries for the
                         collection of data about cancer incidence, type,  treatment,
                         and survival. Data will be transmitted to the  central  reg-
                         istry at the Indiana University Medical Center.


            A   STATEWIDE   SYSTEM    OF    CONTINUING    NURSING    EDUCATION    LINKED
            WITH THE INDIANA REGIONAL MEDICAL PROGRAM PROJECTS*

            Objectives:  Two-year planning activity to establish an organizational
                         framework for planning and handling of operational projects.
                         Existing manpower and facilities will be surveyed to deter-
                         mine needs, establish priorities, and identify existing  re-
                         sources that can be used for operational activities.




























             Approved but not funded          -66-






                                                                       INTERMOUNTAIN    -    I
               NAME OF PROGRAM                        Intermountain Regional  Medical  Program
               GEOGRAPHICAL REGION                    State of Utah, and portions of  Wyoming,
                                                      Montana, Idaho, and Nevada
               ESTIMATED POPULATION                   2, 184, 000
               COORDINATING HEADQUARTERS              Intermountain Regional Medical Pro-
                                                      gram
                                                      50 North Medical Drive
                                                      Salt Lake City, Utah 84112
                                                      (Tel..- 801/322-7901)
               GRANTEE ORGANIZATION                   University of Utah
               EFFECTIVE STARTING DATE                July 1, 1966
               OF PLANNING ACTIVITIES

               EFFECTIVE STARTING DATE                April 1, 1967
               OF OPERATIONAL ACTIVITIES

               TOTAL FUNDING TO DATE                  $7, 302, 716
               FUNDING FOR CURRENT                    $2,620,236
               YEARIS ACTIVITIES

               CHAIRMAN, REGIONAL                     Sister M. Ann Josephine, C.S.C.,Ph.D.
               ADVISORY GROUP                         Administrator
                                                      Holy Cross Hospital
                                                      1045 East First Street South
                                                      Salt Lake City, Utah 84102
               PROGRAM COORDINATOR                    *C. Hilmon Castle, M.D.
                                                      Associate Dean, University of Utah
                                                      College of Medicine
               STAFF                                  ASSISTANT COORDINATOR FOR OR-
                                                      GANIZATIONAL AND INSTITUTIONAL
                                                      RELATIONSHIPS
                                                      Betty S. Gilson, M.D.

                                                      ASSISTANT COORDINATOR FOR EDUCA-
                                                      TION PLANNING AND EVALUATION
                                                      Mitchell Schorow, M.A.

                                                      PROGRAM MANAGER
                                                      Richard F. Haglund

                                                      DIRECTOR,            HOSPITALPROGRAMSAND
                                                      HEALTH MANPOWER
                                                      Douglas C. Carpenter, Jr., IVLH.A.



                 Chief Executive Officer           -67-






                                                           INTERMOUNTAIN - 11


         STAFF (Continued)                  CHIEFS, RESOURCE PROFESSIONAL
                                            STAFF


                                                HEART
                                                Frank M. Mowry, M.D.

                                                STROKE
                                                C. J. Batson, M. D.

                                                CANCER
                                                Stanley J. Altman, M. D.

                                                NURSING
                                                Barbara J. Kerr, R. N.

                                            CHIEFS, PROJECTS DRVISIONS

                                                DIVISION I (HEART DISEASQ
                                                Dallas F. Whaley

                                                DIVISION 11 (CANCER)
                                                Vaughn L. Pulsipher

                                                DIVISION III (STRQ"E
                                                Arthur B. Anderson


                                                DIVISION IV (COMPUTER MONI-
                                                TORING)
                                                Reed M. Gardner, Ph. D.

                                            DIRECTOR, COMMUNICATIONS DIVI-
                                            SION
                                            Donald W. Ulmer


                                            DIRECTOR, ADMINISTRATIVE SERV-
                                            ICES DRVISION
                                            Ray H. Beckett, Jr.

                                            COORDINATOR, POSTGRADUATE
                                            MEDICAL EDUCATION PROGRAMS
                                            Bruce R. McDaniel


















                                          -68-





                                                                   INTERMOUNTAIN - III


               APPROVED OPERATIONAL PROJECTS



               TRAINING FEEDBACK SEMINAR (CORE - STAFF SEMINAR)

               Objectives:   To conduct workshops for members of the staff, core faculty
                             and Regional Advisory Group of the IR@ to demonstrate
                             techniques for keeping professionals abreast of the latest
                             philosophy of comprehensive health care, continuing educa-
                             tion, patient-care research, learning theory, behavioral
                             sciences, and measurement technology.


               NETWORK FOR CONTINUING EDUCATION

               Objectives:   To offer continuing educational opportunities to practitioners
                             in their own communities.  Provides for establishment of
                             Medical Education Coordinators and hospital-based teaching
                             faculties in many communities; expansion of an existing two-
                             way radio network to provide region wide conferences for
                             physicians, nurses, medical technologists, and hospital per-
                             sonnel; video and audio tape libraries; and loan of video tape
                             equipment to institutions for testing and evaluation of this
                             educational medium.



               INFORMATION AND COMMUNICATIONS EXCHANGE SERVICE (INTRA-
               REGIONAL)

               Objectives:   'l-o establish an information service and communications
                             network which will promote understanding of the Regional
                             Medical Program and gain the interest and support of profes-
                             sional and lay groups and individuals in the region; to promote
                             communication among all elements in the Regional Medical
                             Program; and to solicit and evaluate information feedback to
                             assist in continuing program development.  Publishes monthly
                             newsletter and various bulletins, brochures and instructional
                             materials.


               CARDIOPULMONARY RESUSCITATION TRAINING PROGRAM

               Objectives:   To reduce the mortality from reversible cardiovascular and
                             respiratory failure; to prepare physicians and nurses to ad-
                             minister the latest techniques for cardiopulmonary resuscita-
                             tion; to encourage hospitals to have appropriate modern equip-
                             ment available for patient care and training of health person-
                             nel in its use.









                                                  -69-






                                                                     INTERMOUNTAIN - IV

            APPROVED OPERATIONAL PROJECTS (Continued)



            CARDIAC CARE FOR PHYSICIANS

            Objectives:    To provide physicians with current knowledge and skills
                           necessary for delivery of high.quality coronary care.  A
                           "core faculty" of practicing internists and cardiologists has
                           been formed to teach others as a part of this educational ef-
                           fort.  Regularly scheduled training courses, equipment fa-
                           miliarization labs, and CCU operation clinics are elements
                           of the project.

            TRAINING FOR NURSES IN CARDIAC CARE AND CARDIOPULMONARY
            RESUSCITATION

            Objectives.-   To provide three weeks of concentrated study, followed by
                           one-week  refresher  courses  for  nurses  who  will  return   to
                           their  local  communities  and  develop  training   programs   in
                           coronary care for other nurses.  Continuous evaluation and
                           inservice education of nurses working in coronary care units
                           are a part of this project.


            CLINICAL TRAINEE PROGRAM IN CARDIOLOGY  - UNIVERSITY OF
            UTAH MEDICAL CENTER

            Objectives:  To increase the number of practicing cardiologists and up-
                           grade the ability of  general  practitioners  and  internists  to
                           treat cardiac problems.  The training intensity will be varied
                           according to the needs of the physicians.


            VISITING CONSULTANTS AND TEACHER PROGRAM FOR SMALL COM-
            MUNITY HOSPITALS

            Objectives:    To establish clinics to upgrade the level of care available to
                           patients with heart disease who live in remote areas.  Visit-
                           ing specialists  in  cardiovascular  diseases  assist  the  local
                           physician in a precise diagnosis of  his  patients  and,  in  the
                           process, teach him about heart disease.


            COMPUTER-BASED      SYSTEM      FOR      MONITORING       PHYSIOLOGIC       DATA
            ON-LINE FROM REMOTE HOSPITALS
            Objectives:    To carry out a pilot study of the feasibility of processing on
                           a central computer facility a variety of physiological signals
                           generated from patients in remote hospitals and feeding the
                           results of these calculations directly back to stations within
                           these hospitals where the information can be used for diagno-
                           sis and care of that patient.



                                                  -70-






                                                                          INTERMOUNTAIN     -      V

                 APPROVED OPERATIONAL PROJECTS (Continued)



                 CANCER TRAINING AND CONTINUING EDUCATION PROGRAM

                 Objectives:    To upgrade the level of care available to cancer patients.
                                Coordinates existing teaching programs and develops re-
                                fresher  courses  for  practicing  physicians,  technicians,   and
                                other  personnel   involved   in   cancer.care.   Physicianteachers,
                                participate  in  tumor  boards  and  clinics  in  remote  communi-
                                ties,  and  in  two-way  radio  consultation  and  presentations.  A
                                computerized  regional  tumor  registry  is  maintained  to   pro-
                                vide automated data collection, analysis and evaluation of
                                quality of patient care  and  effectiveness  of  cancer  education
                                programs and  to  insure  timely  follow-up  of  cancer  patients.


                 STROKE AND RELATED NEUROLOGIC DISEASE

                 Objectives:    1.  To establish visiting consultant and teaching clinics
                                   that will bring  expert  consultation  service  in  stroke  and
                                   related neurological diseases to local communities and
                                   provide continuing education to local nurses and physi-
                                   cians; and to collect data about  the  type  of  patients  seen
                                   with these diseases  and  the  problems  they  present  to  the
                                   practitioner.

                                2. To  establish  an  information  library  and  telephone   consul-
                                   tation service to  keep  the  practitioner  abreast  of  knowl-
                                   edge about the care  of  stroke  victims;  to  provide  him  with
                                   advice  at  the  moment  he  needs  it.  A  24-hour   telephone
                                   consultation service and information library service is
                                   maintained at the University of Utah Medical Center.

                                3. To  establish  an  inservice  training  program  in   neurology
                                   to train practicing physicians in  the  latest  diagnostic  and
                                   treatment  techniques  and  to  inform  them  of  therapy  avail-
                                   able.  Trainees will be accepted for 4 weeks to 1 year.

                 EDUCATIONAL     PROGRAM     IN     RESPIRATORY     THERA@Y      FOR      PHYSICIANS
                 AND       NURSES

                 Objectives.-   To provide training for  physicians  and  nurses  inhow  to  utilize
                                the special  techniques  and  equipment  in  respiratory  therapy.
                                Five-day  seminars  and  follow-up   two-day   refresher   courses
                                assist participants  in  learning  how  to  administer  therapy  and
                                how to teach others what they have learned.







                                                       -71-






                                                                 INTERMOUNTAIN     -     VI


           APPROVED OPERATIONAL PROJECTS (Continued)



           REGIONAL ENDOCRINE METABOLIC LABORATORY

           Objectives:   To provide service  facilities  where  practicing  physicians  can
                         obtain laboratory data essential to diagnosis and treatment;
                         to  create  awareness  among  physicians  of  the  possible  pres-
                         enceofmetabolicandendocrineabnormalities:toderive          statis-
                         tical information.  Three  laboratories  haven  been  established:
                         an  immuno-assay  laboratory,  a  chemical  laboratory   to   mea-
                         sure steroid hor   nes, and a developmental laboratory to
                         refine techniques. Seminars will be  held  both  inside  and  out-
                         side of the  laboratories.  Abnormal  findings  will  be  reported
                         to the referring physician by telephone  by  a  physician  who  is
                         competent to offer  consultation  and  specific  educational  pro-
                         grams will be designed for each  physician  using  the  laboratory
                         determination as the stimulus and point of entry.


           CORONARY CARE UNITS IN SMALL HOSPITALS

           Objectives:   To assist small hospitals in the region  in  providing  for  their
                         coronary patients the capability  for  monitoring  cardiac  rhythm
                         and recognizing, and  treating  optimally,  any  complications  by
                         means of coordinated training programs for physicians and
                         nurses,  consultation  on  design,  equipment,  procedures,   etc.
                         Also, to create a  network  of  cooperating  hospitals  with  spe-
                         cialized coronary care capabilities, so that 900/o of the  popula-
                         tion can have access to such care  within  two  hours  (50  miles)
                         of onset of symptoms.


           MODEL     DEMONSTRATION     ACUTE     STROKE     CARE     AND     REHABILITATION
           UNIT

           Objectives:   To provide  a  model  unit  for  research,  education  and  demon-
                         stration  of  exemplary  care  in  cerebrovascular  disease.   In-
                         formation obtained on stroke patients in this unit  will  be  used
                         to define what is necessary  and  feasible  to  provide  "optimum"
                         management.


           CORE ADMINISTRATION,        PLANNING, AND EVALUATION PROJECT

           Objectives:  To  support  administrative  and  planning  functions  and  provide
                         objective continuous evaluation of  the  impact  of  IRNM  on  the
                         health professionals and quality of patient care, as  well  as  on
                         patients in the Intermountain Region.






                                              -72-





                                                            INTERMOUNTAIN - VII


              APPROVED OPERATIONAL PROJECTS (Continued)




              REGIONAL MYOCARDIAL INFARCTION DATA SYSTEM AND STUDY OF
              CORONARY CARE*

              Objectives:  To establish a uniform regional myocardial infarction data
                          system and to study the effectiveness of coronary care units
                          in reducing death and complications in patients with acute
                          myocardial infarction.













































               Approved but not funded       -73-






                                                             IOWA-1

        NAME OF PROGRAM              Iowa Regional Medical Program
        GEOGRAPHICAL REGION          State of Iowa

        ESTIMATED POPULATION         2, 774, 000
        COORDINATING HEADQUARTERS    Iowa Regional Medical Program
                                     308 Melrose Avenue
                                     Iowa City, Iowa 52240
                                     (Tel.: 31@/353-4018)
        GRANTEE ORGANIZATION         University of Iowa College of Medicine
        EFFECTIVE STARTING DATE      December 1, 1966
        OF PLANNING ACTRVITIES

        EFFECTIVE STARTING DATE OF   July 1, 1968
        OPERATIONAL ACTIVITIES

        TOTAL FUNDING TO DATE        $1, 037, 696

        FUNDING FOR CURRENT          $486,820
        YEARIS ACTIVITIES

        CHAIRMAN, REGIONAL           Harry Weinberg, M.D.
        ADVISORY GROUP               1333 West Lombard Street
                                     Davenport, Iowa 52804
        PROGRAM COORDINATOR          *Willard A. Krehl, M.D., Ph. D.
        STAFF                        ASSISTANT COORDINATOR
                                     Charles W. Caldwell

                                     DIRECTOR, PROFESSIONAL AND
                                     PUBLIC EDUCATION AND INFORMA-
                                     TION
                                     J. R. (Pat) Gallagher

                                     FIELD CONSULTANTS
                                     (Miss) Doris Steele
                                     William Schaaf
                                     Roger Tracy

                                     ADMINISTRATIVE ASSISTANT
                                     (Mrs.) Mary Henry

                                     COMMUNICATIONS ASSISTANT
                                     (Mrs.) Joyce Lupan







         Chief Executive Officer   -74-






                                                                                  IOWA - II


                APPROVED OPERATIONAL PROJECTS




                CORE ADMINISTRATION

                Objectives:  Coordination of all planning and operational activities, data
                              collection, establishment of priorities, evaluation and over-
                              all administration.



                CENTRAL STROKE EDUCATIONAL PROJECT

                Objectives:   To establish a university-based educational and demonstra-
                              tion facility to improve and expand comprehensive stroke
                              management education through courses given at both the uni-
                              versity and community settings.


                A COMPREHENSIVE PROGRAM IN STROKE MANAGEMENT

                Objectives:   Stroke teams in three communities will be responsible for
                              educational programs for health personnel concerned with the
                              total management of the stroke patient; consultation to phy-
                              sicians; strengthening arrangements in the community for
                              continuity of care; and supervising nursing rehabilitation
                              services.  Long range planning involves expanding to include
                              sixteen subregions covering the entire region.


                TRAINING PROGRAM IN CARDIOPULMONARY RESUSCITATION

                Objectives:  Medical and related personnel will be trained and retrained
                              in CPR methods.  Pilot studies will be made of the effective-
                              ness of training lay personnel to use these techniques.


                EDUCATION AND TRAINING FOR NURSES AND PHYSICIANS RESPON-
                SIBLE FOR THE OPERATION OF INTENSIVE CORONARY CARE UNITS

                Objectives:   Two training centers provide four-week intensive courses for
                              nurses; one training center provides 5-day courses for phy-
                              sicians; advisory service to hospitals indevelopmentof ICCUS;
                              data collection; and utilization of University Hospitals and Des
                              Moines hospitals as training centers.










                                                   -75-






                                                                              IOWA  -  III


          APPROVED OPERATIONAL PROJECTS (Continued)




          COORDINATED OUT-OF-HOSPITAL SERVICES IN POLK COUNTY

          Objectives:   This proposal would support parts of the final year  of  a  three-
                        year  program  currently  funded  by  PHS  grant   for   community
                        planning and coordination of home health activities. IR@
                        would be involved in the home  care  team  activity  and  the  in-
                        formation and referral center.  Support requested for one
                        year, due to end in September, 1969.


          CONTINUING CANCER EDUCATIONAL PROGRAM FOR PHYSICIANS

          Objectives:   This  project,  administered  through  the  Central   Tumor   Reg-
                        istry at the University of Iowa College of Medicine, is de-
                        signed to offer continuing cancer education to the practicing
                        physician  and  allied  health  professionals  within  the  commu-
                        nity hospital setting, utilizing the data  collected  through  the
                        Central  Tumor  Registry  and  its  cooperating  hospitals.   Sup-
                        port of these activities is presently provided  by  a  PI-IS  com-
                        munity cancer demonstration grant, the National Cancer
                        Institute, the Iowa  State  Department  of  Health,  the  American
                        Cancer  Society  and  the  IRNW.  IRNW  funds  have  enabled   ad-
                        ditional hospitals to participate in the ca ncer program.


          ECONOMIC STUDIES, DIVISION OF MEDICAL ECONOMICS

          Objectives:   Launched  as  A  Program  to  Develop  a  Model  Health   Informa-
                        tion  System  in  Iowa,  this  program  would  be  separated  from
                        the IRNM with limited funding that will allow for funding to
                        be sought from other  sources.  This  will  permit  -  on  an  in-
                        terim  basis-analysis,  interpretation,  collation  and  the  pro-
                        per recording  for  retrieval  of  information  and  data  amassed
                        by the Division of Medical Economics during the IR@'s
                        planning stage.


          DIAGNOSIS    AND    FOLLOW-UP    CARE    OF    CHILDREN    WITH    HEART    DIS-
          EASE


          Objectives:   Clinics are presently conducted in  Iowa  for  the  diagnosis  and
                        follow-up of  infants  and  children  with  heart  disease.  These
                        clinics care for approximately  3,  700  patients  per  year.  The
                        shortage of pediatric cardiologists threatens the quality of
                        this program. This project  is  designed  to  alleviate  the  cri-
                        tical lack of manpower by training a  nurse  to  assume  the  role
                        of a pediatric clinical associate and applying  electronic  hybrid
                        computer  screening  techniques  for  the   cardiovascular   eval-
                        uation and follow-up of children.


                                              -76-






                                                             KANSAS - I

           NAME OF PROGRAM               Kansas Regional Medical Program
           GEOGRAPHICAL REGION           State of Kansas-

           ESTIMATED POPULATION          2. 293.;.OOO
           COORDINATING HEADQUARTERS     Kansas Regional Medical Program
                                         3909 Eaton
                                         Kansas City, Kansas 66103
                                         (Tel.: 913-236-9920)
           GRANTEE ORGANIZATION          University of Kansas Medical Center
           EFFECTIVE STARTING DATE       July 1, 1966
           OF PLANNING ACT-RVITI]ES

           EFFECTIVE STARTING DATE       June 1, 1967
           OF OPERATIONAL ACTRVITIES

           TOTAL FUNDING TO DATE         $3,024,144

           FUNDING FOR CURRENT           $2,042,492
           YEARIS ACTIVITIES

           CHAIRMAN, REGIONAL            George A. Wolf, Jr., M.D.
           ADVISORY GROUP                Provost and Dean, School of Medicine
                                         University of Kansas Medical Center
                                         39th and Rainbow Boulevard
                                         Kansas City, Kansas 66103
                                         (Tel.: 913-236-5252)
           PROGRAM COORDINATOR           *Robert W. Brown, M.D.
           STAFF                         ASSOCIATE COORDINATORS

                                            INSTITUTIONS AND ADMINISTRA-
                                            TION
                                            Charles W. Moore

                                            POSTGRADUATE EDUCATION
                                            Jessie D. Rising, M.D.

                                         ASSTSTANT COORDINATORS

                                            RELATED HEALTH PROFESSIONS
                                            (Nfiss) Loanna E. Biers

                                            RESEARCH AND EVALUATION
                                            Richard Watts


                                            NURSING
                                            (Nfiss) Barbee Cassingham


             Chief Executive Officer  -77-

              356-998 0-69-6






                                                                     KANSAS - 11

          STAFF (Continued)                  DIRECTOR, OFFICE FOR LIBRARY
                                             SERV ICES
                                             Earl Farley

                                             DERECTOR, OFFICE FOR COMMUNICA-
                                             ;f IONS
                                             Gordon Titus


                                             DIRECTOR, OFFICE FOR COMPUTER
                                             SERVICES
                                             Robert T. A&nning, IvL D.

















































                                          -78-






                                                                                 KANSAS  -   III

                 APPROVED OPERATIONAL PROJECTS



                 EDUCATIONAL PROGRA@ - GREAT BEND, KANSAS
                 Objectives:   To develop a model educational program in a selected com-
                               munity. A full-time faculty, which will be  affiliated  with  the
                               Kansas  Medical  Center,  will  be  in  residence.  Includedamong
                               a  comprehensive  program  are  plans  for  continuing  physician
                               and nurse education and clinical traineeships for health-re-
                               lated personnel.  Studies will be made of community needs,
                               resources, etc.


                 REACTIVATING NURSES - GREAT BEND, KANSAS
                 Objectives:   A program of clinical and didactic training for inactive nurses
                               in  Great  Bend  or  within   commutingdistance.   Eightfour-week
                               sessions are to be  offered-annually  with  emphasis  on  cancer,
                               heart disease, and stroke.  Evaluations will be made six
                               months after each course or session.  Traineeships will be
                               made available.


                 CIRCUIT COURSE FOR ACTIVE NURSES - WICHITA, PARSONS, EM-
                 PORIA, CONCORDIA, COLBY, GARDEN CITY, GREAT BEND, AND
                 SABETHA

                 Objectives:   A circuit  course  program  using  didactic  presentations,  dem-
                               onstrations, films and panel discussions.  These various
                               teaching methods will be used to highlight the changes that
                               have emerged in professional clinical nursing care of pa  --
                               tients suffering f rom cancer, stroke, and heart dis ea s e.  The
                               circuit teaching team will visit each of the above  cities  three
                               times annually to provide one day sessions in each locality.
                               Participants willbeasked for their evaluations.immediately
                               following each presentation.


                 CARDIOVASCULAR NURSE TRAINING
                 Objectives:   To develop an  in-service  training  program  to  prepare  nurses
                               with basic physiological knowledge of coronary care, ability
                               to use instruments and equipment in coronary care units,
                               experience in home care, and  familiarity  with  social  agencies
                               that can aid in the rehabilitation of patients.







                                                    -79-





                                                                            KANSAS - iv


            APPROVED OPERATIONAL PROJECTS (Continued)




            CARDIOVASCULAR WORK EVALUATION

            Objectives:   To  demonstrate  the  Cardiac  Work  Evaluation  Unit  and  show
                          its usefulness for the evaluation and rehabilitation of the
                          patient; to develop an effective technique for showing phy-
                          sicians and the community at large the ability  of  patients  to
                          return to work.



            CONTINUING EDUCATION FOR CARDIAC CARE

            Objectives:   Wesley Hospital, in Wichita, would initiate a training pro-
                          gram for nurses in  the  following  techniques:  providing  care
                          for heart patients, utilizing self-instructional media, pre-
                          ceptorships, and teaching conferences as well as lectures.
                          The project will also involve St. Francis Hospital, St. Joseph
                          Hospital and Wesley Medical Center, utilizing medical educa-
                          tional faculty from each, as well as a visiting faculty when
                          needed.  The program will provide an intensive course for
                          ten days, two hours a day, and repeated every three months,
                          for nursing as well as other paramedical personnel in the
                          cooperating institutions, and subregional community hos-
                          pitals.  The evaluation methods will be pre-test and post-
                          testing methods, as well as personality tests.


            METROPOLITAN KANSAS CITY NURSE RETRAINING PROGRAM

            Objectives:   All metropolitan area hospitals except one in the greater
                          Kansas City area, will participate in a program for nurse
                          reactivation.  This is the first interregional project.  The
                          proposal represents a coordinated effort of providing an
                          ongoing opportunity for the inactive nurse to become updated
                          and or retrained.  The course will last for six weeks and will
                          provide clinical experience in each of the associate hospitals.
                          Six courses will be offered annually.


            HEALTH DATA BANK

            Objectives:   This project will be concerned with the first phase of the
                          development of a Health Data  Bank.  It  will  thoroughly  dbcu-
                          ment: (1) the need(s) for the system; (2) benefits; (3) cost  in
                          terms of manpower and time  to  develop  the  system;  (4)  type
                          and cost of computer equipment which would be used as a
                          central core to the system; and  (5)  the  funding  requirements
                          for the system.




                                                -80-






                                                                                 KANSAS   -    V

                 APPROVED OPERATIONAL PROJECTS (Continued)


                SELF-INSTRUCTIONAL CENTERS
                Objectives:   This proposal requests funds to  establish  two  other  health
                              self-instructional centers  at  small  community  hospitals  along
                              the lines of the Great Bend  Project.  Its  objectives  will:  (1)
                              reinforce, using established centers  for  the  continuing  educa-
                              tion of health professionals, and(Z)  provide  for  the  distribu-
                              tion of educational materials of  the  Kansas  Heart  Association;
                              the American Cancer Society, Kansas Division, Inc.; the
                              Kansas  Tuberculosis  and  Health  Association;  and  the  Univer-
                              sity of  Kansas  Department  of  Postgraduate  Medical  Education.
                              The Department  of  Postgraduate  Medical  Education  will  be
                              responsible for the supervision of the project.

                PERCEPTUAL      MOTOR      DYSFUNCTION      ASSESSNMNT       AND       TREATNMNT
                Objectives:   A three-day program would be presented  at  the  Institute  of
                              Logopedics, Wichita,  for  100  occupational  therapists  from
                              Kansas  and  six  other  states.   Two   consultants   recommended
                              by  the  Perceptual  Motor  Dysfunction  Committee  of  ADTA  will
                              present  the  program.  Emphasis  will  be  given  to  methods  of
                              assessing perceptual motor dysfunction and the sharing of
                              information as  to  treatment  approaches  which  have  been  used
                              successfully by others. The  project  will  be  evaluated  by  the
                              Postgraduate  Education  Department  of  the  University  of  Kan-
                              sas Medical Center and  by  Regional  Medical  Program  staff.

                PHYSICAL THERAPY WORKSHOP
                Objectives:   A three day workshop  for  10-12  registered  physical  therapists
                              will be held at the  University  of  Kansas  Medical  Center.  The
                              purpose of the workshop  will  be  to  provide  basic  information
                              as to the appropriate  instruction  of  supportive  personnel  em-
                              ployed by adult care homes or small community hospitals.
                              Selection of trainees will be based in part upon their  avail-
                              ability to provide this instruction to supportive personnel in
                              their  local  communities.  One-day  review  conferences  will
                              be conducted for the participating  physical  therapists  a  three
                              and nine-month intervals  following  the  workshop.  A  course
                              outline is presented.  Evaluation will be conducted by the
                              Postgraduate Education Department of the Medical Center,
                              the physical therapy  staff,  and  the  Regional  Medical  Program
                              staff.








                                                   -81-






                                                                        KANSAS   -   VI


           APPROVED OPERATIONAL PROJECTS (Continued)



           THERAPEUTIC NUTRITION

           Objectives:  A twelve-day institute at Kansas State  University  is  planned
                        for therapeutic dietitians which will update their knowledge
                        of current dietetic information.  Instructions will include
                        lectures, audio-visual aids, and discussions.  Enrollment
                        will be limited to 30 trainees and the course will carry two
                        hours graduate credit. The pyoject will  be  evaluated  by  the
                        faculty member presenting the course and by Regional Me-
                        dicalprogram staff.  A course outline is provided.


           CANCER CHEMOTHERAPY SEMINAR

           Objectives:  Two one-day seminars  for  practicing  physicians  are  planned
                        for presentation at Tope@ and  Hays.  This  pilot  proposal  is
                        sponsored by the State Medical Society, the State  Division  of
                        the American Cancer Society, the State chapter of the Ameri-
                        can College of Surgeons, the State Department of Health, and
                        the Department of Postgraduate Medical Education of the
                        School of Medicine. A primary  objective  is  to  present  cur-
                        rent information regarding  clinical  chemotherapy  of  cancer.
                        Enrollment would be limited to 24 physicians.  A seminar
                        schedule is presented.  Evaluation would be made by Regional
                        Medical Program staff.


           CORE PROGRAM

           Objectives:  Sixty-one persons are indicated as currently employed full
                        or part-time in the ten offices organized  under  the  program.
                        The offices are designated functionally as those of: (1) the
                        Coordinator, (Z) Administration and Institutions, (3) Con-
                        tinuing Education, (4) Nursing Education,  (5)  Health  Related
                        Professions, (6) Research  and  Evaluation,  (7)  Data  Proces-
                        sing, (8) Medical Communications, (9) Library Services,
                        and (10) the Wichita Coordinator.

















                                               -8Z-






                                                                                KANSAS  -  V   II


                 APPROVED OPERATIONAL PROJECTS (Continued)



                 A     CONTINUING     EDUCATION     PROGRAM     FOR     OCCUPATIONAL     THERA-
                 PISTS*

                 Objectives:   (1) To increase the occupational therapists' professional
                               value to patients with stroke  and  post-cardiac  disability  by
                               training them in this more current and basic treatment
                               method: (2) to bring patient treatment in this area of  the  coun-
                               try up to the highest current level; (3) to  train  occupational
                               therapists, not in a particular method but in a concept of
                               treatment  which  is  the  foundation  for  many  neuro  uscular
                               facilitation techniques; (4) to most effectively present this
                               involved  method  of  treatment,  the  Rood  Technique,  through
                               live demonstration and  supervised  practice  in  order  to  teach
                               the correct application and gain an  understanding  of  this  mod-
                               ern neurophysiological concept; and,  (5)  to  disseminate  this
                               knowledge so that the participants will  be  able  to  competently
                               teach other staff the concept and technique.


                 CEREBROVASCULAR AND NEUROLOGICAL NURSE TRAINING*
                 Objectives:   To increase: (1) understanding and  participation  in  the  multi-
                               disciplinary approach to patient care; (2)  understanding  of  the
                               interrelatedness of patient, family  and  community;  (3)  ability
                               to assess and analyze  nursing  problems  peculiar  to  patients
                               with. cerebrovascular  and  neurological  disease;  (4)  knowledge
                               and skills necessary to give direct care to  patients  with  cere-
                               brovascular and neurological  conditions;  (5)  skills  in  pre-
                               ventive measures  of  complications  from  prolonged  bed  rest;
                               and, (6) ability to help patient move  from  dependence  to  in-
                               dependence, i. e. activities of daily living.


                 KANSAS MEDICAL LIBRARY SYSTEM*

                 Objectives:   Medical library services include: (1)  development  of  a  collec-
                               tion of books, journals and other  materials  pertinent  to  the
                               biomedical sciences, (2) maintenance  of  special  subject  refer-
                               ences, files and indexes, (3) circulation of  material  by  photo-
                               copying, (4) filing and indexing of internal reports, (5)  main-
                               tenance of reference services, and (6)  compilation  of  biblio-
                               graphies on biomedical topics.  In  order  to  provide  adequate
                               medical library services in  the  state,  an  organized  network
                               provides knowledge  of  medical  library  services  to  health-re-
                               lated personnel; assistance to hospital administrators  in  build-
                               ing basic medical literature and to medical librarians, a
                               source of material not available at their local level.




                  Approved but not funded           -83-






                                                                              KANSAS - VIII


            APPROVED OPERATIONAL PROJECTS (Continued)



            FOOD    SERVICE     PERSONNEL     USING     THE     DIETARY     CONSULTANT     AP-
            PROACH*

            Objectives:    (1) To contribute to patient care through improvement of
                           menu planning, food preparation and service, sanitation, and
                           related topics  and,  (2)  to  supplement  the  existing  knowledge
                           of non-professional food service personnel concerning menu
                           planning,  food  preparation  and  service,  sanitation,  and   re-
                           lated areas.


            COORDINATED SYSTEM FOR THE CONTINUING EDUCATION OF NM-
            DICAL AND PARAMEDICAL PERSONNEL*

            Objectives.-   (1) To establish and maintain coordinated efforts of existing
                           in  service  training  programs  in  Newman  and  St.   Mary   Hos-
                           pitals, Emporia, Kansas; (2) to extend these programs to
                           other area hospitals and nursing homes and other community
                           groups concerned with patient care in the areas of heart,
                           cancer, stroke and related diseases; (3) to provide a common
                           community  resource  for  continuing   education,   consisting   of
                           personnel facilities, equipment, and libraries; (4) to stimulate
                           continuing  education  for  medical  and  paramedical   groups   in
                           the areas of heart, cancer, stroke and related diseases; and,
                           (5)  to  improve  patient  care  through  consumer  education   and
                           better trained medical and paramedical personnel.


            CANCER CARE CONTINUING EDUCATION PROGRAM*

            Objectives:    The program will combine the clinical teaching resources
                           and medical experience of this region with the educational re-
                           sources of the University of Kansas Medical Center.  The
                           educational resources of the Kansas Division of the American
                           Cancer  Society  Wesley  Medical  Center,  St.  Francis   and   St.
                           Joseph  hospitals  in  Wichita  will  also  be  used.  By  properly
                           utilizing and coordinating all of these existing resources, we
                           believe we can develop a very effective cancer care continu-
                           ing education program for nursing and paramedical personnel.










            *Approved but not funded              -84-






                                                                                     KANSAS   -   IX
                 APPROVED OPERATIONAL PROJECTS (Continued)


                 SEMINAR ON BASIC MEDICAL LIBRARIANSHIP*
                 Objectives:    To impart the  basic  skills  of  medical  librarianship  to  sub-
                                professionals  in  order  to  improve  medical  library   services
                                in the state; (2)  to  improve  acquisitions,  cataloging,  refer-
                                ence services, and  inter-library  loans;  (3)  to  increase  inter-
                                library cooperation;  and  (4)  to  indoctrinate  the  sub-profes-
                                sionals in ways and means of keeping  up  to  date  in  the  art  of
                                medical  librarianship.  A  two-day  symposium  will  be   held   on
                                May 15-16, 1969 at the University of Kansas.

                 KANSAS CITY COUNCIL ON HEALTH CAREERS HEALTH MANPOWER
                 RECRUITMENT PROGRAM*
                 Objectives.-   Incooperationwiththestatemedicalsociety,            statenursesasso-
                                ciation, high s chool counselors and directors of health prof es -
                                sional schools (1) to create an increase  in  numbers  of  student
                                applicants to allied health  professional  schools;  (2)  to  create
                                an increase  in  numbers  of  student  health  professionals  enter-
                                ing schools from families  with  incomes  less  than  $5,  000;  and
                                (3) to develop more effective  and  efficient  methods  of  health
                                science  recruiting.  A  7-point  program   will   encompass   the
                                following;  High  school  biomedical  career  programs   and   as-
                                semblies, counseling, tutoring, academic program, job
                                placement, tours, and testing.

                SUBREGIONAL OFFICE IN TOPEKA
                Objectives:     This is a request to establish  a  second  subregional  office  in
                                Topeka similar to the  one  in  Wichita  which  is  functional.  The
                                Topeka   sub-region   is    described    inthenarrativeandrepresents
                                the third largest grouping in health  personnel  and  facilities  in
                                theKansasRegion.                TheTopekasubregionalCoordinatorwould
                                work with a local action group  in  defining  health  needs  and  in
                                identifying  appropriate  programs  to  meet  them,   promotion   of
                                effective utilization of health resources,  and  in  assisting  with
                                the coordination of training  or  retraining  program  for  health
                                manpower.










                 Approved but not funded              -85-






                                                      LOU15IANA
        NAME OF PROGRAM             Louisiana Regional Medical Program
        GEOGRAPHICAL REGION         State of Louisiana

        ESTIMATED POPULATION        3. 7z6, ooo
        COORDIMTING HEADQUARTERS    Louisiana Regional Medical Program
                                    Claiborne Towers Roof
                                    119 South Claiborne Avenue
                                    New Orleans, Louisiana 701 1 2
                                    (Tel.: 504/522-5678)
        GRANTEE ORGANIZATION        Louisiana State Department of
                                    Hospitals
        EFFECTRVE STARTING DATE     January 1, 1967
        OF PLANNING ACTRVITEES

        TOTAL FUNDING TO DATE       $1,177,840
        FUNDING FOR CURRENT         $467,550
        YEARIS ACTRVITIES

        CHAERMAN, REGIONAL          Charles B. Odom, M.D.
        ADVISORY GROUP              4500 Magnolia Street
                                    New Orleans, Louisiana 70115
        PROGRAM DIRECTOR            *Joseph A. Sabatier, Jr., NL D.
        STAFF                       ADVISORS TO THE DIRECTOR

                                      Robert Sappenfield, M. D.
                                      School of Medicine, Louisiana
                                      State University (New Orleans)

                                      Jerome Ryan, M.D.
                                      Tulane University School of Medicine
                                      (New Orleans)

                                      Joseph T. Hamrick, M.D.
                                      School of Public Health and Tropical
                                      Medicine
                                      Tulane University (New Orleans)

                                    ASSISTANT DIRECTOR FOR
                                    ADMINISTRATION
                                    Frank Roberts

                                    PLANNING SECTION
                                    C. Jerre Lloyd, Acting Chief
                                    Beverly Baird



       *Chief Executive Officer    86-






                                                                     LOUISIANA - II

              STAFF (Continued)                PROJECT DEVELOPMENT AND
                                               EVALUATION SECTION
                                               Ijaurence J. Baas,, Acting Chief
                                               Rafael Sanchez, K D.
                                               B. A. Gla s s, M.D.

                                               BUSINESS MANAGER
                                               Louis J. Edmondson

                                               CONSULTANT, PUBLIC RELATIONS
                                               AND INFORMATION
                                               Joseph Coyle
                                               Tulane University School of Medicine
                                               (New Orleans)













































                                           -87-






                                                         MAINE  I


        NAME OF PROGRAM             Maine's Regional Medical Program

        GEOGRAPHICAL REGION         State of Maine

        ESTIMATED POPULATION        1, 000, 000

        COORDINATING HEADQUARTERS   Maine's Regional Medical Program
                                    295 Water Street
                                    Augusta, Maine 04330
                                    (Tel. : 267/622-7566)

        GRANTEE ORGANIZATION        Medical Care Development, Inc.

        EFFECTIVE STARTING DATE     May 1, 1967,
        OF PLANNING ACTIVITIES

        EFFECTRVE STARTING DATE     July 1, 1968
        OF OPERATIONAL ACTIVITIES

        TOTAL FUNDING TO DATE       $1, 355,455

        FUNDING FOR CURRENT         $865,ogo
        YEARIS ACTRVITIES


        CHAIRMAN, REGIONAL          Donald H. Horsman, M.D.
        ADVISORY GROUP              50 Goff Street
                                    Auburn, Maine 04210
                                    (Tel. : 7-07/78.2-8350)

        PROGRAM COORDMTOR           *Manu Chatterj ee, M.D.

        STAFF                       ASSISTANT PROGRAM COORDINATOR
                                    Niles L. Perkins, M.D.

                                    ASSOCIATE COORDINATOR, MAINE
                                    CITIES
                                    John R. Davy, "D.

                                    DIRECTORS


                                      ADMINISTRATIVE SERVICES
                                      Justin W. Cowger

                                      COMMUNITY RELATIONS
                                      Jefferson D. Ackor


                                      NURSING
                                      (Miss) Cora E. Pike, R.N.

                                      TELECOMMUNICATIONS AND
                                      DATA PROCESSING
                                      John A. LaCasse




        *Chief Executive Officer    -88-






                                                                        @INE - n
              STAFF (Continued)                 ADMINISTRATIVE ASSLSTANT
                                                (Mrs. ) Janet H. Jones

                                                RESEARCH ASSISTANT
                                                (Miss) Patricia Wallace

                                                PROJECT DIRECTORS

                                                  CORONARY CARE
                                                  Harold 4 Osher, M.D.

                                                  PHYSICIANS' CONTINUING
                                                  EDUCATION
                                                  Philip G. Good, K D.

                                                  SMOEING CONTROL
                                                  Joseph L. Ha enfus

                                                  REGIONAL HEALTH AGENCY
                                                  UPPER KENNEBEC VALLEY
                                                  Burt C. Sheehan

                                                  GUEST RESIDENT PROGRAM
                                                  George J. Robertson, M. D.
                                               ASSISTANT PROJECT DIRECTOR,
                                               CORONARY CARE
                                               Joseph @ Edgar, M.D.

                                               NURSE TRAINING DIRECTOR,
                                               CORONARY CARE-
                                               (Miss)   eve C. Brady, R.N.

                                               CONSULTANTS

                                                  RESEARCH AND EVALUATION
                                                  Bhopinder S. Bolaria, Ph. D.

                                                  STROKE
                                                  E. Charles Kunkle, K D.

                                                  REHABILITATION
                                                  John J. Lorentz, M.D.

                                                  HEART



                                                  CANCER
                                                  Hadley Parrot, K D.






                                          -89-


                                                                               I



                                                           MAINE - III
         TAFF (Continued)             NURSING

                                     COMPUTERIZED MEDICAL
                                      RECORDS, CORONARY CARE






















































                                 -90-






                                                                             MAINE - IV
                APPROVED OPERATIONAL PROJIECTS



                VISITING GUEST RIESIDIENT PROJECT
                Objectives:  To continue and expand a program initiated'by the Bingham
                             Associates Fund which sends senior residents or fellows at
                             Tufts-New England Medical Center to small community
                             hospitals.  Thisestablishesalineofcommunicationsbetween
                             the University Hospital Center and the relatively isolated
                             practitioners.


                KENNEBEC VALLEY REGIONAL HEALTH AGENCY PROGRAM
                Objectives:  This project establishes cooperation between Maine's
                             Regional Medical Program and the Regional Health
                             Agency of Maine's Upper Kennebec Valley in the develop-
                             ment of a regional approach to comprehensive health
                             care and planning for rural area residents.


                SMOKING CONTROL
                Objectives:  This project is designed to improve the health status of
                             Maine people through an educational and action program
                             directed against "cigarette disease. 11 Basic work has
                             already been done by the Maine Interagency Council on
                             Smoking and the Health Council of Maine.  This project
                             involves Maine's Regional Medical Program in these
                             activities and provides a coordinator and other staff
                             assistance, office equipment and supplies, and supplies
                             administrative funds.


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




                                             -91-






                                                                        MAINE - V

           APPROVED OPERATIONAL PROJECTS (Continued)



           PHYSICIANS' CONTINUING EDUCATION PROGRAM

           Objectives:   This project wi 11 establish teaching programs in 20
                         community hospitals and five groups of small community
                         hospitals.  Four programs will be presented annually to
                         the staffs of these hospitals in the areas of heart disease,
                         cancer, stroke, and rehabilitation.


           CORE PROGRAM

           Objectives:   The major objective of the administrative shift from plan-
                         ning to core will be to connect operational projects to the
                         planning process.  Other goals are: (1) provide leadership
                         and assistance in the development and accomplishment of
                         program objectives; (2) maintain regional relevance within
                         individual operational projects; (3) update and redefine
                         operational objectives; and (4) expand the services of the
                         Research and Evaluation Unit at the University of Maine.


           DIRECTOR OF MEDICAL EDUCATION PROGRAM*

           Objectives:  Proposes a "third faculty" composed of Directors of
                         Medical Education.  Expanded and improved opportunities
                         for continuing education of rural area health professionals
                         is the major emphasis of this program.


           REGIONAL LI]BRARY*

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
















           *Approved but not funded       -92-





                                                         MARYLAND - I
           NAME OF PROGRAM             Maryland Regional Medical Program
           GEOGRAPHICAL REGION         State of Maryland, less environs of
                                       Washington, D. C. ; includes lower
                                       southeastern counties of Delaware,
                                       Accomac County (Virginia), and York
                                       County (Pennsylvania)

           ESTIMATED POPULATION        3,754,000
           COORDINATING HEADQUARTERS   Maryland Regional Medical Program
                                       550 North Broadway
                                       Baltimore, Maryland 21ZO5
                                       (Tel. :301/342-7445)
           GRANTEE ORGANIZATOIN        The Johns Hopkins Medical Institutions
           EFFECTIVE STARTING DATE     January 1, 1967
           OF PLANNING ACTIVITIES

           EFFECTIVE STARTING DATE
                                       March 1, 1969
           OF OPERATIONAL ACTIVITIES

           TOTAL FUNDING TO DATE       $3,204,046

           FUNDING FOR CURRENT         $2,236,5?.o
           YEARIS ACTIVITIES

           CHAIRMAN, REGIONAL          M. Shakman Katz
           ADV OR Y                    2609 Talbot Road
                                       Baltimore, Maryland 21216
           CHAIRMAN, ADMINISTRATIVE    William Peeples, M.D.
           COMMITTEE                   Commissioner, State Health Department
                                       301 West Preston Street
                                       Baltimore, Maryland 21201
           PROGRAM COORDINATOR         *William S. Spicer, Jr., M.D.

           STAFF                       DIRECTOR
                                       Abraham M. Lilienfeld, M. D.
                                       Epidemiology and Statistical Center

                                       ASSOCIATE COORDINATORS

                                         Edward S. Stafford, M.D.
                                         Johns Hopkins University

                                         Perry Stearns, M. D.
                                         State Health Department

                                         Arlie R. Mansberger, Jr., M.D.
                                         University of Maryland

                                     -93-
           *Chief Executive Officer


              356-998 0-69- 7





                                                        MARYLAND II
         STAFF (Continued)           ASSOCIATE COORDINATORS
                                     (Continued)

                                       HEALTH PLANNING AND
                                       RESEARCH
                                       Louis P. Hellman, Sc. D.

                                       CONTINUING EDUCATION
                                       Bruce E. Strem, Ph., D.

                                       EPIDEMIOLOGY AND STATISTICAL
                                       CENTER
                                       Maureen Henderson# M. B. B. S.

                                    ASSISTANT COORDINATORS

                                       MEDICAL CARE ADMINISTRATION
                                       AND  AMBULATORY  SERVICES
                                       Harle V. Barrett, K D.

                                       CONTINUING EDUCATION
                                       Eugene J. Linberg, M.D.

                                       AUDIOVISUAL   DEVELOPMENT
                                       J. D. Allred, D. Ed.

                                       CONTINUING EDUCATION  AND
                                       ADMINISTRATION
                                       Richard C. Peters

                                    BUSINESS MANAGER
                                    Richard M. Metzinger

                                    SURVEY DIRECTOR, EPIDEMIOLOGY
                                    AND STATISTICAL CENTER
                                    Jean Galkin, D.P. H.

                                    PUBLIC INFORMATION OFFICER
                                    Bernard A. Curtis


















                                 -94-






                                                                      MARYLAND - III


               APPROVED OPERATIONAL PROJECTS




               CONTINUING EDUCATIONAL PROGRAM FOR PENINSULA GENERAL
               HOSP-ITAL

               Objectives:  To meet the need of a sound continuing educational program,
                            funds for 500/o support of a Director of Continuing Education
                            are requested for this 334 bed community hospital located
                            100 miles from Baltimore on the Eastern Shore.


               DEVELOPMENT AND EVALUATION OF A COMPREHENSIVE
               TECHNICAL SCREENING PROGRAM FOR SCHOOL-AGE CHILDREN OF
               LOW-INCOME FAMILIES

               Objectives:  By utilizing specially trained health technicians, the
                            Community Pediatric Center of the University of Maryland,
                            in cooperation with the Baltimore City Health Der)artment,
                            would develop a comprehensive technical screening pro-
                            cedure for school-age children with a high incidence of un-
                            diagnosed cardiovascular renal and pulmonary diseases.


               EARLY DETECTION OF CARDIAC AND MALIGNANT DISEASE IN
               PRE-SCHOOL AND SCHOOL CHILDREN

               Objectives:  The pediatric clinic of Mercy Hospital proposes to establish
                            screening programs and diagnostic centers for children
                            from low-income families living in the inner city of
                            Baltimore, and to other children when local resources
                            are not available.


               A PROGRAM FOR MASS DETECTION OF HEART DISEASE IN SCHOOL
               CHILDREN

               Objectives:  In the first year, children of nine schools will be screened
                            by phono-cardioscan team trained by the Community
                            Pediatric Center of the University of Maryland,  Approxi-
                            mately 3, 500 children will be surveyed initially, with
                            planned increase in activity up to 20, 000 screenings per
                            year.



               EARLY DETECTION OF HEART DISEASE IN THE NEWBORN

               Objectives:  A case-finding program for the early detection of congenital
                            heart disease will be established under the auspices of the
                            Johns Hopkins Hospital in six city and four regional cooperating
                            hospitals.




                                               -95-





                                                                  MARYLAND       rV

           APPROVED OPERATIONAL PROJECT-S (Continued)



           CORONARY CARE PROGRAM
           Objectives:  A comprehensive training program in management of acute
                        coronary care units for physicians and nurses will be
                        established in conjunction with the seven bed unit already
                        m operation at the University of Maryland Medical School.


           CLOSED CHEST CARDIOPULMONARY RESUSCITATION
           Objectives:  The Heart Association of Maryland proposes to establish a
                        cardiopulmonary resuscitation teaching center in each
                        community hospital in the Region to instruct physicians,
                        nurses and select lay personnel in closed chest cardio-
                        pulmonary resuscitation techniques.


           ACUTE AND CHRONIC STROKE UNITS

           Objectives:  A four-bed acute stroke unit will be established at Johns
                        Hopkins to provide initial diagnosis and intensive care
                        of patients with acute cerebral vascular episodes.


           ACUTE INTERMEDIATE AND LONG TERM STROKE CARE PROGRAM
           Objectives:  The York Hospital, a 530 bed acute general hospital, would
                        establish a four-bed acute stroke unit, an eighteen bed
                        intermediate care unit, and a three bed special evaluation
                        and post-intermediate care unit for the complete care and
                        rehabilitation of patients with stroke.


           PROPOSAL ON STROKE - UNRVERSITY OF MARYLAND
           Objectives:  The University of Maryland would expand the services of
                        its functioning out-patient stroke clinic, to establish a four
                        bed acute stroke unit, and augment an existing cooperative
                        arrangement with Montebello State Hospital for care of
                        patients with rehabilitation potential.












                                          -96-





                                                                           MARYLAND - V
                APPROVED OPERATIONAL PROJECTS (Continued)


                PROPOSED COORDINATED DISCHARGE PLANNING PROGRAM FOR
                WICOMICO AND SOMERSET COUNTIES
                Objectives:   Through the joint cooperation of the Wicomico County
                              Health Department  and  the  Peninsula  General  Hospital,
                              a public health nurse will coordinate  a  planned  program
                              of follow-up care for indigent and medically indigent patients
                              discharged from Peninsula  General  Hospital  to  home  or
                              to chronic disease hospitals or nursing homes.


                REGIONAL MEDICAL PROGRAM FOR OUTPATIENT STROKES

                Objectives:   The Deer's Head Chronic Disease and Rehabilitation
                              Hospital in cooperation with the Peninsula General
                              Hospital  and  Wicomico  County  Health  Department   will
                              establish an outpatient community rehabilitation clinic
                              for stroke patients.


                DEMONSTRATION AND TRAINING PROGRAM IN THE REHABILITATION
                OF STROKE PATIENTS
                Objectives:   By expansion of existing facilities at Sinai Hospital, the
                              Department of Rehabilitation Medicine proposes a
                              comprehensive demonstration program for the management
                              of patients with stroke.


                CLINICAL CANCER PROGRAM AND REGISTRY*
                Objectives:  Peninsula General Hospital would establish a clinical
                              cancer program registry as outlined by the American
                              College of Surgeons.


                AN     AMBULATORY     PROGRAM      FOR      COMPREHENSIVE      PULMONARY
                SERVICES

                Objectives:   The Maryland General Hospital proposes to establish a
                              model ambulatory pulmonary service unit to demonstrate
                              optimum, comprehensive  care  for  patients  with  chronic
                              respiratory disease.








                *Approved but not funded        -97-





                                                        MEMPHIS - I
         NAME OF PROGRAM             Memphis Regional Medical Program
         GEOGRAPHICAL REGION         Western Tennessee, Northern
                                      Mississippi, Eastern Arkansas, and
                                      portions of Kentucky and Missouri
         ESTIMATED  POPULATION       2, 435, 000
         COORDINATING HEADQUARTERS   Memphis Regional Medical Program
                                     The University of Tennessee Medical
                                      Units
                                     62 South Dunlap
                                     Memphis, Tennessee 38103
                                     (Tel. : 901/527-8371)
         GRANTEE  ORGANIZATION       The University of Tennessee College
                                     of Medicine
         EFFECTIVE STARTING DATE     April 1, 1967
                          ITIES
         EFFECTIVE STARTING DATE     July 1, 1968
         OF OP   TIONAL A TIVITI]ES
         TOTAL FUNDING TO DATE       $1, 192, 974
         FUNDING FOR CURRENT         $781, 789
         YEA  AC   ITI]ES
         CHAIRMAN, REGIONAL          Frank M. Norfleet
         DVISORY GROUP               Mid-South Medical Center Council
                                     1331 Union Avenue
                                     Memphis, Tennessee 38104
         PROGRAM COORDINATOR         *James W. Culbertson, M.D.
         STAFF                       EPIDEMIOLOGIST - STATISTICIAN
                                     Mark Kashgarian, D.

                                     CONSULTANT IN COMMUNITY
                                     SERVIC S
                                     Kathryn Taylor, M. S. S. W.

                                     MEDICAL ECONOMIST
                                     Lewis N.  mis, Ph.D.

                                     CONSULTANT IN NURSING SERVICES
                                     Ruth H.  ryc e, R. N. , M.N.

                                     NUR
                                     Jean

                                     NURSING SPECIALIST IN CANCER
                                     Patricia unigan, R- N.. M.
       *Ch ef Executive Officer   -98-






                                                                           MEMPHTS - E

               STAFF (Continued)                   INFORMATION OFFICER
                                                   Clayton Braddock,  M.  A.

                                                   ASSOCIATE INFORMATION OFFICER
                                                   Kenneth L. Johnson, B. J.

                                                   ASSISTANT INFORMATION OFFICER
                                                   Fred Rawlinson, B. F.  A.

                                                   PLANNING ADVISOR
                                                   Joyce H. Harrell, B.A.

                                                   COMMUNICATIONS OFFICER
                                                   John Vincent, M. B.A.

                                                   EDITORIAL OFFICER
                                                   Betty S. @rk, B. J.

                                                   ADMINISTRATIVE ASSISTANT FOR
                                                     OPERATION
                                                   Ellen P. McDowell

                                                   CHAIRMAN OF COMMITTEES
                                                   (University of Tennessee College of
                                                     Medicine)

                                                   CENTRAL COMMITTEE AND
                                                     PLANNING BOARD
                                                   James W. Pate, M. D.

                                                   CARDIOVASCULAR
                                                   Charles E. Kossmann, M.D.

                                                   CANCER AND COMMUNICATIONS
                                                   Edward H. Storer,  NL  D.

                                                   CEREBROVASCULAR
                                                   Robert A. Utterback, M. D.

                                                   COMMUNITY        MEDICINE
                                                   Henry Packer, M.D.

                                                   DISEASE PREVENTION
                                                   Dean F. Davies, M.D.

                                                   AUTOMATION (COMPUTER SERVICES)
                                                   Glenn Clark, M.D.

                                                   CONTINUING EDUCATION
                                                   William North, NL D.

                                                   RESEARCH
                                                   Richard Overman,  Ph.  D.


                                                -99-





                                                                      MEMPHIS      IH
           STAFF (Continued)                   BEHABILTXATIQN
                                               Robert Christopher, M.D.

                                               ALLI]ED HEALTH PROFESSIONS
                                               Blair Erb, M.D.
                                               Jackson, Tennessee

                                               LEBRARY SCIENCE AND SERVICES
                                               Andrew Lasslo, Ph.D.
                                               (College of Pharmacy)

                                               NURSING
                                               Ruth Neil Murry, B.S. N., NL S.
                                               (College of Nursing)

                                               DENTISTRY
                                               Roy M. Smith, D. D. S.
                                               (College of Dentistry)

                                               PHARMACY
                                               Grover Bowles, B. S.
                                               Baptist Memorial Hospital
                                               Memphis, Tennessee

                                               COMMUNITY SERVICES
                                               (Chronic Disease Advisory)
                                               Richard Block
                                               Memphis, Tennessee































                                           -100-





                                                                         MEMPHIS - rV
               APPROVED OPERATIONAL PROJECTS


               ESTABLISHMENT   OF   A   STROKE   CENTER   IN    THE    MEMPHIS    REGION
               Objectives:   A "model center" for management of stroke, including a
                             special unit for the intensive care of stroke, would be
                             developed in the University of Tennessee - City of
                             Memphis Medical Center.  The Center would be used for
                             development of a training program to provide special
                             nursing skills, dissemination of new information techniques
                             and therapeutic approaches, expansion of  physical  therapy
                             training facilities, and development of continuing education
                             programs for stroke management.  The facility would be
                             availableforcomplexdiagnosticproblems   referred    fromall
                             medical institutions in the Region.

               REGIONAL LABORATORY FOR GASTROINTESTINAL MUCOSAL
               SUCTION BIOPSY
               Objectives:  Project would establish a laboratory for gastrointestinal
                             mucosal suction biopsy at the University of Tennessee.
                             Servicesofthelaboratorywouldbeavailable   to   allphysicans
                             in the Region.


               PROGRAM FOR PREVENTION AND IMPROVED TREATMENT OF
               SKIN     CANCER
               Objectives:   Skin cancer is the indigenous cancer of the Memphis
                             Region.  Although such cancers can be successfully
                             treated in dermatologists' offices, many patients are  poor
                             farm workers who under-utilize medical facilities.  The
                             proposal would combine a study for defining the problem
                             with educational activities aimed at the general public, as
                             well as at health professionals.  Appropriate laboratory
                             facilities will assure recruitment of a highly qualified
                             clinician-investigator.

               REGIONAL PROGRAM FOR PERIPHERAL VASCULAR DISEASE
               Objectives:   Renovation and remodeling of space in an out-patient
                             clinic of the University of Tennessee Medical Center will
                             permit establishment of a first class vascular out-patient
                             teaching service and clinic. Approximately 250/o of support
                             would come from sources other than RMP.







                                             -101-





                                                                      MEMPH15 - V
            APPROVED OPERATIONAL PROJECTS (Continued)


            CORONARY CARE TRAINING UNIT
            Objectives:  A I 2-bed coronary care unit would be installed in the
                         City of Memphis Hospital of the  University  of  Tennessee
                         Medical Center.  The unit would be a training and demon-
                         stration "show case" for health professionals  from  other
                         hospitals in the Region. Training and  consultation  would
                         be facilitated by a standard -format for coronary care unit
                         data which would be suitable for analysis by computer.
                         The coronary care unit would be affiliated with an existing
                         myocardial infarction center.


           REGIONAL PROGRAM ON EMPHYSEMA AND COR PULMONALE
           Objectives:   A special out-patient facility for chronic obstructive
                         lung disease will be housed in the City of Memphis Hospital
                         out-patient department.. Pulmonary function  studies  will
                         make use of data processing facilities and will assist in
                         evaluation of results.


           STREPTOCOCCAL DISEASE CENTER
           Objectives:   A service laboratory for the Region will be established
                         in the City of Memphis Hospital out-patient clinic.
                         Diagnostic services and epidemiological studies will be
                         available for the entire Region.  Objectives are to
                         standardize culture techniques, and to  develop  epidemio-
                         logical teams.  Clinical facilities for referral of rheumatic
                         fever victims would also be provided.

           REGIONAL ELECTROCARDIOGRAPHIC DIAGNOSTIC CENTER
           Objectives:   The project will provide im-proved service in the recording
                         and processing of electrocardiograms for outlying areas
                         in the Region.  Facilities will be centralized to utilize
                         modern technology for rapid recording and processing.
                         A computer program for ECG interpretation will be
                         developed; it will be suitable for smaller computers,
                         which will be more practical economically for smaller
                         hospitals or communities.









                                       -102-






                                                                          MEMPHis - VI

                APPROVED OPERATIONAL PROJECTS (Continued)



                OBION COUNTY GENERAL HOSPITAL PROJECT

                Objectives:  This General Hospital in  Union  City,  Tennessee,  requests
                             support for upgrading certain key facilities in order to
                             increase its potential and capability for handling heart,
                             cancer, and stroke.  Facilities concerned are radiographic
                             equipment, radioisotope laboratory facilities, pulmonary
                             function laboratory, and equipment for a coronary care unit.


                COMBINED ATTACK ON CERTAIN FORMS OF HEART DISEASE,
                CANCER, AND STROKE

                Objectives:  Two hospitals, Community Methodist, Paragould, Arkansas,
                             and Dunklin  County  Memorial,  Kennett,  Missouri,  request
                             support for forming a transportation service between the
                             two institutions.  The service would avoid duplication of
                             facilities by transporting patients, specimens,  educational
                             materials, personnel, blood and blood products, and
                             various documents.


                A PROPOSAL FOR A CARDIOVASCULAR INTENSIVE CARE UNIT*

                Objectives:  Proposed by the St. Bernard's Hospital, Jonesboro,
                             Arkansas, this project proposes to install and operate
                             monitoring devices with four bedside  unit  components,  and
                             one central nursing station console and to train necessary
                             paramedical personnel by sending them to operational
                             centers in geographic proximity of the hospital.



















               *Approved but not funded       -103-




                                        METROPOLITAN WASHINGTON, D.C. -I
          NAME OF PROGRAM                    Metropolitan Washington, D. C.
                                              Regional Medical Program
          GEOGRAPHICAL REGION                District of Columbia and contiguous
                                              counties in Maryland (2) and Virginia
                                              (2), and the cities of Alexandria,
                                              Falls Church, and Fairfax, Virginia
          ESTIMATED POPI@,  TION            2, 160, 000
                    TING HEADQUARTERS       Metropolitan Washington, D. C.
                                              Regional Medical Program
                                            Medical Society of the District of
                                              Columbia
                                            2007 Eye Street, Northwest
                                            Washington, D. C.  20006
                                            (Tel.: 202/223-6490)
          GRANT-Fr. r-iPr--ATTT17 ATION     Medical Society of the District of
                                             Columbia
          EFF]Er.TTVr- 'Z'rA T) rING DATE   January 1, 1967
          v.r 1-@-NNING ACTRVIT  S
          EFFIEC,'TTVr. C-rA ID -ING DATE   March 1, 1968
          u.r IL).Fh;RATIONAL         s
          TOTAL F                          $2,229,145
          FUNDTWR. rr-ID f-TTnnENT         $1, 058,523
                 ACTIVITIES
          CHAIIRMA     EGIONAL             Francis C. Mayle, Jr., M. D.
                                           8218 Wisconsin Avenue
                                           Bethesda, Maryland  20014
          PROGRAM rnnIDr%rKTA TOR          *Arthur E. Wentz, NL D.
            FF                             EXECUTRVE OFFICER
                                           .LY.LcLiL Aavier

                                           MANAG]EX41PW-r A?-,T,& T @eT
                                           Freci weamer

                                          ASSOCIATE ronT?nMTArrr%ns
                                             Otis L. Anderson, M.D.
                                             Hospital Council of the
                                              National Capital Area, Inc.
                                             Martin E. Levy, M.D.
                                             D. C. Department of Health


          Chief Executive Officer    -104-





                                         METROPOLITAN WASHINGTON, D. C. - H
             STAFF (Continued)                ASSOCIATE COORDINATORS
                                               (Continued)

                                                W. E. Anderson, M. D.
                                                George Washington University
                                                  Medical Center


                                                Maurice E. Odoroff
                                                Georgetown University Medical
                                                  Center


                                                Joel W. Novak
                                                Howard University Medical Center

                                             PROJECT DIRECTORS

                                                CANCER
                                                John R. Heller, NL D.

                                                HEART
                                                John F. Stapleton, M.D.

                                                STROKE
                                                James W. Watts, M. D.


































                                         -105-


                                                                                     I


                                          METROPOLITAN WASHINGTON, D. C. - III

            APPROVED OPERATIONAL PROJECTS



            THE FREEDMENIS HOSPITAL STROKE STATION FOR THE DIAGNOSIS,
            TREATMENT, AND INVESTIGATION OF CEREBRAL VASCULAR
            DISEASE


            Objectives:   To establish a stroke station in which the  latest  methods
                          for the diagnosis and treatment of cerebral vascular
                          disease will be carried out and taught to medical per-
                          sonnel, students, and  paramedical  and  allied  personnel.
                          A team of physicians, social workers, psychologist,
                          occupational therapist, etc. will be involved.


            CEREBROVASCULAR DISEASE FOLLOW-UP AND SURVEILLANCE
            SYSTEM OF GEORGETOWN UNIVERSITY

            Objectives:  To establish baseline data in a formal system.  Incidence
                          of stroke, effectiveness of care, and results of follow-up
                          efforts will be recorded.


            A TRAINING PROGRAM FOR CARDIOVASCULAR TECHNICIANS -
            WASHINGTON HOSPITAL CENTER

            Objectives:  To meet the needs for specially trained paramedical man-
                          power to support physicians and nurses in  a  highly  tech-
                          nical medical and surgical area.


            AUDIOVISUAL LIBRARY OF OVARIAN NEOPLASMS FOR CONTINUING
            EDUCATION

            Objectives:   This project will test the value of audiovisual  projectors
                          in the community hospitals and medical centers as a means
                          of continuing education. A cassette  library  dealing  with
                          ovarian neoplasms will be developed by Columbia Hospital,
                          Medical Illustrations Department of George Washington
                          University, Armed Forces Institute of Pathology, and Rodel
                          Studios.  Distribution will be made to hospitals.














                                            -106-





                                             METROPOLITAN   WASHINGTON,   D.   C.   -    IV

                APPROVED OPERATIONAL PROJECTS (Continued)



                COMPREHENSIVE   CARE    OF    PATIENTS    WITH    PULMONARY    DISEASE    -
                GEORGETOWN

                Objectives:   This project will establish a  continuing  teaching  program
                              between Georgetown and, initially,  6  community  hospitals.
                              Physicians,  nurses,  cardiopulmonary  technologists,  chest
                              physical therapists, and inhalation therapists will  receive
                              training required for modern diagnostic and treatment
                              services. The training  program  consists  of  a  "compre-
                              hensive visit" by a Georgetown staff team  to  the  community
                              hospitals to work with professional counterparts;  on-site
                              visits of health personnel to Georgetown; the  out-patient
                              breathing clinic at  Georgetown;  the  computer  pulmonary
                              function program; and two-day seminars.


                MOBILE    CORONARY    CARE    UNIT    -    MONTGOMERY    COUNTY    HEART
                ASSOCIATION

                Objectives:   This project will establish a mobile coronary care unit
                              primarily to serve Montgomery County, Northwest
                              Washington, D. C. and Metropolitan Prince George's
                              County.  The unit will be stationed on a rotating basis
                              at the three hospitals in the area which now  have  Coronary
                              Care Units. These hospitals will  provide  trained  nurses
                              for the unit; physicians will be provided by the Heart  Dis-
                              ease  Control  Program,  HEW;  and  Cardiovascular   techni-
                              cians will be recruited from among Navy and Army
                              corpsmen.



                HOME TELECASTS OF MEDICAL-SURGICAL CARDIOVASCULAR
                CONFERENCES

                Objectives:   This is a one-year pilot project to introduce medical  tele-
                              vision to the Region's physicians as a source for  continuing
                              education.  The program to be presented is the weekly
                              medical-surgical conference conducted by Georgetown
                              University's Division of Cardiology.  The media is an
                              educational station which can place expensive operating
                              equipment and trained manpower at the disposal of the
                              project. Evaluation  mechanisms  have  been  developed  by
                              the Director of the Center for Educational Technology,
                              Graduate School of Education, Catholic University of
                              Am erica.








                                               -107-





                                         METROPOLITAN WASHINGTON, D.C. - V

           APPROVED OPERATIONAL PROJECTS (Continued)



           PARAMEDICAL PROFESSIONAL RETRAINING BY VI]DEOTAPE*

           Objectives:   To use videotape to retrain medical technologists who have
                         been out of practice ten years or more.  Will be conducted
                         in the Laboratory Service of the Veterans Administration
                         Hospital, with the cooperation of the Pathology Department
                         at George Washington Hospital Center.


           A HEALTH CAREERS COUNCIL FOR THE NATIONAL CAPITAL AREA*

           Objectives:   A Council will be established to coordinate and amplify
                         existing recruitment efforts within the Region and develop
                         new programs.  Through this Council, the Region hopes to
                         make information about  health  careers  and  scholarships
                         available to school guidance counselors, health groups,
                         and interested individuals.



           METROPOLITAN WASHINGTON REGI<)NAL CANCER REGISTRY*

           Objectives:   The D. C. Department of  Health  cancer  registry  can  be
                         computerized and enlarged to collect complete cancer
                         data for the entire Metropolitan Washington Region,
                         analyze it thoroughly, and report findings to  physicians,
                         hospitals, and health departments.


           METROPOLITAN WASHINGTON AREA PERIPHERAL VASCULAR
           FACILITY*

           Objectives:   To establish a Central Peripheral Vascular Facility at the
                         George Washington University with independent Peripheral
                         Satellite Clinics at Providence Hospital, D.  C.  General,
                         D. C. Village, and Fairfax Hospital.


           CORE PROGRAM

           Objectives:   Aims at assisting the process of  regionalization  through
                         linking patient care with health research and education by
                         developing programs through the use  of  5  Associate  Co-
                         ordinators, reaching into the university  medical  schools
                         and hospitals of the community.  The implementation of a
                         program for continuing medical education and the training
                         of paramedical personnel has been structuredby committees
                         representing  all  hospitals--community,  university,  and
                         federal-- of the Region and will be one of the core staff Is
                         major objectives for 1969-1970.


           *Approved but not funded         -108-





                                                                               MICHIGAN I

              NAME OF PROGRAM                      Michigan  Regional  Medical  Program

              GEOGRAPHICAL REGION                  State of Michigan

              EST@TED POPULATION                   8, 739, 000

              COORDINATING HEADQUARTERS            Michigan Association for Regional
                                                    Medical    Programs
                                                   Suite 200, 1 1 1 1 Michigan Avenue
                                                   East Lansing, Michigan  48823
                                                   (Tel. : 517/351-0290)

              GRANTEE ORGANIZATION                 Michigan Association for Regional
                                                    Medical    Programs

              EFFECTIVE STARTING DATE              June 1, 1967
              OF PLANNING ACTIVITIES

              EFFECTIVE STARTING DATE              July 1, 1968
              OF OPERATIONAL ACTIVITIES

              TOTAL FUNDING TO DATE                $3, 135, 919

              FUNDING FOR CURRENT                  $1, 841, 470
              YEARIS ACTIVITIES

              CHAIRMAN, REGIONAL                   Michael Brennan, IvL D.
              .ADVISORY GR UP                      Suite 200, 1 1 1 1 Michigan Avenue
                                                   East Lansing, Michigan  48823

              PRESIDENT, MICHIGAN                  Don  Marshall,  M.D.
              ASSOCIATION FOR                      President, Michigan Association  for
              REGIONAL MEDICAL PROGRAMS             Regional Medical Programs
                                                   Suite 200, 1 1 1 1 Michigan Avenue
                                                   East Lansing, Michigan  48823

              PROGRAM COORD@TOR                    *Albert E. Heustis, M. D.

              STAFF                                ASSOCIATE PROGRAM COORD@TOR
                                                   Gaetane M. Larocque, Ph. D.

                                                   ASSISTANT PROGRAM COORDMTOR
                                                   Harold Poindexter


                                                   ASSISTANT   TO    PROGRAM    COORDI-
                                                    NATOR
                                                   (Mrs.) Ilze V.  Koch

                                                   FIELD REPRESENTATRVES
                                                   David Eaton-
                                                   Jerard Riddell




              *Chief Executive C)fficer       -109-


                  356-998 0-69-8





                                                                    MICHIGAN  -   II

           APPROVED OPERATIONAL PROJECTS



           CENTRAL PLANNING AND ADMINISTRATIVE STAFF

           Objectives:  Provides guidelines and assistance in development of
                        subregions and districts and is responsible for overall
                        coordination and development of regional cooperative
                        arrangements.


           COORDINATED DATA COLLECTION AND ANALYSIS; PLANNING FOR
           AUTOMATION OF MULTIPLE SCREENING

           Objectives:  To provide designated types of data on heart disease,
                        cancer, and stroke to Regional Medical Program  participants
                        on a block by block basis.


           MICHIGAN HEART ASSOCIATION - MODEL CORONARY CARE UNIT
           CONTINUING EDUCATION CURRICULUMS

           Objectives:  To develop, implement, and evaluate a model teaching
                        package for coronary care unit and intensive care unit
                        personnel. Methods include a  two-week  course  for  nurses,
                        continuing education courses for physicians (1-3 days)
                        and a programmed electronic teaching unit model.  The
                        project demonstrates the value and effectiveness of
                        cooperative program planning and leads  to  the  development
                        of programmed learning texts for classroom use.

           MICHIGAN   STATE   UNIVERSITY    PLANNING    AND    FACILITATING    OF-
           FICE FOR HEART DISEASE, CANCER, STROIKE AND RELATED
           DISEASES

           Objectives:  Under the college of Human Medicine, the  planning  office
                        develops cooperative arrangements for certain geographi-
                        cal areas and plans and conducts continuing education
                        programs.  Long-range  objectives  include  a  preliminary
                        evaluation of health care resources and systems and
                        development of information  resources.  A  local  advisory
                        committee assists in establishing these objectives.


           ESTABLISHMENT OF A CENTER FOR -PHYSICIAN EDUCATION IN
           HYPERTENSION

           Objectives: An existing clinic at the Sparrow Hospital is being  expanded
                        into a training center for the continuing education of
                        physicians in the management of hypertension.  Sparrow
                        Hospital will contribute approximately 300/o of the costs.



                                         -110-





                                                                         MICHIGAN - III


                APPROVED OPERATIONAL PROJECTS (Continued)



                UNIVERSITY OF MICHIGAN ADMINISTRATIVE SECRETARIAT


                Objectives:  This office within the Department of Postgraduate Medicine
                             of the University of Michigan Medical School functions as
                             a major coordination and implementation point for
                             University efforts in programs related to heart  disease,
                             cancer and stroke. Its purpose is  to  avoid  unnecessary
                             duplication of efforts with other University-sponsored
                             programs and to provide core personnel and facilities for
                             carrying out certain specific initial projects.  A local
                             advisory committee provides advice and guidance.


                POSTGRADUATE NURSING EDUCATION - HEART DISEASE, CANCER
                AND STROKE NURSING

                Objectives:  The University of Michigan School of Nursing proposes to
                             identify continuing education needs of nurses in the
                             categorical diseases, to design and implement short-term
                             programs to meet these needs, to  develop  teaching  aids
                             and to evaluate the effectof teaching programs.  Consulta-
                             tion services from the University of Michigan Center for
                             Research in Learning and Teaching and the University of
                             Michigan Center for Research in the Utilization of Scientific
                             Knowledge will be used extensively.


                DRUG INFORMATION AND THERAPY ANALYSIS AND REPORTING
                SYSTEM

                Objectives:  The College of Pharmacy and the University Hospital
                             Pharmacy are conducting a pilot drug information and drug
                             therpay analysis and reporting  system.  The  purpose  is
                             to reduce time between development of new practices,
                             procedures, and methodologies and their practical appli-
                             cation to patient care in the categorical disease. Computeri-
                             zation of information retrieval is involved.



                MEDICAL CARE EVALUATION

                Objectives:  A three to five year pilot study to evaluate and attempt to
                             improve delivery of heart, cancer, and stroke care in an
                             urban community.  The study team will involve collabora-
                             tion between resources of the University of Michigan and
                             a local self-study team made upof consumers andpurveyors
                             of medical care.





                                                                   MICHIGAN - rV

          APPROVED OPERATIONAL PROJECTS (Continued)



          SCHOOL OF DENTISTRY PROGRAM FOR HEART DISEASE, CANCER
          AND     STROKE

          Objectives:  Baseline data requirements for implementation of specific
                       training programs will be developed.  Continuing education
                       programs will be developed and will assist practicing
                       dentists to acquire the ability to detect oral cancer and
                       to manage patients whose cancer or cancer treatment
                       affects their oral health.  An effort will be made to provide
                       information for practicing physicians oral diagnosis and
                       the importance of early consultation in lesions affecting
                       the oral region.


          STUDY OF PHYSICIAN ATTITUDES TOWARD CONTINUING MEDICAL
          EDUCATION

          Objectives:  The degree to which physicians in the Region feel they are
                       able to keep up with the advances in medical knowledge is
                       being surveyed.  Physicians who occupy key roles in the
                       dissemination of new information to their colleagues will
                       be identified.  The data obtained will be the basis for im-
                       proving the system of continuing education in Michigan.


          WAYNE STATE UNRVERSITY STAFF FOR REGIONAL MEDICAL
          PROGRAMS

          Objectives:  A planning group reporting to the Dean of the School of
                       Medicine will be developed to involve all University depart-
                       ments having an interest and capability in relationship to
                       Regional Medical Programs.  Staff maintain fiscal records,
                       coordinate efforts in various departments, and provide
                       central office services to expedite planning activities.
                       Preliminary planning efforts involve studies of the needs of
                       allied health groups for educational programs as well as
                       continuing professional education for physicians.


          ZEIGER/BOTSFORD HOSPITALS PARTICIPATION

          Objectives:  With the organization of a small project staff, these
                       osteopathic hospitals hope to develop and promote effective
                       programs for disseminating knowledge of heart disease,
                       cancer, and stroke management to the osteopathic profes-
                       sion and to other MARMP participants.     In conjunction
                       with the Professional Evaluation Service of the American
                       Public Health Association they are developing a device
                       for evaluating skills of practicing osteopathic physicians.


                                         -112-





                                                                         MICHIGAN - V

               APPROVED OPERATIONAL PROJECTS (Continued)



               SURVEILLANCE OF ELECTRONIC EQUIPMENT IN SPECIAL CARE
               UNITS*

               Objectives:  Sponsored by Wayne State University, this one-year demon-
                            stration program is concerned with the identification and
                            elimination of potential or actual hazards to the care of
                            patients in special care units in hospitals in which acutely
                            ill patients with heart and other diseases are customarily
                            treated.  A survey is being made of all hospitals in the
                            Greater Detroit Metropolitan Area.



































               *Approved but not funded       -113-






                                                     MISSISSI]PPI - I
        NAME OF PROGRAM            Mississippi Regional Medical Program
        GEOGRAPHICAL REGION        State of Mississippi
        ESTIMATED POPULATION       2, 344, 000
        COORDINATING HEADQUARTERS  Mississippi Regional Medical Program
                                   University of Mississippi Medical
                                     Center
                                   2500 North State Street
                                   Jackson, Mississippi 39216
                                   (Tel. : 601/362-4411, ext. 2627)
        GRANTEE ORGANIZATION       University of Mississippi Medical
                                     Center

        EFFECTIVE STARTING DATE    July 1, 1967
        OF PLANNING ACTIVITIES

        TOTAL FUNDING TO DATE      $i, o6o, 505

        FUNDING FOR CURRENT        $648,607
        YEARIS ACTRVITIES

        CHAIRMAN, REGIONAL         Alton B. Cobb, M.D.
        ADVISORY GROUP             510 Lamar Life Building
                                   Jackson, Mississippi 39201


        PROGRAM COORDINATOR        *Guy D. Campbell, M.D.
        STAFF                      HEART AND STROKE COORDINATOR
                                   T. D. @mpton, M.D.

                                   CANCER COORDINTAOR
                                   Guy T. Gillespie, Jr., M.D.

                                   CONTINUING EDUCATION COORDI-
                                     NATOR
                                   William 0. Barnett, NL D.

                                   ALLIED HEALTH PROFESSIONS
                                     SPECIALIST
                                   James B. Moore, Ed. D.

                                   ASSISTANT TO THE COORDINATOR
                                   Maurice Hill







        *Chief Executive Officer  -114-





                                                                   MISSISSEPPI - 11

              STAFF (Continued)                ADMINISTRATIVE ASSISTANT FOR
                                                 OPERATIONS AND FISCAL AFFAIRS
                                               Betty Zimmerman

                                               COMMUNICATIONS SPECIALIST
                                               Maurine Twiss
































































                                           -115-





                                                       MISSOURI - I

        NAME OF PROGRAM             Missouri Regional Medical Program

        GEOGRAPHICAL REGION         State of Missouri, exclusive of St. Louis

        ESTIMATED POPULATION        4, 625, 000

        COORDINATING HEADQUARTERS   Missouri Regional Medical Program
                                    406 Turner Avenue - Lewis Hall
                                    University of Missouri
                                    Columbia, Missouri 65201
                                    (Tel.: 314/449-2711)

        GRANTEE ORGANIZATION        University of Missouri School of
                                     Medicine

        EFFECTIVE STARTING DATE     July 1, 1966
        OF PLANNING ACTIVITIES

        EFFECTIVE STARTING DATE     April 1, 1967
        OF OPERATIONAL ACTIVITIES

        TOTAL FUNDING TO DATE       $13,038,812

        FUNDING FOR CURRENT         $5, 303, 871
        YEARIS ACTIVITIES

        CHAIRMAN, REGIONAL          Nathan J. Stark
        ADVISORY GROUP              Group Vice President, Operations
                                    Hallmark Cards', Inc.
                                    25th and McGee Trafficway
                                    Kansas City, Missouri 65108

        PROGRAM COORDINATOR         *Arthur E. Rikli, M.D., M.P. H.

        STAFF                       ASSOCIATE COORDINATOR
                                    William C. Allen, M.D., M.P. N.

                                    DIRECTOR FOR PLANNING
                                    George E. Wakerlin, M.D., Ph.D.

                                    ASSOCIATE DIRECTORS FOR
                                     PLANNING
                                    Yeu-Tsu Lee, M.D.
                                    Robert S. Cartwright, M. D.

                                    DIRECTOR FOR OPERATIONS
                                    Warren P. Sights, M.D.







        *Chief Executive Officer  -116-






                                                                          MISSOURI  -   II


               APPROVED OPERATIONAL PROJECTS




               SMITHVILLE COMMUNITY HEALTH SERVICE PROGRAM

               Objectives:  To establish a model community health service program.
                            Programs  include:  continuing  education  training   programs
                            and lay health education; emergency, intensive, and
                            restorative care  facilities;  home  care  and  homemaker
                            program; public health, preventive medicine, and school
                            health programs; voluntary health agency coordination;
                            custodial facilities; vocational rehabfl- itation; family
                            counseling; and cancer detection.


               COMMUNICATION RESEARCH UNIT

               Objectives:  To provide the NMMP public information office with re-
                            search support; to identify public attitudes,  opinions,  mis-
                            conceptions, etc. about heart  disease,  cancer,  and  stroke,
                            and, in turn, to learn motivations for seeking health care;
                            to determine effective  methods  for  communicating  with  the
                            public and leading them to seek medical care.


               MULTIPHASIC TESTING OF AN AMBULANT POPULATION

               Objectives:  To establish centers to perform a  series  of  diagnostic
                            laboratory tests which will identify the most useful tests
                            for separating the ill from the healthy population,. either
                            individually or in patterns.  Model  centers will be
                            established at the University Medical Center and the State
                            Mental Hospital. A third is planned  for  the  Smithville
                            complex.


               MASS SCREENING - RADIOLOGY

               Objectives:  To improve the accuracy of radiologic diagnosis of heart
                            disease, cancer and stroke; to  evaluate  the  diagnostic
                            efficiency to various electronic communication media; to
                            determine the applicability of ultra-sound and thermography
                            as screening techniques for neoplastic and vascular diseases.
                            Three hospitals will be connected  by  appropriate  electronic
                            communication systems  to  the  Department  of  Radiology  and
                            Medical Center computer at the University.









                                                  -117-






                                                                   MISSOURI - M

           APPROVED OPERATIONAL PROJECTS (Continued)



           AUTOMATED PATIENT HISTORY

           Objectives:  To investigate the feasibility of an automated system that
                        will provide the physician with (1) a case history and (2)
                        a preliminary analysis of complaints prior to the examina-
                        tion.


           DATA EVALUATION, COMPUTER SIMULATION AND SYSTEMS DESIGN

           Objectives:  To determine: (1) what data from the general public and
                        physicians are needed to allow early detection of heart
                        disease, cancer, and stroke; (2) what mechanisms are
                        needed to produce these data; and (3) how to extract the
                        necessary information from data and present it in the form
                        of a decision or as a basis for a decision.  To evaluate and
                        design the most effective systems.  The departments of
                        electronic engineering, statistics, and mathematics will
                        cooperate with the medical staff in this project.


           COMPUTER FACT BANK

           Objectives:  To develop and apply techniques for delivering the latest
                        information on diagnosis and care of patients with stroke
                        and diseases to the local physicians.  An IBM electronic
                        data information storage and retrieval system will be de-
                        veloped at the University Medical Center.  A depth index
                        will be created which will allow a single word or concept to
                        recall information stored at upper levels of the hierarchy
                        of data.  Students will be taught to use the system.  It will
                        later be extended to include St. Louis, Smithville, and other
                        communities.



           OPERATIONS RESEARCH AND SYSTENZ DESIGN

           Objectives:  To develop operating systems to assist in the objectives of
                        the Regional Medical Program.


           POPULATION STUDY GROUP SURVEY

           Objectives:  To study the factors contributing to the decision of small
                        town and rural families to utilize health services.  The
                        principal relationship to be studied is the influence of the
                        availability of care on the decision to use it.  The
                        National Health Survey Questionnaire will be used.




                                             -118-






                                                                        MISSOURI - IV

               APPROVED OPERATIONAL PROJECTS (Continued)



               AUTOMATED HOSPITAL PATIENT SURVEY

               Objectives:  To use the patient discharge data already collected by the
                             Missouri Hospital Association and tabulated on McBee
                             cards for planning and evaluation of health programs under
                             the Regional Medical Program.


               PROGRAM EVALUATION CENTER

               Objectives:   To identify two communities which have potential for
                             "grass roots" organization for the implementation of com-
                             munity health service programs; to accumulate data about
                             health care, needs, attitudes, etc. in the communities; to
                             initiate the long term process of developing instruments for
                             measuring quality of care and levels of health in terms of
                             an individuals function in his community. The Center, which
                             is a multidisciplinary research unit, will direct this project.


               BIOENG@ERING

               Objectives:  To provide technical assistance in the evaluation and de-
                             velopment of sensor-transducers for early detection of
                             heart disease, cancer, and stroke.


               CENTRAL ADMINISTRATION

               Objectives:  To provide for a staff to assist the Advisory Council and
                             its Subcommittees in overviewing, coordinating, reviewing,
                             and evaluating the program and project proposals.


              AUTOMATED ELECTROCARDIOGRAPHY IN A RURAL AREA

               Objectives:   To provide hospitals and physicians with an automated
                             system of analyzing electrocardiograms; to demonstrate
                             the feasibility of providing physicians with electrocardio-
                             graphic analysis where this service is limited or non-
                             existent; to demonstrate the feasibility of these systems
                             for regional, inter-regional and national use; to develop,
                             test and implement the usage of bioengineering signals to
                             diagnose cardiovascular, neoplastic and related diseases;
                             to develop usage of automated data analysis to screen
                             populations.






                                                 -119-






                                                                   MISSOURI - V

           APPROVED OPERATIONAL PROJECTS (Continued)



           COMPREHENSIVE CARDIOVASCULAR CARE UNITS - SPRINGFIELD,
           MISSOURI

           Objectives:  To develop a comprehensive care unit for grouping  patients
                        with heart or circulatory disease or who have been ad-
                        mitted for other purposes but require close cardiac ob-
                        servation. The program will be conducted where a house
                        staff is non-existent. It is hoped that this grouping of patients
                        relieves the work load for nurses on general medical and
                        surgical wards and improves the quality and efficiency of
                        care.



           A COMPUTER ASSEMBLED ON-GOING @NUAL OF MISSOURI MEDICAL
           AND PARAMEDICAL SERVICES - MISSOURI HEALTH COUNCIL

           Objectives:  To establish a directory of the names, services, and
                        addresses of medical and paramedical services in the
                        entire state of Missouri as a reference source.

           STROKE INTENSIVE CARE UNIT - UNIVERSITY OF MISSOURI MEDICAL
           SCHOOL AND HOSPITAL

           Objectives:  To demonstrate appropriate advance care techniques for
                        stroke patients and train nurses and other medical  person-
                        nel to use these techniques to evaluate the effect of this
                        type of care on the prognosis of the stroke patient.  Follow-
                        up studies and care will be assured by a team of physicians,
                        physical therapists, social workers, etc.


           TRAINING UNIT FOR INTENSIVE CARE OF THE CARDIAC PATIENT
           UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE TEACHING
           HOSPITAL

           Objectives:  To train paramedical personnel in appropriate techniques
                        for intensive care of patients with acute myocardial
                        infarction.



           PROGRAMMED COMPREHENSIVE CARDIOVASCULAR CARE
           KANSAS CITY GENERAL HOSPITAL

           Objectives:  To develop, demonstrate, and train in new methodologies
                        of cardiovascular care, stressing the continuity of care
                        planning from onset of a cardiovascular crisis through  re-
                        covery and rehabilitation.





                                             -120-





                                                                        MISSOURI - VI

               APPROVED OPERATIONAL PROJECTS (Continued)



               NORTHEAST MISSOURI COOPERATIVE STROKE PILOT PROJECT -
               K[RESVILLE CLINIC OF OSTEOPATHY AND SURGERY

               Objectives:  To study and demonstrate how physicians, clinics, and
                            hospitals can cooperate to improve stroke detection, care,
                            and rehabilitation in a rural 5-county area.  Cooperative
                            arrangements in the subregion are being developed between
                            M. D. Is and D. 0. Is, local hospitals, and community leaders.


               COOPERATIVE TUMOR REGISTRY AND COMPUTATION SERVICE
                LLIS FISCHEL CANCER REGISTRY CENTER, COLUMBIA, MISSOURI
               Objectives:  To raise the quality of cancer diagnosis by strengthening
                            and enlarging an automated network of tumor registries
                            in Missouri.  Information collected in each established
                            registry would be transmitted to a centrally located com-
                            puter center.


               -CORE PLANNING ACTIVITIES

               Objectives:  The MRMP planning staff has responsibility for meetings
                            of the MRMP Advisory Council, Project Review Committee,
                            Liaison Committee and Project Directors: working with
                            groups in the Region on initiation and development of pilot
                            project proposals; preparing MRMP operational grant
                            applications; professional and public relations; facilitating
                            inter-regional arrangements; and preparing and up-dating
                            the MRMP plan.  Three separate staff units are involved.
                            Central Administration, Program Evaluation Center for
                            developing evaluation methodology, and Kansas City plan-
                            ning at Kansas General Hospital.  In past years these
                            activities were funded by Grant # GOZ RM 00009.  In addi-
                            tion, consultants in Springfield and Jackson are coordinat-
                            ing planning for those areas.






                                                                      MISSOURI   -   VII

           APPROVED OPERATIONAL PROJECTS (Continued)



           EFFECTIVENESS    OF    THE    "DETAIL    MAN"    APPROACH     IN     DISSEMM-
           TION OF INFORMATION TO PHYSICIANS

           Objectives:   In an attempt to effect a reduction in incidence  of  rheu-
                         matic heart disease,  a  "detail  man"  from  the  Missouri
                         Heart Association will call on 1, 311  medical  and  osteo-
                         pathic physicians in  general  practice,  pediatrics,  internal
                         medicine and  cardiology,  outside  metropolitan  St.  Louis
                         and Kansas City,  to  provide  information  about,  and  enlist
                         involvement  in  the  primary  and  secondary  prevention  pro-
                         grams of the state  Division  of  Health.  Follow-up  calls
                         will be made six months later to the  first  262  physicians
                         reached (200/o), to check on use and obtain  suggestions  on
                         the service. A third  follow-up  is  also  planned.  Evalua-
                         tion will be based on use of either or both  the  primary  pre-
                         vention service (Fluorescent  Antibody  Technique  for  identi-
                         fication of beta-hemolytic  streptococcus)  and  the  secondary
                         prevention service (registry, follow-up and low cost
                         prophylactic drug distribution).


           CONTINUING EDUCATION FOR THE HEALTH PROFESSIONS

           Objectives:   It is proposed to establish, over a  three-year  period,  a
                         dedicated  telephone  communication  system  for   education
                         between the medical  center  and  100  community  locations.
                         Half-hour telelectures followed by  a  half-hour  question,
                         answer and discussion periods  are  now  being  tested  in  ten
                         locations  and  will  be  programmed  for  physicians,  nurses,
                         physical  therapists,  occupational  therapists,  medical   and
                         radiologic  technologists,  and  others.  Records  and   visual
                         materials of the presentations will be  made  available  to
                         the  community  hospital  as  permanent  library  resources.
                         This proposal is part of a long-range plan to expand patient-
                         centered continuing education for  the  health  professions  in
                         the Region.


           COMMUNITY    SERVICES    FOR    HEART    DISEASE,    CANCER    AND     STROKE
           PATIENTS

           Objectives:   This project supports the last year  of  a  three-year  project
                         to develop a  Kansas  City  area-wide  comprehensive  plan  for
                         the establishment,  extension  and  coordination  of  community
                         service for heart disease,  cancer,  stroke  and  related  dis-
                         eases, and to  extend  the  Information  and  Referral  Service
                         of the Kansas City  Regional  Health  and  Welfare  Council  to
                         persons  and  families  affected  by  these  diseases.  Support
                         for the first two years was through a  grant  from  the  PHS
                         Division of Chronic Diseases.


                                              -122-





                                                                      MISSOURI - VIII

               APPROVED OPERATIONAL PROJECTS (Continued)



               MISSOURI CERVICAL CYTOLOGY PROJECT

               Objectives:  This is a project to demonstrate the use of the self-obtained
                            irrigation smear technique in early detection of cervical
                            cancer.  Women will be enrolled in the project through an
                            intensive educational campaign utilizing mass media.
                            Evaluationwill be based on the numberof women reached for
                            the first time, the number of positive and suspicious find-
                            ings, follow-up results, and study of the increased number
                            of "Pap smears. 11


               ESTABLISHMENT OF SOUTHEAST MISSOURI RADIOISOTOPE CANCER
               PROGRAM WITH SATELLITE FACILITIES

               Objectives:  Establishes a complete Isotope Laboratory at St. Francis
                            Hospital in Cape Girardeau, to bring to Southeast Missouri,
                            procedures and specialized equipment not now available to
                            aid in cancer diagnosis and therapy and management of
                            cardiovascular diseases.  Training for physicians and tech-
                            nical personnel is requested.  During the second year, three
                            satellite isotope laboratories will be established in smaller
                            institutions near Cape Girardeau and in the third year, four
                            more.  The satellite facilities will be under direct super-
                            vision of St. Francis laboratory which will also be re-
                            sponsible for training the technical personnel.


               HOMEMAKER - HOME HEALTH AIDE PROJECT - GREEN COUNTY

               Objectives:  Extends a new type of home care service for patients with
                            heart disease, cancer, or stroke.  A minimum of 24 indi-
                            viduals would be trained each year to perform both home-
                            maker" functions of cleaning, marketing and child care and
                            "home health aide" functions relating to personal care of
                            patients.  Traditionally, these services have been performed
                            by two individuals but a pilot project indicates the functions
                            can be combined.  The Visiting Nurses Association would
                            administer the project with assistance from the Missouri
                            University Extension Service, Burge Hospital staff in
                            Springfield, the County Medical Society and others.  Fees
                            for service will be collected and proceeds applied to ad-
                            ministration of the service.










                                                 -123-





                                                                   MISSOURI - IX
          APPROVED OPERATIONAL PROJECTS (Continued)


          A SCHOOL HEART SOUND SCREENING PROGRAM, USING THE
          PHONOCARDIOSCAN, ON A DEMONSTRATION BASIS
          Objectives:   Under sponsorship of Missouri Heart Association, program
                        plans to do heart sound screening, using an analog-digital
                        computer on a demonstration basis in seven cities, as well
                        as in a number of smaller outlying communities, to detect
                        possible previously unsuspected heart diseases in children
                        in these communities and to attempt to compare the per-
                        centage of undetected heart disease in children in the more
                        metropolitan areas as compared to the rural areas of the
                        state.




















































                                           -124-






                                                       MOUNTAIN STATES - I

           NAME OF PROGRAM                Mountain States Regional Medical
                                           Program

           GEOGRAPHICAL REGION            States of Idaho, Montana, Nevada, and
                                           Wyoming

           ESTIMATED POPULATION           z,i6o,ooo

           COORDINATING HEADQUARTERS      Mountain States Regional Medical
                                           Program
                                          525 West Jefferson Street
                                          Boise, Idaho  83702
                                          (Tel. : Z08/342-4666)

           GRANTEE ORGANIZATION           Western Interstate Commission for
                                          Higher Education

           EFFECTRVE STARTING DATE        November 1, 1966
           OF PLANNING ACTRVITIES

           EFFECTRVE STARTING DATE        March 1, 1968
           OF OPERATIONAL ACTIVITIES

           TOTAL FUNDING TO DATE          $3,679,96Z

           FUNDING FOR CURRENT            $1,583,653
           YEARIS ACTRVITIES

           CHAIRMAN, REGIONAL             Charles A. Terhune, M.D.
           ADVISORY GROUP                 1341 Overland Avenue
                                          Burley, Idaho  83381

           PROGRAM COORDINATOR            Kevin P. Bunnell, Ed. D.
                                          Associate Director
                                          Western Interstate Commission for
                                           Higher Education
                                          Post Office Drawer "pit
                                          Boulder, Colorado 80302
                                          (Tel. : 303/449-3333)

           STAFF                          PROGRAM DIRECTOR
                                          *Alfred M. Popma, M.D.

                                          COORDINATOR FOR OPERATIONAL
                                           PROGRAMS
                                          John W. Gerdes, Ph.D.

                                          STATE DIRECTORS


                                            IDAHO
                                            David M. Barton, M.D.
                                            310 Idaho Street
                                            Boise, Idaho 83702


           *Chief Executive Officer     -125-

              356-998 0-69-9






                                                             MOUNTAIN STATES"' H

          STAFF (Continued)                   STATE DIRECTORS (Continued)

                                                 MONTANA
                                                 Sidney C. Pratt, M.D.
                                                 Post Office Box 2829
                                                 Great Falls, Montana  59401

                                                 NEVADA
                                                 Lorne M. Phillips, M.D.
                                                 956 Willow Street
                                                 Reno, Nevada  89502

                                                 WYOMING
                                                 Claude 0. Grizzle, M.D.
                                                 3100 Henderson Drive, Suite 14
                                                 Cheyenne, Wyoming  82001











































                                             -126-






                                                                  MOUNTAIN STATES - ][II

               APPROVED OPERATIONAL PROJECTS



               CORE ADMINISTRATION, ADVANCED PLANNING AND EVALUATION

               Objectives:   Will provide  for  continued  program  planning  and  transition
                             into programs to meet the established needs, both at the
                             state as well as regional levels.  The regional office will
                             continue to coordinate programs and plan for their extension,
                             and also link activities in each state with similar  efforts  in
                             other MS/RMP states and in other Regional Medical
                             Program s.


               INTENSIVE CORONARY CARE IN SMALL HOSPITALS

               Objectives:   To provide  intensive  coronary  care  throughout  the  Montana,
                             Wyoming, Nevada and Idaho Mountain States.  A Center in
                             Missoula, Montana, trains physicians and nurses to staff in-
                             tensive coronary care units.  Eventually there will be centers
                             in all states in the Region.


               DIAGNOSTIC, TREATMENT AND EDUCATIONAL PROGRAM TO
               IMPROVE CARE OF CANCER PATIENTS

               Objectives:   Will develop a regional cancer diagnostic and treatment
                             resource--well  organized,  well  staffed  and  well  equipped--
                             and will provide a concurrent, intensive and continuous
                             cancer educational program for medical, dental and para-
                             medical personnel, for patients, their families and the
                             general public.  This  will  be  accomplished  through  develop-
                             ment of the Mountain States Tumor Institutes in Boise, Idaho,
                             as a subsidiary of St. @ke's Hospital in Boise.


               PROGRAM TO PROVIDE CONTINUING EDUCATION TO ALL HEALTH
               PROFESSIONAI-S IN MONTANA AND ADJACENT AREAS OF THE
               MOUNTAIN STATES REGION*

               Objectives:   Will provide (a)  intraprofessional  continuing  education  pro-
                             grams;  (b)  interprofessional  continuing  education  programs;
                             (c) promote interprofessional communication arnong-all
                             health professionals so the multiprofessional approach to
                             patient care can be maximized; and (d) provide an ongoing
                             evaluation system to assess  the  effectiveness  and  efficiency
                             of programs that are developed.






               *Approved but not funded            -127-






                                                           MOUNTAIN STATES - IV

            APPROVED OPERATIONAL PROJECTS (Continued)



            WICHE/MOUNTAIN STATES REGIONAL MEDICAL PROGRAM ROCKY
            MOUNTAIN TUMOR REGISTRY*

            Objectives:  To give direct assistance to the physician who is treating
                         the cancer patient, providing him with actual patient data
                         for as long as a particular case requires it and better
                         comparative planning data.  This is a proposal shared by
                         three RMP's--Colorado-Wyoming, Intermountain and
                         WICHE/Mountain States-covering six states: Colorado,
                         Wyoming, Montana, Idaho, Utah, Nevada.







































            *Approved but not funded         -128-






                                                                   NASSAU-SUFFOLK
              NAME OF PROGRAM                     Nassau-Suffolk Regional Medical
                                                   Program
              GEOGRAPHICAL REGION                 Counties of Nassau and Suffolk (Long
                                                   Island, New York)
              ESTIMATED POPULATION                2, 450, 000
              COORDINATING HEADQUARTERS           Nassau-Suffolk Regional Medical
                                                   Program,   Inc.
                                                  Health Sciences Center
                                                  State University of New York
                                                  Stony Brook, New York  11790
                                                  (Tel. : 516/246-7081)

              GRANTEE ORGANIZATION
                                                  Nassau-Suffolk Regional Medical
                                                   Program,   Inc.
              EFFECTIVE STARTING DATE             January 1,  1969
              OF PLANNING ACTIVITI]ES

              TOTAL FUNDING TO DATE               -$233, ?.56

              FUNDING FOR CURRENT                 $233,256
              YEARIS ACTIVITIES

              CHAIRMAN, REGIONAL                  SigmundA. Wesolowski, M.D.
              ADVISORY GROUP                      Mercy Hospital
                                                  1000 North Village Avenue
                                                  Rockville Centre, New York  11570
              SECRETARY, REGIONAL                 Frank J.  Gibson
              ADVISORY GROUP-                     Box 344
                                                  Aqueboque, New York  11931
              PROGRAM COORDINATOR                 *Glen E. Hastings, M.D.

















                                               -129-





                                           NEBRASKA-SOUTH DAKOTA    I
         NAME OF PROGRAM              Nebrask-a-South Dakota Regional
                                       Medical Program
         GEOGRAPHICAL REGION          States of Nebraska and South Dakota

         ESTIMATED POPULATION         2, 0 95, 000
         COORDINATING HEADQUARTERS    Nebraska-South Dakota Regional
                                       Medical Program
                                      1408 Sharp Building
                                      Lincoln, Nebraska 68508
                                      (Tel.: 402/432-2825)
         GRANTEE ORGANIZATION         Nebraska State Medical Association
         EFFECTIEVE STARTING DATE     January 1, 1967
         OF PLANNING ACTRVITIES

         TOTAL FUNDING TO DATE        $1, 066, 532

         FUNDING FOR CURRENT          $51 i, zo6
         YEARIS ACTRVITIES

         CHAIRMAN, REGIONAL           Robert Quinn, M.D.
         ADVISORY GROUP               President, South Dakota State Medical
                                       Association
                                      1320 South Minnesota Avenue
                                      Sioux Falls, South Dakota 57105
         PROGRAM COORDINATOR          *Harold S. Morgan, M. D.
         STAFF                        ADMINISTRATRVE ASSISTANT TO
                                       COORDINATOR'AND DIRECTOR
                                       OF INFORMATION
                                      Darrel D. Buettow

                                      PROJECT ADMINISTRATOR,
                                       OPERATIONS AND EVALUATION
                                       FOR CONTINUING EDUCATION
                                      George L. Morris, Jr., Ed. D.

                                      PROJECT ADMINISTRATOR,
                                       CORONARY CARE PROGRAM AND
                                       STAFF COORDINATOR FOR HEART
                                       DISEASE
                                      Deane S. Marcy, M.D.








       *Chief Executive Officer     -130-






                                               NEBRASKA-SOUTH DAKOTA  -  II


            STAFF (Continued)             ASSOCIATE COORDINATOR AND
                                           PLANNING  DIRECTOR,   UNIVERSITY
                                           OF NEBRASKA  AND  STAFF  COORDI-
                                           NATOR FOR CANCER
                                          J. P. Tollman, M. D
                                          University of Nebras@a College of
                                           Medicine
                                          42nd and Dewey Avenue
                                          Omaha, Nebraska 68105

                                          ASSISTANT TO  PLANNING  DIRECTOR,
                                           UNIVERSITY OF NEBRASKA AND
                                           STAFF  COORDINATOR  FOR   STROKE
                                          Sally A. Chapple

                                          PLANNING DIRECTOR, CREIGHTON
                                           UNIVERSITY
                                          John B. Hermann
                                          Creighton University School of Medicine
                                          657 North 27th Street
                                          Omaha, Nebraska 68131

                                          .ASSISTANT TO PLANNING  DIRECTOR,
                                           CREIGHTON UNIVERSITY AND STAFF
                                           COORDINATOR FOR CONTINUING
                                           EDUCATION
                                          Harriet DeLapp

                                          ASSOCIATE COORDINATOR - SOUTH
                                           DAKOTA  AND  STAFF   COORDINATOR
                                           FOR MANPOWER
                                          Robert H. Hayes, M.D.
                                          Nebraska-South Dakota Regional
                                           Medical Program
                                          216 East Clark
                                          Vermillion, South Dakota  57069

                                          PLANNING DIRECTOR FOR NURSING
                                          Therese Schwab, R. N.
                                          Nebraska-South Dakota Regional
                                           Medical Program
                                          216 East Clark
                                          Vermillion, South Dakota  57069

                                          FISCAL ADMINISTRATOR
                                          Kenneth E. Neff
                                          Executive Secretary
                                          Nebraska State Medical Association
                                          1315 Sharp Building
                                          Lincoln, Nebraska 68508

                                          ASSISTANT TO FISCAL ADMINIS-
                                           TRATOR
                                          William 4 Schellpeper


                                       -131-





                                                    NEW JERSEY - I
        NAME OF PROGRAM             New Jersey Regional Medical Program
        GEOGRAPHICAL REGION         State of New Jersey
        ESTIMATED POPULATION        7, 093, 000
        COORDINATING HEADQUARTERS   New Jersey Regional Medical Program
                                    88 Ross Street
                                    East Orange, New Jersey 07018
                                    (Tei. : Zol/674-7270)
        GRANTEE ORGANIZATION        New Jersey Joint Committee for
                                     Implementation of Public Law 89-239
        EFFECTRVE STARTING DATE     July 1, 1967
        Ul,'.PL,AN

        EFFECTIVE STARTING DATE     April 1, 1969
        OF OPERAT

        TOTAL FUNDING T DATE        $1, 400, 108
        FUNDING FOR CURRENT         $501, 055
        YEARIS ACT ITIES
        CHAIRMAN, REGIONAL          Richard J. Gross, M.D.
                                    Professor of Medicine and Associate
                                     Dean
                                    Rutgers Medical School
                                    New Brunswick, New Jersey 08903
        PROGRAM COORDINATOR         *Alvin A. Florin, M.D., M.P. H.
        STAFF                       ASSISTANT COORDINATOR

                                    James P. Harkness, Ph. D.

                                    DEPUTY COORDINATORS

                                     PHYSICIAN EDUCATION

                                     James A. Rogers, M.D.

                                     PROGRAM ACTIVITIES

                                     Marvin H. Burton, M. A., M. P. H.

                                     COMMUNICATIONS

                                     Frederick A. Botting




      *Ch ef Executive Officer
                                  -132-






                                                                       NEW JERSEY - II
               APPROVED OPERATIONAL PROJECTS



               NURSE TRAINING IN CORONARY CARE - HACKENSACK HOSPITAL
               Objectives:   To provide three training courses in intensive coronary care
                             for a total of 60 nurses, 20 per each three-week course.
                             Individualized clinical practice is scheduled for the trainees
                             in coronary care units in several hospitals of the region,
                             under the supervision of the core faculty from Hackensack
                             Hospital.  A regional advisory group is organized to provide
                             medical consultation and direction as well as nursing and
                             educational consultation for achievement of objectives and
                             evaluation of the program.


               NURSES TRAINING IN CORONARY CARE - RUTGERS-COOPER HOSPITAL
               Objectives:   To establish a new intensive coronary care training program
                             for nurses in hospitals in the southern region of the state,
                             under the direction of Rutgers University Department of
                             Continuing Education for Nurses.  Training courses of four
                             weeks each will be held for 32 nurses, eight per course, at
                             Cooper Hospital in Camden, New Jersey.  A cooperative
                             faculty of medical and nursing personnel has been organized
                             under the educational direction of the University and medical
                             direction by Cooper Hospital.


               CORONARY CARE TRAINING FOR NURSES - NEWARK BETH ISRAEL
               MEDICAL CENTER

               Objectives:   To provide three 4-week training courses for 60 nurses from
                             hospitals in the most populated regions of the state at Newark
                             Beth Israel Medical Center in Essex County. Upon return to
                             the employing hospital, each nurse-trainee will be visited by
                             a traveling team of physicans and nurses to assist in adapt-
                             ing new knowledge and skills and offer consultation to the
                             coronary care team. A one-day follow-up refresher course
                             will be held for those nurses completing the program.
               STATEWIDE PROGRAM IN EXTERNAL CARDIOPULMONARY RE-
               SUSCITATION

               Objectives:   ToprovideAmericanHeartAssociationapprovedtraining
                             in ECPR technique for physicians, dentists, nurses and
                             otheralliedhealthpersonnel, lifeguards, physicaleducation
                             teachers, policeandfirepersonnel, andhigh-riskindustry
                             personnel. Fourtrainingcenterswillbeestablishedin
                             community hospitals throughout the state for the preparation
                             ofmultidisciplinaryteachingteams. Twenty-oneteamswill
                             conduct 42 courses to train 1, 260 persons.



                                                 -133-






                                                                  NEW JERSEY - III
           APPROVED OPERATIONAL PROJECTS (Continued)


           TRAINING PROGRAM IN SELECTIVE CORONARY CINEANGIOGRAPHY
           Objectives:  To provide training for four cardiologists and/or cardio-
                        vascular surgeons in the performance of coronary cineangio-
                        graphy and in the interpretation of cineangiograms and bi-
                        plane views of the coronary arteries.  Two courses will be
                        conducted for two physicians at a time.  Trainees will be
                        given full hospital privileges and will spend one fall day or
                        two half-days in training each week over a six-month period.
                        In addition, a traveling consultant team will be provided to
                        help any New Jersey Hospital with problems in this field.

           EVALUATION OF THE STATUS OF IMPLANTED PACEMAKERS
           Objectives:  To develop improved methods for the prediction of implanted
                        pacemaker failure, thereby avoiding emergency replacement.
                        Facilities of the Pacemaker Clinic at the Newark Beth
                        Israel Medical Center Institute will be extended to an esti-
                        mated 750 New Jersey patients with implanted pacemakers.
                        Each patient, referred by his physician, will be examined
                        every two months for evaluation of pacemaker status.  Com-
                        puter techniques will be utilized in the evaluation.

           ESTABLISHMENT OF TUMOR CONFERENCE BOARDS IN NEW JERSEY
           Objectives:  To encourage and assist in the establishment and upgrading
                        of tumor conference boards in community hospitals through-
                        out New Jersey with the purpose of improving the quality of
                        diagnosis and treatment of cancer and strengthening the con-
                        tinuing education of physicians.  Traveling tumor conference
                        teams will be drawn from hospitals with outstanding cancer
                        programs to provide the consultation in tumor board organi-
                        zation and operation.  In addition to consultation teams, the
                        project will provide audio-visual equipment for participating
                        hospitals, with shared funding; stipends for physicians attend-
                        ing a two-week training course at Memorial Sloan-Kettering
                        Cancer Center; and an annual regional one-day symposium on
                        cancer diagnosis and therapy.












                                            -134-






                                                                    NEW JERSEY - rV


              APPROVED OPERATIONAL PROJECTS (Continued)



              MEDICAL TAPES BY TELEPHONE

              Objectives:   To provide readily accessible, up-to-date information on
                            diagnosis and treatment of heart disease, cancer, stroke,
                            and related diseases to practicing physicians by establish-
                            ing a library of 4-6 minute, pre-recorded tapes which are
                            transmitted by telephone.  The tape library is housed at a
                            physicians' telephone answering service.  Most tapes are
                            producedby New Jersey physicians.  The subject matter of
                            tapes most frequently requested will be considered in the
                            development of physician continuing education programs.


              HEMODIALYSIS TRAINING PROGRAM

              Objectives:   To train physicians, nurses and technicians in the skills and
                            procedures of hemodialysis at Newark Beth Israel Medical
                            Center Institute.  Intensive training will be provided for six
                            physicians, three per course, to prepare them for directing
                            hemodialysis programs in their own hospitals.  Twelve
                            nurses will receive training in nursing procedures in a four-
                            week course, four per course.  Twelve technicians will be
                            trained in four-week courses, four students per course.
                            Three-day orientation will be provided for physicians at-
                            tending hemodialysis patients, and five-day orientation on
                            home-care dialysis will be provided to ten visiting nurses.
                            Consultation will be available to trainees concerning es-
                            tablishment of their hemodialysis units in their respective
                            hospitals.  An advisory committee will evaluate effective-
                            ness of the training and the need for additional training
                            centers.



























                                                 -135-






                                                       NEW MEXICO - I
         NAME OF PROGRAM              New Mexico Regional Medical Program
         GEOGRAPHICAL REGION          State of New Mexico
         ESTIMATED   POPULATION       1, oo6, ooo
         COORDINATING HEADQUARTERS    New Mexico Regional Medical Program
                                      University of New Mexico Medical
                                        School
                                      920 Stanford Drive, Northeast -
                                        Building 3-A
                                      Albuquerque, New Mexico 87106
                                      (Tel. : 505/277-3434)
         GRANTEE   ORGANIZATION       The University of New Mexico
         EFFECTIVE STARTING DATE      October 1, 1966
         OF PLANNING ACTIVITIES
         EFFECTIVE STARTING DATE      July 1, 1968
         OF OPERATIONAL ACTRVITEES
         TOTAL FUNDING TO  DATE       $1, 730, 944
         FUNDING FOR CURRENT          $1, 1'72,160
         YEARIS ACTRVITIES
         CHAIRMAN, REGIONAL           Hugh B. Woodward, M.D.
         ADVISORY GROUP               200 Oak Street, Northeast
                                      Albuquerque, New Mexico 87106
         PROGRAM COORDINATOR          *Reginald H. Fitz, M.D.
         STAFF                        ASSISTANTS TO THE DIRECTOR

                                        ADMINISTRATION
                                        William Weeks


                                        HEART
                                        Loyal L. Conrad, K D.

                                        CANCER
                                        Charles R. Key, M.D.

                                        STROKE
                                        Lauren Welch, M.D.

                                        RELATED DISEASE
                                        L E. Hendryson, M.D.

                                        EDUCATION
                                        G. M. Boyden, M. D. (Acting)


       *Chief Executive Officer    -136-





                                                                       NEW MEXICO      II
               STAFF (Continued)                    EVALUATION AND DESIGN
                                                    R. 0. Oseasohn, M.D.

                                                    PROJECT EVALUATION
                                                    @rvin Chatkoff

                                                    PARAMEDICAL EDUCATION
                                                    SPECIALIST
                                                    (Mrs.) Elizabeth Barnett

                                                    NURSING EDUCATION SPECIALIST
                                                    (Miss) Mary C.' Pozorski

                                                    DIRECTOR OF REGISTRIES
                                                    (Mrs) Dorothy Brylinski









































                                                -137-





                                                 NEW MEXICO   III

        APPROVED OPERATIONAL PROJECTS



        MODEL CORONARY CARE UNIT

        Objectives: Training program for practitioners, house staff, and
                  physician assistants, and for communities seeking advice
                  on Coronary Care Units.


        TRAINING COURSE IN CORONARY CARE UNIT NURSING
        Objectives: Will provide pertinent training for registered nurses.

        TRAINING PROGRAM - LABORATORY SCIENCES IN ALLIED  HEALTH
        PROFESSIONS

        Objectives: Will establish a unified training program in clinical labora-
                  tory science at the University of New Mexico School of
                  Medicine, to improve the laboratory capabilities of medical
                  facilities in the state.


        STROIKE PROGRAM

        Objectives.- Will establish a model for comprehensive care and rehabi.1-
                  itation of patients with vascular diseases, including con-
                  tinuing education for medical, paramedical and lay per-
                  sonnel.


        RELATED DISEASES (EMERGENCY HEALTH SERVICES)
        Objectives: Will establish an Emergency Medical Services Council to
                  coordinate and develop a system to improve such services.


        EDUCATIONAL PROGRAMS
        Objectives: Will attempt to relate medical school resources with local
                  health information needs by means of programs in com-
                  munity hospitals which will reach about 750/o of the region's
                  physicians.

        HEALTH INFORMATION AND COMMUNICATION
        Objectives: Will establish a regional Health Science Information Center
                  and Communication Network to provide consultation ser-
                  vices, training programs and literature support to health
                  science libraries in the region.



                                -138-






                                                                      NEW MEXICO       IV

                APPROVED OPERATIONAL PROJECTS (Continued)



                PEDIATRIC PULMONARY CENTER (LOVELACE CLINIC)

                Objectives: Will establish a model for providing the region with  special
                             diagnostic and therapeutic competence, as well as social
                             services, for the management of children with  chronic  non-
                             tuberculosis respiratory disease.


                CORE SUPPORT

                Objectives:  For core administrative and planning staff, equipment,
                             supplies, alterations and renovations for central core
                             activities.


                CARDIOPULMONARY EVALUATION LABORATORY, ST. VINCENTIS
                HOSPITAL, SANTA FE, NEW MEXICO

                Objectives:  This would be the sole such laboratory serving northern
                             New- Mexico. The laboratory would be  designed  to  prevent,
                             diagnose, and assist in the rehabilitation of patients with
                             cardiopulmonary disease, referred  from  private  physicians
                             and state health and welfare agencies.






























                                                 -139-





                                                     NEWYORK METROPOLITAN -I
         NAME OF PROGRAM                      New York Metropolitan Regional
                                               Medical     Program
         GEOGRAPHICAL REGION                  New York City and Westchester County,
                                               New    York

         ESTIMATED POPULATION                 8,940,000
         COORDINATING HEADQUARTERS            New York Metropolitan Regional
                                               Medical     Program
                                              2 East 103rd  Street
                                              New York, New York  10029
                                              (Tel.: 212/427-4100)
         GRANTEE ORGANIZATION                 Associated Medical Schools of Greater
                                               New    York

         EFFECTRVE STARTING DATE              June 1, 1967
         OF PLA

         TOTAL FUNDING TO DATE                $2,189,935
         FUNDING FOR CURRENT                  $1,480,826
         YEARIS ACTRVITEES

         CHAIRMAN, REGIONAL                   J. Frederick Eagle, M.D.
         ADVISORY GROUP                       President, Associated Medical Schools
                                               of Greater New York
                                              2 East 103rd  Street
                                              New York, New York  10029
         PROGRAM DIRECTOR                     '-L Jay Brightman, M.D.
         STAFF                                ASSISTANT DIRECTORS
                                                 FOR PROGRAM DEVELOPMENT
                                                 Bruce D. Bennett
                                                 FOR ADMINISTRATION
                                                 Walter  H.  Gelby

                                              SPECIAL ASSISTANT FOR
                                               COMMUNICATIONS
                                              Frederica Brooks

                                              CHIEF OF RESEARCH AND EVALUA-
                                               TION
                                              Peter M. Marano

                                              PROGRAM REPRESENTATIVES
                                              Rose Heifetz
                                              Margaret Barnett
                                              Allen Fite
                                              Lucie Benedikt
                                              ADMINISTRATIVE ASSISTANT
                                              Josephine   Kopetzky


        *Chief Executive Officer          -140-






                                                   .NORTH CAROLINA  I

          NAME OF PROGRAM             North Carolina Regional Medical
                                        Program

          GEOGRAPHICAL REGION         State of North Carolina

          EST@TED POPULATION          5, 122, 000

          COORDINATING HEADQUARTERS   Association for the North Carolina
                                        Regional Medical Program
                                      4019 North Roxboro Road
                                      Durham, North Carolina 27704
                                      (Tel. : 919/477-0461)
          GRANTEE ORGANIZATION        Duke University
          EFFECTIVE STARTING DATE     July 1, 1966
          OF PLANNING ACTIVITIES

          EFFECTRVE STARTING DATE     March 1, 1968
          OF OPERATIONAL ACTrVITi-ES

          TOTAL FUNDING TO DATE       $2, 797, 310

          FUNDING FOR CURRENT         $1, 799, 654
          YEARIS ACTRVITIES

          CHAIRMAN, REGIONAL          George W. Paschal, Jr., M.D.
          ADVISORY GROUP              Past President, Medical Society of
                                        State of North Carolina
                                      I 1 10 Wake Forest Road
                                      Raleigh, North Carolina 27604
          PROGRAM COORDINATOR         *Marc J. Musser, M.D.
          STAFF                       DIRECTOR, RESEARCH AND EVALUA-
                                        TION DIVISION
                                      Harvey L. Smith, Ph.D.
                                      Miller Hall
                                      University of North Carolina
                                      Chapel Hill, North Carolina 27514

                                      DIRECTOR, CANCER PROGRAM
                                        M. Simmons Patterson, M. D.

                                      DERECTOR, STROKE PROGRAM
                                      B. Lionel Truscott, M. D.
                                      C-5 Castle Towers
                                      Beech and Grove Park Avenue
                                      Winston-Salem, North Carolina 27103






          *Chief Executive Officer   -141-

             356-998 0-69-10





                                                         NORTH CAROL@        H
          STAFF (Continued)                 DIRECTOR, EDUCATION AND
                                              TRAINING PROGRAM
                                            William DeMaria, ZvL D.
                                            Baker House
                                            Duke Medical Center
                                            Durham, North Carolina  27706

                                            DIRECTOR, ADMINISTRATRVE
                                             SERVICES DIVISION
                                            William J. McComb, F. A. C. H. A.

                                            DIRECTOR, HOSPITALS DIVISION
                                            William W. Lowrance, F. A. C. H. Tk.
                                            President, North Carolina
                                            Hospital Association

                                            DIRECTOR, COMMUNICATIONS AND
                                             INFORMATION DRVISION
                                            V rginia H. Benton, B.A.

                                            ASSOCIATE DERECTORS

                                              PROGRAM DEVELOPMENT
                                              Lydia S. Holley, M. P. H. 9 R. P. T.

                                              EDUCATION AND TRAINING
                                               PROGRAM
                                              Audrey J. Booth, R.N., M.S.

                                            INSTITUTIONAL COORDINATORS

                                              E. Harvey Estes, Jr., M.D.
                                              Duke University Medical Center
                                              Durham, North Carolina  27706

                                              Louis DeS. Shaffner, NL D.
                                              Bowman Gray School of Medicine
                                              Winston-Salem, North Carol'
                                               27103

                                              Robert @ Smith, M.D.
                                              School of Medicine
                                              University of North Carolina
                                              Chapel Hill, North Carolina 27514

                                              Herman A. Tyroler, NL D.
                                              School of Public Health
                                              University of North Carolina
                                              Chapel Hill, North Carolina 27514







                                        -142-






                                                               NORTH CAROLINA - III


               APPROVED OPERATIONAL PROJECTS




               EDUCATION AND RESEARCH IN COMMUNITY MEDICAL CARE

               Objectives:  To assign responsibility for developing cooperative arrange-
                            ments between hospitals and communities and medical cen-
                            ters to the existing Division of Education and Research  in
                            Community Medical Care of the University of North
                            Carolina. Specific projects in both rural and  urban  areas
                            have been developed through support from other sources
                            than Regional  Medical  Programs.  This  RMP  project  will
                            complement and expand efforts to improve medical care
                            administration, health service planning, and resource
                            development.  Regional Medical Programs will support
                            area wide planning, transportation, continuing education
                            through TV, etc.


               CORONARY CARE TRAINING AND DEVELOPMENT

               Objectives:  To use the project as a medium for developing cooperative
                            arrangements among the various elements in the health care
                            community.  Initial and continuing education will be pro-
                            vided to nurses and physicians, consultation will be availa-
                            ble to hospitals in establishing Coronary Care Units and  a
                            computer-based system of medical  record  keeping  will  be
                            developed.


               DIABETIC CONSULTATION AND EDUCATIONAL SERVICES

               Objectives:  To establish three medical teams to deliver services
                            throughout the state; to assist in expansion of diabetic con-
                            sultations and teaching clinics; to provide seminars for
                            physicians and teaching sessions for nurses and patients to
                            assist in organization of a state Diabetes Association and
                            local chapters; to test techniques of data collection.


               DEVELOPMENT OF A CENTRAL CANCER REGISTRY

               Objectives:  To devise a uniform re gion-wide cancer reporting system,
                            integrated with the PAS, the computer-stored data from
                            which can be retrieved to serve a broad range of educa-
                            tional, research, statistical, and other purposes.









                                                -143-






                                                            NORTH CAROLINA - IV


           APPROVED OPERATIONAL PROJECTS (Continued)




           MEDICAL LIBRARY EXTENSION SERVICE

           Objectives:   To bring medical library facilities of the three  medical
                         schools into the daily work of those engaged  in  medical
                         practice.  Local hospital personnel will be trained to assist
                         medical staff; libraries will be organized into a functional
                         unit for responding to requests for services; a bibliographic
                         request service will be established.

           CANCER INFORMATION CENTER

           Objectives:  To provide practicing physicians with immediate consulta-
                         tion by telephone and follow-up literature. Each  of  the
                         three medical schools will be responsible  for  providing
                         service in its geographic locale.


           CONTINUING EDUCATION IN INTERNAL MEDICINE

           Objectives:  To bring practicing internists to the Medical Center for a
                         month of up-to-date training in their subspecialities.  They
                         will share responsibilities with attending physicians and
                         make ward rounds with students, staff, and together.


           CONTINUING EDUCATION IN DENTISTRY

           Objectives:   To provide physicians and dentists with the knowledge of
                         mutual concern which will enable them to be more effective
                         members of the health team.  Courses will be given at the
                         University of North Carolina and in communities.  Studies
                         will be made of facilities needed to provide dental care in
                         hospitals.


           CONTINUATION EDUCATION FOR PHYSICAL THERAPISTS

           Objectives:  To develop and establish continuing education for physical
                         therapists.  Subregions will be delineated where needs and
                         interests will be identified and committees will be organized
                         to arrange local activities.












                                              -144-







                                                                 NORTH CAROLINA - V

               APPROVED OPERATIONAL PROJECTS (Continued)



               STATE OF FRANKLIN CORONARY CARE DEMONSTRATION PROJECT

               Objectives:  Will attempt to show the feasibility of establishing a network
                            of coronary care units in small hospitals (50 - 154 beds) in
                            the rural Appalachian area of North Carolina.  The physician
                            serving as a unit director and the unit nurses will be inten-
                            sively trained.  An analytical study of unit effectiveness will
                            be conducted.


               MOBILE CARDIAC INTENSRVE CARE CAPABILITY IN APPALACHIA
               (Feasibility Study)

               Objectives:  To evaluate the impact of Intensive Coronary Care ambu-
                            lances on immediate survival in acute myocardial infarction.
                            Two ambulances will be specially equipped and Rescue
                            Squad drivers will be appropriately trained.  Eight physi-
                            cians will provide voluntary assistance.


               CLOSED CHEST CARDIOPULMONARY RESUSCITATION UNIT

               Objectives:  The project is co-sponsored by the North Carolina Heart
                            Association, which will assign staff members.  It is pro-
                            posed to,initiate a Regional Cardiopulmonary Resuscitation
                            Program to make this technique known and available through-
                            out the Region.  A survey will establish the present state of
                            training and the need for further training,  A regional train-
                            ing facility will be developed and the appointment of local
                            CPR hospital coordinators will be encouraged.


               HEART CONSULTATION AND EDUCATION PROGRAM

               Objectives:  In order to bring latest techniques and research findings to
                            the developing network of coronary care units, a monthly
                            consultation-education clinic will be initiated at the
                            Memorial Mission Hospital in Asheville.  The project rep-
                            resents a cooperative arrangement between the hospital
                            and the Bowman Gray School of Medicine.  It will provide
                            a training base for the ItState of Franklin" Coronary Care
                            Unit project, funded in the initial operational award.











                                                 -145-






                                                             NORTH   CAROLINA   -    VI


          APPROVED OPERATIONAL PROJECTS (Continued)




           COMPREHENSIVE STROKE PROGRAM

           Objectives:   Community  development  of   comprehensive   stroke   programs
                         will be encouraged through a central coordinating unit at
                         Bowman Gray School of Medicine.  Activities will be:
                         publication of guidelines for community stroke programs,
                         arranging educational activities such as training programs
                         for nurses, conducting an annual stroke workshop, and
                         developing a family-patient education unit.  The latter is a
                         demonstration project to show the usefulness of modern
                         teaching devices in helping patients and their families  learn
                         to cope with the long-term effects of stroke disability.


           HYPERTENSION

           Objectives:  To explore the means of making available the best of
                         modern diagnostic and therapeutic  measures  to  the  patients
                         with hypertension in the Region.


           ADMINISTRATION, RESEARCH, AND EVALUATION

           Objectives:  To provide for a staff for overviewing, coordinating, re-
                         viewing and evaluating the program.


           NORTH CAROLINA TUMOR TISSUE REGISTRY*

           Objectives:  The Moses H. Cone Memorial Hospital, Greensboro,
                         North Carolina, proposes to establish a tumor tissue
                         registry, directly tied to the North Carolina Regional
                         Medical Program Central registry.


           BOWMAN GRAY CORONARY CARE DEMONSTRATION UNIT

           Objectives:   To establish a model unit in a medical center setting to
                         augment existing teaching facilities for training  physicians,
                         nurses and other personnel in coronary care unit procedures.
                         This teaching-demonstration unit will provide  a  resource  in
                         consultation capability to assist in the development of
                         coronary care units and continuing  education  in  small  com-
                         munities and remote  hospitals  cooperating  with  the  Bowman
                         Gray School of Medicine for these purposes.






           *Approved but not funded           -146-






                                                               NORTH CAROLINA - VU

               APPROVED OPERATIONAL PROJECTS (Continued)



               TROPHOBLASTIC CANCER PROJECT*

               Objectives:   To enable the development of a radioimmunoassay for human
                             chorionic gonadotropin (HCG) in the Southeastern Regional
                             Center for Gestational Trophoblastic Neoplasms located at
                             Duke University and which serves primarily in addition to
                             North Carolina, the states of Alabama, Florida, Georgia,
                             Kentucky, Louisiana, Mississippi, South Carolina,
                             Tennessee, Virginia and West Virginia.






























               *Approved but not funded          -147-






                                                  NORTH DAKOTA - I

        NAME OF PROGRAM             North Dakota Regional Medical Program

        GEOGRAPHICAL REGION         State of North Dakota

        ESTE"TED POPULATION         627, 000

        COORDINATING HEADQUARTERS   North Dakota Regional Medical Program
                                    University of North Dakota
                                    1600 University Avenue
                                    Grand Forks, North Dakota 58201
                                    (Tel.: 701/77Z-5961)

        GRANTEE ORGANIZATION        North Dakota Medical Research Founda-
                                     tion

        EFFECTIVE STARTING DATE     July 1, 1967
        OF PLANNING GRANT

        TOTAL FUNDING TO DATE       $z67,777

        FUNDING FOR CURRENT         $192, 96o
        YEARIS ACTRVITIES


        CHAIRMAN, REGIONAL          Lee A. Christoferson, M.D.
        ADVISORY GROUP              The Neuropsychiatric Jnstitute
                                    Post Office Box 32
                                    Fargo, North Dakota 581OZ

        PROGRAM COORDINATOR         Theodore H. Harwood, M. D.
                                    Dean, School of Medicine
                                    University of North Dakota
                                    Grand Forks, North Dakota 58201

        STAFF                       PROGRAM DIRECTOR
                                    *Willard A. Wright, M. D.

                                    ASSISTANT PROGRAM DIRECTORS


                                      CONTINUING EDUCATION ALLIED
                                       HEALTH PERSONNEL
                                      (Mrs. ) Lorraine Parker

                                      CONTINUING EDUCATION FOR
                                       PHYSICIANS
                                      J. 1. Pennington

                                      PLANS AND PROGRAMS
                                      John A. Grim


                                      COMPUTER SERVICES
                                      Conrad Dietz





        *Chief Executive Officer  -148-






                                                                 NORTHEAST OHIO

             NAME OF PROGRAM                     Northeast Ohio Regional  Medical
                                                  Program

             GEOGRAPHICAL REGION                 12 Counties in Northeast Ohio

             ESTIMATED POPULATION                4,170,000

             COORDINATING HEADQUARTERS           Northeast Ohio Regional  Medical
                                                  Program
                                                 10205 Carnegie Avenue
                                                 Cleveland, Ohio 44106
                                                 (Tel. : 216/368-4626)

             GRANTEE ORGANIZATION                Northeast Ohio Regional  Medical
                                                  Program,   Inc.

             EFFECTIVE STARTING DATE             January 1,  1968
             OF PLANNING ACTRVITIES

             TOTAL FUNDING TO DATE               $285,783

             ,FUNDING FOR CURRENT                $285,783
             YEARIS ACTIVITIES

             CHAERMAN, REGIONAL                  Charles L. Hudson, M.D.
             kDVISORY GROUP                      The Cleveland Clinic
                                                 2020 East Ninety-third Street
                                                 Cleveland, Ohio  44106

             CHAIRMAN, BOARD OF                  Frederick C. Robbins, M. D.
             TRUSTEES                            Dean, School of Medicine
                                                 Case Western Reserve University
                                                 2107 Adelbert Road
                                                 Cleveland, Ohio  44106

             PROGRAM COORDINATOR-                *Barry Decker, M. D.

             STAFF                               ASSISTANT DIRECTORS
                                                 (Miss) Mary Lou Harrison
                                                 Hiram H. Nickerson
                                                 (Mrs.) Mary P. Wheeler
                                                 (Mrs.) Martha E. McCrary

                                                 DIRECTOR OF EDUCATION
                                                 Eugene B. Johnson

                                                 DIRECTOR   OF    RESEARCH    AND
                                                  EVALUATION
                                                 James  T.  Suter







             *Chief Executive Officer         -149-






                                                          NORTHEAST OHIO - II

          STAFF (Continued)                DIRECTOR OF ADMINISTRATION AND
                                            COMMUNICATIONS
                                           Richard C. Meloy

                                           DIRECTOR OF PUBLIC EDUCATION
                                           Lowell Bernard






























































                                           -150-





                                                        NORTHERN NEW ENGLAND - I


               NAME OF PROGRAM                      Northern New England Regional Medical
                                                     Program

               GEOGRAPHICAL REGION                  Vermont and three counties in North-
                                                     eastern New York

               EST@TED POPULATION                   425, 000

               COORDINATING HEADQUARTERS            Northern New England Regional Medical
                                                     Program
                                                    University of Vermont College of
                                                     Medicine
                                                    25 Colchester Avenue
                                                    Burlington, Vermont  05401
                                                    (Tel. : 802/864-4511, ext. 777)

               GRANTEE ORGANIZATION                 University of Vermont College of
                                                     Medicine

               EFFECTIVE STARTING DATE              July 1, 1966
               OF PLANNING ACTIVITIES

               EFFECTIVE STARTING DATE              May 1,  1969
               OF OPERATIONAL ACTIVITIES

               TOTAL FUNDING TO DATE                $2,343,090

               FUNDING FOR CURRENT                  $972,053
               YEARIS ACTIVITIES

               CHAIRMAN, REGIONAL                   Edward C. Andrews, M.D.
               ADVISORY GROUP                       Dean, College of Medicine
                                                    University of Vermont
                                                    Given Building
                                                    Burlington, Vermont  05401

               PROGRAM DIRECTOR                     *John E. Wennberg, M.D.

                                                    ASSISTANT TO DIRECTOR
                                                    Helen  Brink


                                                    PROJECT MANAGER
                                                    William Wrighton

                                                    PROJECT MANAGER
                                                    Caryl Stewart

                                                    BUSINESS MANAGER, PROJECT
                                                     MANAGER
                                                    Darwin G. Merrill

                                                    PROJECT MANAGER, -PROGRESSIVE
                                                     CORONARY CARE
                                                    David Wagner

               *Chief Executive Officer          -151-






                                                   NORTHERN NEW ENGLAND - II

          STAFF (Continued)                    PROJECT ENGINEER
                                               Peter Watts

                                               COORDINATOR,          CONNECTICUT
                                                VALLEY HEALTH COMPACT
                                               Eigil   deneergaard

                                               COORDINATOR, PLANNING AND
                                                EVALUATION
                                               Jeanette Forsyth, Ph. D.

                                               INSTRUCTOR,, CORONARY CARE UNIT
                                               Marjorie Porter

                                               CARDIOLOGIST
                                               Otto  Brusis,  M.D.

                                               COMPUTER PROGRAMMER
                                               John Senning

                                               MATHEMATICIAN
                                               David Odle


                                               TECHNOLOGIST
                                               Karen Provost


                                               ASSISTANT DEAN FOR REGIONAL
                                                MEDICAL AFFAIRS
                                               John Mazuzan, M.D.
                                               Assistant  Professo'r of Anesthesiology
                                               University of Vermont College  of
                                                Medicine


                                               ASSISTANT TO DEAN FOR REGIONAL
                                                MEDICAL AFFAIRS
                                               R. Rolf Struthers, M.D.

                                               PROFESSOR, COMMUNITY MEDICINE
                                               Julian Waller, K D.
                                               University of Vermont College  of
                                                Medicine


                                               CONSULTANT,     OPS      RESEARCH
                                               Robert Dunn


                                               CONSULTANT, BIOSTATISTICIAN
                                               Alan Gittelsohn










                                            -152-






                                                      NORTHERN NEW ENGLAND - III

               APPROVED OPERATIONAL PROJECTS




               SUPPORT OF REGIONAL MEDICAL PROGRAM OFFICE

               Objectives:  Project development, technical project support, general pro-
                             gram support, and program review and management will be
                             the responsibility of the Regional Medical Program staff.


               PROGRESSRVE CORONARY CARE

               Objectives:   Proposes to establish a system of coronary  care  units  which
                             contains certain innovations related to the exigencies of
                             rural medical care. Project  implementation  will  essentially
                             complete the process of regionalization for treatment of  this
                             disease during the acute phase.  The  immediate  project  goal
                             is to reduce in-hospital mortality from acute  myocardial  in-
                             farction by one third.


               CONTINUING EDUCATION FOR HEALTH PROFESSIONALS

               Objectives:   Proposes to establish a regional system of Educational
                             Coordinators in community hospitals to establish and main-
                             tain direct liaison with the communities for educational  pro-
                             grams.  The overall objectives: motivate health pro-
                             fessionalstowardself-development, encouragecommunicati6ns
                             and cooperation to improve coordination of educational pro-
                             grams, improve the effectiveness  of  programs,  and  increase
                             recruitment of health care personnel.


























                                                  -153-






                                                 NORTHLANDS-I

       NAME OF PROGRAM             Northlands Regional Medical Program

       GEOGRAPHICAL REGION         State of Minnesota

       ESTIMATED POPULATION        3, 647, 000

       COORDINATING HEADQUARTERS   Northlands Regional Medical Program,
                                    Inc.
                                   Fifth Floor - Farm Credit Banks
                                    Building
                                   375 Jackson Street
                                   St. Paul, Minnesota 55101
                                   (Tel. : 612/224-4771)

       GRANTEE ORGANIZATION        Northlands Regional Medical Program,
                                    Inc.

       EFFECTRVE STARTING DATE     January 1, 1967
       OF PLANNING ACTRVITIES

       EFFECTRVE STARTING DATE     March 1, 1969
       OF OPERATIONAL ACTIVITITES

       TOTAL FUNDING TO DATE       $2,032,702

       FUNDING FOR CURRENT         $1, 209, 910
       YEARIS ACTRVITEES

       CHAIRMAN, REGIONAL          The Honorable Stephen L. Maxwell
       ADVISORY GROUP              Judge of the District Court
                                   1521 Court House
                                   St. Paul, Minnesota 551OZ

       PROGRAM DIRECTOR            *Winston R. Miller, M.D.

       STAFF                       ASSOCIATE DIRECTOR
                                   Robert J. Wilkins, M. H. A.

                                   ASSOCIATE DIRECTOR FOR
                                    UNIVERSITY OF MINNESOTA CORE



                                   ASSOCIATE DIRECTOR FOR MAYO
                                    FOUNDATION CORE
                                   J. Minott Stickney, M. D.

                                   COORDINATOR OF CANCER PROGRAMS
                                   LeRoy G. Berglund, B.A.

                                   REHABILITATION COORDINATOR
                                   (Miss) Marlene J. Deschler, M. P. H.




       *Chief Executive Officer .154-






                                                                  NORTHLANDS - II

             STAFF (Continued)                 COORDENATOR OF HEART AND
                                                STROKE PROGRAMS
                                               Lawrence B. Stadler, M.A.

                                               COORDINATOR OF EDUCATIONAL
                                                PROGRAMS
                                               (Mrs.) Edith Leyasmeyer, Ph.D.

                                               COMMUNICATIONS OFFICER



                                               LIAISON LIBRARIAN OFFICER
                                               (Miss) Mary Jane Ryan, Ph.D.

                                               LIAISON NURSING OFFICER
                                               (Miss) Joyce K Schowalter, R.N.,
                                                M. N. A., M. Ed.

                                               RESEARCH ASSOCIATE IN SOCIOLOGY
                                               (Mrs.) Lynda F. Cole, M.A.






































                                            -155-






                                                                  NORTHLANDS - III

           APPROVED OPERATIONAL PROJECTS




           CORE PROPOSAL

           Objectives:  The Region requests support for the central organization and
                        for staff components at the University of Minnesota., Mayo
                        Foundation, and American Rehabilitation Foundation.  The
                        core staff is administered by a Core Council of the  Director
                        and three Associate Directors.


           MULTIDISCIPLINARY IMPROVEMENT IN MEDICAL CARE OF MYO-
           CARDIAL INFARCTION - MINNESOTA HEART ASSOCIATION

           Objectives:  This project will provide practical training courses and
                        consultative service for physicians, nurses, and medical
                        directors of Intensive Coronary Care Units.  A data collec-
                        tion, analysis and repository system will be developed.
                        Area seminars will be conducted.


           POSTGRADUATE EDUCATION IN PEDIATRIC CARDIOLOGY - UNIVER-
           SITY OF MINNESOTA

           Objectives:  The purpose of this project is to increase the knowledge  and
                        skills of practicing physicians in pediatric cardiology.
                        Planned in three stages:  I - Planning, trial postgraduate
                        seminars and analysis of results; II - Locally oriented,
                        Northlands Regional Medical Program catalyzed post-
                        graduate programs will be developed in the geographic areas
                        served by the State Crippled Childrens Cardiac Clinics;  and,
                        III - Locally oriented, locally catalyzed, self-sustaining
                        programs will fulfill the ultimate goal of this project.


           DIABETES REGIONAL CENTER-DIABETES DETECTION AND
           EDUCATION CENTER

           Objectives:  To plan, instigate, and develop new programs through the
                        Center aimed at improving the care of patients with  diabetes
                        in community hospitals.  The program has these phases:
                        1.  Evaluation of existing facilities, personnel and programs;
                        2.  Education courses at the Center; 3.  Development of
                        materials and techniques; 4.  Implementation of in-service
                        educational programs; and,  5.  Re-evaluation.









                                            -156-





                                                                             NORTHLANDS-IV

              APPROVED OPERATIONAL PROJECTS (Continued)




              SERVICE-ORIENTED CANCER REGISTRY*

              Objectives:   To develop a service-oriented cancer registry in a successive
                            series of phases.  1.  Emphasis on service orientation in-
                            cluding optimal utilization of feedback materials..' 2. inclusion
                            of all identified or identifiable patients with neoplastic dis-
                            ease residing within the Northlands Region; and 3.  Follow-
                            up, integrated with activities of physicians responsible for
                            care of patients, as well as inclusive of all patients whose
                            cases have been registered.


              IMPROVING STROKE REHABILITATION THROUGH A REGIONAL PRO-
              GRAM OF CONTINUING EDUCATION - AMERICAN REHABILITATION
              FOUNDATION

              Objectives:   To improve rehabilitation of stroke patients through augment-
                            ing the supply of trained health professionals and concerned
                            community members. The  objective  will  be  attained  through
                            short courses for nurses, social workers, clergymen, and
                            families of stroke patients, presented over a period of  three
                            years.



              TELEPHONE DIAL ACCESS MEDICAL LIBRARY

              Objectives:   This project is a cooperative effort with the Wisconsin
                            Regional Medical Program.  It will expand the Dial Access
                            Medical Library being supported by Regional Medical
                            Programs in Wisconsin and make itavailabletoallph
                                                                                  y@icians
                            in the Northlands Region by toll-free telephone  transmission.
                            The Northlands Regional Medical Program will produce tapes
                            for the library which cover topics recommended by com-
                            mittees in Northlands.


              POSTGRADUATE    EDUCATION    IN    DISEASES    OF     CARDIOVASCULAR     AND
              NERVOUS SYSTEMS AND NEOPLASTIC DISEASE IN CHILDHOOD*

              Objectives:   This program is designed to provide postgraduate education
                            to physicians of the State of Minnesota and adjacent regions
                            in cardiovascular, neurologic, and neoplastic diseases of
                            children.  The physicians will attend one session per month
                            for a period of four months.







              *Approved but not funded,           -157-

                  356-998 0-69-11





                                                                    NORTHLANDS - V

            APPROVED OPERATIONAL PROJECTS (Continued)


            PILOT PROGRAMOFREGIONALPOSTGRADUATEMEDICALEDUCATION*
            Objectives:   This program has been designed to provide one to three
                          months of residency type training to general practitioners
                          internists, and surgeons.  Training is available -m neurology,
                          physical medicine, oncology, hematology, gastroenterology,
                          surgery, and cardiovascular diseases.

            A COLLABORATIVE BASIC REGIONAL INFORMATION NETWORK FOR
            EDUCATION AND CLINICAL EVALUATION APPLIED TO CORONARY
            ARTERY DISEASE - MAYO CLINIC AND MAYO FOUNDATION*
            Objectives:   By the use of a digital computer, a system is to be provided
                          to the clinician by which he may compare numerous para-
                          meters of a patient with myocardial infarction with para-
                          meters of a large number of patients in the same classifi-
                          cation.  The program will enable the isolated hospital or a
                          physician in a peripheral area to function as an extension of
                          a complex medical center.























          *Approved but not funded            -158-






                                                NORTHWESTERN OHIO - I

           NAME OF PROGRAM             Northwestern Ohio Regional Medical
                                        Program

           GEOGRAPHICAL REGION         20 Counties in Northwestern Ohio

           EST@TED POPULATION          1,36o, ooo

           COORDINATING HEADQUARTERS   Northwestern Ohio Regional Medical
                                        Program
                                       2313 Madison Avenue
                                       Toledo, Ohio 43624
                                       (Tel. : 419/248-6201)

           GRANTEE ORGANIZATION        Medical College of Ohio at Toledo

           EFFECTIVE STARTING DATE     January 1, 1968
           OF PLANNING ACTIVITI]ES

           TOTAL FUNDING TO DATE       $482, 107

           FUNDING FOR CURRENT         $310, 397
           YEARIS ACTIVITI]ES

           CHAERMAN, REGIONAL          William T. Collins, M.D.
           ADVISORY GROUP              2313 Madison Avenue
                                       Toledo, Ohio 43624

           PROGRAM COORDINATOR         *C. Robert Tittle, Jr., M.D.

           STAFF                       ASSISTANT PROGRAM COORDINATORS
                                       Donald A. Grubb
                                       Daniel J. Hanson, M.D.
                                       Anthony M. lannone, M. D.
                                       Don C. Nouse M.D.
                                       Herman W. R@as, M.D.

                                       PUBLIC HEALTH SPECIALIST
                                       James Pullella


                                       NURSE RESEARCH AND LECTURE
                                        ASSOCIATE
                                       Loalouise Geiger
                                       SYSTENO/COMMUNICATION-S SPECIAL-
                                        IST
                                       James B. Felkey









           *Chief Executive Officer  -159-





                                                            OHIO STATE - I
         NAME OF PROGRAM                 Ohio State Regional Medical Program
         GEOGRAPHICAL REGION             Central and southern two-thirds of
                                          Ohio (61 counties, excluding Metropol-
                                           itan Cincinnati area)

         ESTDAATED POPULATION            4, 68o, ooo
         COORDINATING HEADQUARTERS       Ohio State Regional Medical Program
                                         1480 West Lane Avenue
                                         Columbus, Ohio 43221
                                         (Tel.: 614/293-5995


         GRANTEE ORGANIZATION            The Ohio State University College of
                                          Medicine

         EFFECTIVE STARTING DATE         April 1, 1967
         OF PLANNING ACTRVITEES

         EFFECTRVE STARTING DATE         May 1. 1969
         OF OPERATIONAL ACTrvifi-Es

         TOTAL FUNDING TO DATE           $1,408,311

         FUNDING FOR CURRENT             $1,254,775
         YEARIS ACTIVITIES

         CHAIRMAN, REGIONAL              Richard L. Meiling, M.D.
         ADVISORY GROUP                  Dean, College of Medicine
                                         The Ohio State University
                                         410 West Tenth Avenue
                                         Columbus, Ohio 43210
         PROGRAM COORDMTOR               *Neil C. Andrews, b& D.
         STAFF                           ASSOCIATE COORDINATOR
                                         Charles IL White, Ph.D.

                                         DIRECTOR OF FIELD RELATIONS
                                         Braxton E. Tewart

                                         ASSISTANT DIRECTOR, FIELD
                                         RELATIONS
                                         Gerald D. Fry

                                         DIRECTOR OF PUBLIC INFORMATION
                                         Robert C. Ringe

                                         EDITORIAL  ASSISTANT
                                         Mary Margaret Patterson

                                         ADMINISTRATIVE ASSISTANT
                                         Leona J. Short

         *Chief Executive Officer    -i6o-





                                                                          OHIO STATE - H


               APPROVED OPERATIONAL PROJECTS




               CORONARY CARE UNIT EDUCATION

               Objectives:  This is a training prcigram for practicing nurses, nurse-
                            educators, and physicians.  It is a cooperative effort
                            between the Central Ohio Heart Association and the Ohio
                            State University College of Medicine.  Hospitals in 10 cities
                            will serve as the "core" of each surrounding geographical
                            area.  Two nurses will be selected from each core hospital
                            for intensive training in Columbus as nurse educators.  Semi-
                            nars for physicians will be held in core hospitals.  There
                            will be two programs for training practicing nurses.  A full-
                            time, two-week course will be given in Columbus; courses
                            will be offered in the core hospitals one evening per week in
                            two-hour periods for a total time of 33 weeks.  If course
                            space is available, applicants will be accepted for the
                            program in College from outside the area of the Central
                            Ohio Heart Association.  (The COHA covers 47 of the 61
                            counties within the Ohio State Regional Medical Program.
                            Audiovisual equipment and supplies are requested in order
                            to investigate the types of aids needed by the core hospitals
                            to insure adequate presentation of professional materials.


               A REHABILITATION TRAINING PROJECT FOR HEALTH PROFES-
               SIONALS (LICKING COUNTY MEMORIAL HOSPITAL)

               Objectives:  A model stroke rehabilitation unit will be developed in phases,
                            which consist of placing completed stroke patients on a
                            single unit; acquiring aid-to-daily living equipment; and
                            organizing an occupational therapy unit.  A beginning faculty
                            will.be designed from among existing personnel at the hos-
                            pital and additional faculty will be recruited in order to
                            expand educational activities into homes, nursing homes,
                            and continuing education programs.  The project director,
                            assisted by consultants in medical education, will develop
                            instruments for evaluation.  The types of measures to be
                            developed are discussed in the application. One goal of this
                            project is to develop a body of educational materials and
                            training experiences.

               CAREERS IN HEALTH SCIENCE PROGRAM

               Objectives:  This project is designed to stimulate interest among high
                            school students in health science careers.  It will be di-
                            rected by volunteers and existing staff of the Ohio Academy
                            of Sciences.  The Academy previously has engaged in a
                            number of recruitment activities which can be modified to
                            the health sciences.




                                               -161-





                                                     OHIO VALLEY - I
         NAME OF PROGRAM             Ohio Valley Regional Medical Program
         GEOGRAPHICAL REGION         Greater part of Kentucky, Southwest
                                      Ohio, and contiguous parts of Indiana
                                      and West Virginia
         ESTIMATED POPULATION        6, 000, 000
         COORDINATING HEADQUARTERS   Ohio Valley Regional Medical Program
                                     1718 Alexandria Drive
                                     Post Office Box 4025
                                     Lexington, Kentucky 40504
                                     (Tel. : 606/278-6071)
         GRANTEE ORGANIZATION        University of Kentucky Research
                                     Foundation
         EFFECTIVE STARTING DATE     January 1, 1967
         OF PLANNIN ACTIVITIES
         EFFECTIVE STARTING DATE     January 1, 1969
         OF OPERATIO@L ACTIVITIES
         TOTAL FUNDING TO DATE       $1, 390, 464
         FUNDING FOR CURRENT         $935, 317
         YEARIS A

         CHAIRMAN, REGIONAL          Mrs. Rexford S. Blazer, Jr.
                                     2711 Seminole Avenue
                                     Ashland, Kentucky 41101
         PROGRAM DIRECTOR            'William H. McBeath, M.D.
         STAFF                       ASSOCIATE DIRECTORS

                                      RESEARCH AND EVALUATION
                                      Donald K I-'reeborn, Ph. D.

                                      PROGRAM DEVELOPMENT
                                      Laurel  True, M. P. H.

                                     ADMINISTRATIVE OFFICER
                                     T. R. Newman, Jr.

                                     INFORMATION OFFICER
                                     Quentin D. Al en








       *Chief Executive Officer  -16z-





                                                                    OHIO VALLEY - II


               APPROVED OPERATIONAL PROJECTS




               CORE STAFF AND UNIVERSITY COORDINATORS

               Objectives:  Support is requested for a core staff in Lexington with
                            general administrative planning and coordinating functions.
                            Coordinating staffs at the three medical schools would also
                            be supported.  The functions of these groups include gener-
                            al university coordination, as well as personnel contribut-
                            ing to the operational projects.


               COMMUNITY HOSPITAL STAFF DEVELOPMENT

               Objectives:  Support is requested for seven Directors of Continuing
                            Professional Education to serve eight hospitals committed
                            to Ohio Valley Regional Medical Program objectives.  The
                            seven Directors of Medical Education serving either full-
                            time or part-time, represent an effort equal to 5. 7 "I-
                            time directors.  The primary function of the director is to
                            develop and coordinate an organized, hospital-based pro-
                            gram of continuing education.  The outcome of these educa-
                            tional efforts will be evaluated in terms of their effect upon
                            needs.



               REGIONAL MEDICAL TELEVISION

               Objectives:  Support is requested for the first steps toward long
                            range goals established in preliminary planning to develop
                            inter-connections between the three University medical
                            television functions.  Partial support is also projected for
                            the cost of tapes, production materials and distribution.


               LIBRARY EXTENSION SERVICES

               Objectives:  This project proposes to provide a strong library support
                            function in the eight demonstration hospitals for which
                            educational activities are to be developed in this opera-
                            tional application.













                                               -163-





                                                                OHIO VALLEY - III
          APPROVED OPERATIONAL PROJECTS (Continued)


          UNIVERSITY CONTINUING EDUCATION RESOURCES
          Objectives:   This project proposes to augment the continuing education
                        resources of the three medical centers, described as not
                        staffed, equipped or supported so as to respond effectively
                        to needs in the life-time learning of health professionals.
                        Also, that the medical center resources must be made more
                        accessible to the cooperating community hospitals by means
                        of staff specifically devoted to mobilizing these resources
                        in response to specific local needs.


          DRUG INFORMATION SERVICES
          Objectives:   The proposal describes a plan to extend University-based
                        drug information center services to selected community
                        hospitals.  Center staff will conduct a local, organized,
                        informational and educational orientation for medical,
                        nursing, and pharmacy staff of participating hospitals to
                        the use of drug information services.  The proposal also
                        includes a plan to develop a collaborative training program
                        for "drug information specialists" to beprepared for
                        employment in regional hospitals.






















         *Approved but not funded         -i64-





                                                         OKLAHOMA - I

           NAME OF PROGRAM             Oklahoma Regional Medical Program

           GEOGRAPHICAL REGION         State of Oklahoma

           ESTIM&TED POPULATION        2. 520, 000

           COORDINATING HEADQUARTERS   Oklahoma Regional Medical Program
                                       University of Oklahoma Medical Center
                                       800 Northeast Thirteenth Street
                                       Oklahoma City, Oklahoma 73104
                                       (Tel.: 405/232-8561)
           GRANTEE ORGANIZATION        Medical Center Research and Develop-
                                        ment
                                       Office of the University of Oklahoma
                                       Foundation, Inc.
           EFFECTIVE STARTING DATE     September 1, 1966
           OF PLANNING ACTIVITIES

           EFFECTIVE STARTING DATE     May 1. 1969
           OF OPERATIONAL ACTIVITIES

           TOTAL FUNDING TO DATE       $1, 818, 000

           FUNDING FOR CURRENT         $1, 255, 244
           YEARIS ACTRVITIES

           CHAIRMAN, REGIONAL          James L. Dennis, M.D.
           ADVISORY GROUP              Vice President and Dean
                                       University of Oklahoma Medical Center
                                       800 Northeast Thirteenth Street
                                       Oklahoma City, Oklahoma 73104

           DIRECTOR                    *Dale Groom, M.D.

           STAFF                       (ASSISTANT) COORDINATORS

                                         CARDIOVASCULAR ACTRVITIES
                                         L. Lee Conrad, M.D.

                                         RADIOLOGY, BREAST CANCER
                                          AND MAMMOGRAPHY PROGRAMS
                                         Eugene Durso, M.D.

                                         HEALTH CAREER RECRUITMENT
                                          PROGRAMS
                                         Kenneth C. Hager

                                         EDUCATION PROGRAMS FOR
                                          HEALTH RELATED PROFESSIONS
                                         Harry J. Parker, Ph.D.



           *Chief Executive Officer   -165-





                                                                    OKLAHOMA
           STAFF (Continued)                   (ASSISTANT) COORDINATORS
                                                 (Continue@d

                                                  LIBRARY AND INFORMATION
                                                   SERVICES
                                                  Patricia A. Smith, M. L. S.

                                                  NURSING ACTIVITIES
                                                  Donna Barlow, R.N.

                                                  CONTINUING EDUCATION.
                                                   HEftl,'I'ki RE;LATED Pl;
                                                  John M. White

                                                  COMMUNICATIONS'K.4EDIA
                                                  -Roger Wolfe

                                               ASSISTANT. HEALTH DATA AND
                                                 PI
                                               Nor an E. Goodwin

                                               CHIEF, PROGRAMS EVALUATION
                                               AND REI
                                               David W. Pearson, Ph.D.

                                               PROGRAM MANAGER
                                               Neal H.   rdin, Jr.

                                               ASSISTANT FOR ADMINISTRATIVE
                                               SERVICES AND COMMUNICATIONS
                                               Erwina B. Cornelison

























                                           -166-





                                                                       OKI.AHO@ - III

               APPROVED OPERATIONAL PROJECTS



               CORE SUPPORT

               Objectives:  This project will support core staff and central administra-
                            tive expenses.  A higher level of support is requested than
                            is presently funded under the planning grant.  The first year
                            request is for funds in addition to the current planning grant,
                            and the request for future years will be total funding since
                            the planning grant will expire after this year.


               A CORONARY CARE PROGRAM FOR OKLAHOMA
               Objectives:  To develop a network for monitoring acutely ill cardiac
                            patients and for promoting continuing education with respect
                            to the management of these patients.  The plan seeks to
                            create acute coronary care beds in hospitals financially un-
                            able to develop complete coronary care units.  The program
                            calls for the development of "central monitoring units"
                            (CMUS) in larger, usually urban hospitals.  The CMUs will
                            serve as coronary care units, but will also monitor electro-
                            cardiographic tracings relayed continuously by telephone
                            lines from patients in smaller hospital "remote stations"
                            (RS).  Training programs for physicians, nurses, and
                            allied health personnel are included.


               A REGIONAL EMPHYSEMA PROGRAM FOR OKIAHOMA
               Objectives:  A teaching and demonstration unit to be established at the
                            University of Oklahoma Medical Center would serve as a
                            regional emphysema unit.  It would be available as a con-
                            sultative and educational resource to community hospitals
                            in the Region.  Initially, hospitals in Oklahoma City,
                            Muskogee, Stillwater, Tulsa and Clinton would cooperate in
                            the University of Oklahoma Medical Center Program.  The
                            goal of the project, to improve the care of patients with
                            emphysema at the community level, would be achieved by
                            recruiting and training personnel; developing continuing
                            education programs; evaluating equipment and services;
                            establishing more effective collaborative group relationships;
                            improving and expanding screening activities and establish-
                            ing evaluative mechanisms.










                                             -167-





                                                                    OKLAHOMA    -    IV

           APPROVED OPERATIONAL PROJECTS (Continued)



           CONTINUING EDUCATION PROGRAM FOR THE ENID AREA

           Objectives:   A prototype "medical education center" would be established.
                         Ten surrounding counties with eight participating hospitals
                         would be included.  Continuing education modalities would
                         include video tape, audio tape, library resources, self-
                         instructional materials, films, conference-type telephone
                         communications, and short courses.  A small core staff
                         operating primarily out of one hospital would coordinate
                         and evaluate the-program.  The project seeks to demonstrate
                         the feasibility of a subregional "medical education center,
                         and hopes to stimulate the development of a network of
                         similar subregional centers.


           A CANCER CONTROL PROGRAM FOR THE TULSA AREA

           Objectives:   The first part seeks to evaluate the prevalence and character
                         of cancer among roughly 50, 000 people in a  poverty  area  of
                         Tulsa.  A second part seeks to develop a computerized
                         tumor registry combining data from three major Tulsa
                         hospitals. A third part proposes to integrate  the  continuing
                         education activities of three major Tulsa, hospitals in the
                         field of cancer. A fourth  part  seeks  to  increase  communi-
                         cations in the field of cancer between physicians in Tulsa
                         and those in a sparsely populated county to the south of
                         Tulsa. The fifth. part would survey the quality  and  quantity
                         of rehabilitation services for cancer in Tulsa and in four
                         representative smaller communities.


           A REGIONAL PROGRAM TO IMPROVE LI]BRARY AND INFORMATION
           SERVICES

           Objectives:   Oklahoma Regional Medical Program, primarily through the
                         University of Oklahoma Medical Center Library, seeks to
                         improve library information services by increasing the
                         scope of services, increasing the speed of delivery, and
                         improving the relevance of the information retrieved.  Three
                         model programs, involving five  hospitals  in  Oklahoma  City,
                         Tulsa, and Enid are proposed.  Like  those  proposed  for  the
                         regional unit, devices to speed references to  various  health
                         professionals would be instituted in these hospitals.  The
                         program  would  promote  knowledge  of  the  improved  library
                         facilities among the medical community.







                                             -168-





                                                                            OKLAHOMA       V


               APPROVED.OPERATIONAL PROJECTS (Continued)



               A    REGIONAL    PROGRAM    TO    PROMOTE    EARLY    DIAGNOSIS    OF     BREAST
               CANCER WITH SPECIAL EMPHASIS ON MAMMOGRAPHY

               Objectives:    A Regional  Mammography  Unit  would  be  established  at  the
                              University Medical Center, under the supervision of a
                              physician trained specially in gynecology and radiology.
                              Oklahoma  Regional  Medical  Program  would  work   with   the
                              Oklahoma  Division  of  the  American  Cancer  Society.   Mass
                              mammography  screening  would  be  initiated  in   cooperation
                              with the  Oklahoma  State  Health  Department.  Provision  for
                              including Zerography  and  Thermography  in  future  years  is
                              included.



               A REGIONAL PROGRAM IN NUTRITION AND DIABETES FOR
               OKLAHOMA

               Objectives:    This program seeks to  improve  the  care  of  diabetic  patients
                              at the community  level,  and  to  improve  nutritional  services
                              in  hospitals  and  nursing  homes  throughout  Oklahoma.  The
                              program  would  help  support  an  ongoing  diabetes   demonstra-
                              tion clinic at the University Hospital which would deve  op  t  e
                              teaching -materials  and  manpower  to  extend  improved  care
                              for diabetic  patients  throughout  the  Region.  The  program
                              would  organize  workshops,  seminars,  and   consultation   ser-
                              vices to physicians, nurses and  dieticians,  and  would  also
                              seek  to  improve  community   education.   The   program   would
                              coordinate continuing education and public education with
                              mass screening  procedures  performed  by  the  State  Health-
                              Department.


               REGIONAL    UROLOGY    PROGRAM    WITH    INITIAL     EMPHASIS     ON     CANCER
               OF THE PROSTATE

               Objectives:    The  program  would  create  a  consortium  of  urologists,  each
                              of whom would coordinate project  activities  within  his  own
                              subregion.  Thirteen  subregions  are  identified.  Initially,
                              the program would appraise local facilities, resources, man-
                              power and medical practices  as  they  relate  to  the  diagnosis
                              and treatment of  cancer  of  the  prostate.  The  program  would
                              analyze hospital  records  and  tumor  registries,  with  follow-
                              up on all new cases, and would   identify the local needs  for
                              continuing  education.  This  program  would  interdigitate  with
                              other proposed  programs,  such  as  the  Tulsa  poverty  area
                              program.







                                                    -169-





                                                            OREGON-I
         NAME OF PROGRAM              Oregon Regional Medical Program
         GEOGRAPHICAL REGION          State of Oregon
         EST@TED      POPULATION      2, 050, 900
         COORDINATING HEADQUARTERS    Oregon Regional Medical Program
                                      University of Oregon Medical School
                                      3181 S. W. Sam Jackson Park Road
                                      Portland, Oregon 97201
                                      (Tel. : 503/228-9181, ext. 603)
         GRANTEE    ORGANIZATION      University of Oregon Medical School
         EFFECTIVE STARTING DATE      April 1, 1967
         OF PLANNING  ACTIVITIES

         EFFECTIVE STARTING DATE      April 1, 1968
         OF OPERATIONAL.ACTIVITIES

         TOTAL FUNDING  TO  DATE      $i, 639, 027
         FUNDING FOR CURRENT          $728,389
         YEARIS A

         CHAIRMAN, REGIONAL           HermanA. Dickel, M.D.
         ADVISORY GROUP               511 S. W. Tenth Avenue, #1308
                                      Portland, Oregon 97205
         PROGRAM COORDINATOR          *Edward L. Goldblatt, M. D.
         STAFF                        COORDINATORS

                                        FOR INFORMATION AND COMMU-
                                         NICATIONS
                                        (Mrs.) Dale Caldwell

                                        FOR PROGRAM ADMINISTRATION
                                        Jerry 0. Elder

                                        FOR PROJECT DEVELOPMENT
                                         AND COMMUNITY ORGANIZATION
                                        Delbert NL Kole, M.D.

                                        FOR NURSING AND ALLIED HEALTH
                                        (Miss) Susan Rich, R.N.








        *Chief Executive Officer   -170-





                                                                          OREGON - ]:I


             APPROVED OPERATIONAL PROJECTS


               HEART,, CANCER, STROKE CIRCUIT POSTGRADUATE PROGRAM
               Objectives:   To expand the existing University of Oregon Medical School
                             circuit program so that courses can be made available to
                             all physicians and allied health personnel three times a year
                             at 18 locations in Oregon, Idaho, and Montana.  Circuits
                             presented by faculty members, and by one faculty member
                             and video tapes will be tried and compared.

               EARLY DIAGNOSIS AND THERAPY OF CEREBROVASCULAR DISEASE
               Objectives:   In addition to the usual careful history, examination and
                             laboratory tests, measurements of the circulation time of
                             the brain and of factors known to interfere with the circula-
                             tion will be determined in an effort to arrive at a diagnosis
                             as early as possible.  Patients will then be placed on a low-
                             fat diet, and others followed as controls.  Facilities, per-
                             sonnel, and patient resources will be available at the
                             University of Oregon Medical School and Good Samaritan
                             Hospital.


               SURGICAL TREATMENT OF VASCULAR LESIONS AND CEREBRAL
               COMPLICATIONS OF CEREBROVASCULAR DISEASE
               Objectives:   This project will be conducted jointly with Project #I, uti-
                             lizing the same clinic and study facilities.  Early cases will
                             be screened for operable lesions of the neck and arteries
                             and a study made of the effectiveness of surgery on longevity
                             and neurological status.


               DIAGNOSIS AND TREATMENT OF CEREBROVASCULAR DISEASE AND
               THE INFLUENCE OF A STROKE CLINIC ON STROKE CARE
               Objectives:   The purpose of this project will be to study the natural his-
                             tory of disease; to establish a demonstration clinic which
                             will apply model current methods of therapy in order to
                             determine ff the presence of such a clinic in a community
                             hospital will improve stroke-patient care; and to disseminate
                             pertinent information to medical and paramedical personnel
                             concerned in the care of stroke patients.









                                                 -171-






                                                                      OREGON-IH

          APPROVED OPERATIONAL PROJECTS (Continued)



          A STROKE CONTINUING EDUCATION PROGRAM PLANNED BY
          COMMUNITY PHYSICIANS: AN EVALUATION OF EFFECTIVENESS

          Objectives:   This project will assess the quality of stroke care available
                        in four selected sample communities and will institute con-
                        tinuing education programs in these communities to deter-
                        mine the effectiveness of traditional continuing education
                        programs as compared to the "process model" type of edu-
                        cational programs.


          CORONARY CARE TRAINING - SALEM MEMORIAL HOSPITAL
          Objectives:   This project will provide a series of three-week training
                        programs for nurses to learn the fundamentals of coronary
                        care nursing.  The courses will be reinforced with follow-
                        up sessions and evaluation in the hospitals of nurse partici-
                        pant s.


          CORONARY CARE TRAINING - SACRED HEART GENERAL HOSPITAL

          Objectives:   This project will establish a continuing series of three-week
                        programs to train nurses in current techniques of caring for
                        patients with acute myocardial infarctions.  Courses will be
                        reinforced by follow-up sessions and evaluation in hospitals
                        of participants.


          CENTRAL OREGON HEART, CANCER, AND STROKE PILOT PROJECT
          Objectives:   This project is a cooperative arrangement among four small
                        community hospitals in a -geographically isolated area of
                        central Oregon.  Initially, the Central Oregon group will
                        explore methods through which cooperative use of resources
                        can favorably influence patient care.  The present project
                        has two parts: First, support for a Nursing In-Service
                        Education Coordinator, who will be shared by the areals
                        four hospitals, to develop and coordinate programs that will
                        up-grade nursing practice.  Second, to provide physicians
                        with rapid electrocardiogram consultation via a telephone
                        relay system.











                                          -172-






                                                                               OREGON - IV

                APPROVED OPERATIONAL PROJECTS (Continued)



                CORONARY CARE TEACHING AIDS

                Obj ectives:  This project would  create  alibrary  of  electrocardio  raphic
                                                                                     9
                              tapes.  The tapes will be accompanied by continual voice
                              interpretation of the arrhythmias as they occur on the
                              oscilloscope.  These tapes would be used for the training
                              of coronary care medical and paramedical personnel and
                              would be available without charge to any health institution
                              or agency within the Region.


                GUIDING ADULT PATIENTS WITH APHASIA

                Objectives:   This project will provide an eight-day instructional and
                              clinical course to increase the ability of health professionals
                              to handle the patient whose  communication.  skills  have  been
                              impaired following a stroke.  Personnel and facilities in
                              Oregon are not adequate to aid these patients.  This project
                              would pool the resources of physicians and allied health
                              workers who work with stroke patients so that this important
                              phase of rehabilitation will not be overlooked.  Five training
                              courses will be given each year, with fifteen students per
                              course.



                EDUCATIONAL OPPORTUNITIES FOR THE OREGON REGIONAL
                PHYSICIAN IN THE DIAGNOSIS AND THERAPY OF CANCER*

                Objectives:   This project will provide a training  program  at  the  Univer-
                              sity of Oregon Medical School with the aim of improving
                              treatment of cancer patients by practitioners  in  the  Region.
                              Eight training courses, lasting four weeks each, will be
                              given per year.  Initially, one physician will be accepted for
                              each session.  The curriculum will be modified to the individ-
                              uals' special interests, but will include clinics and con-
                              ferences which are part of the regular activity of the Medical
                              School.



                SOUTHERN OREGON DIABETIC INSTRUCTION AND EVALUATION*

                Objectives:  Provide instruction for diabetic patients, responsible
                              relatives, and medical personnel.  Courses will vary ac-
                              cording to the groups. Instructors  will  be  health  personnel
                              available in the community.






                *Approved but not. funded         -173-


                    356-998 0-69-12





                                                                    PUERTO RICO - I

           NAME OF PROGRAM                      Puerto Rico Regional Medical Program

           GEOGRAPHICAL REGION                  Puerto Rico

           ESTIMATED POPULATION                 2, 723, 000
           COORDINATING HEADQUARTERS            Puerto Rico Regional Medical Program
                                                Post Office Box M.  R.
                                                Caparra Heights Station, Puerto Rico
                                                 00922
                                                (Tel. :  809/765-2272)
           GRANTEE ORGANIZATION                 University of Puerto Rico
                                                Medical Sciences Campus

           EFFECTRVE STARTING DATE              June 1, 1968
           OF PLANNING ACTRVITIES

           TOTAL FUNDING TO DATE                $238,327

           FUNDING FOR CURRENT                  $238,327
           YEARIS ACTIVITIES

           CHAIRMAN, REGIONAL                   Jose"D. Sffontes, M.D.
           ADVISORY GROUP                       Dean, University of Puerto Rico
                                                School of Medicine
                                                San Juan, Puerto Rico  00905
           PROGRAM COORDINATOR                  *Adan Nigaglioni, M.D.
                                                Chancellor, Medical Sciences Campus
                                                University of Puerto Rico

           STAFF                                ASSOCIATE COORDINATOR
                                                Cristino Col6n, M.  D.

                                                ASSISTANT COORDINATOR FOR
                                                 HEALTH       SERVICES
                                                Merlin Lugo, M.D.

                                                HEAD, SECTION OF BIOSTATISTICS
                                                (Mrs.) Carmen Allende

                                                SOCIAL SCIENTIST
                                                Ra&l Munoz

                                                HOSPITAL ADMINISTRATOR
                                                Ram6n Rivera

                                                CONSULTANT IN CONTINUING
                                                 EDUCATION
                                                JosT Chaves Estrada, NL D.




                                            -174-
           *Qhief Executive Officer





                                                                  PUERTO RICO - II

               STAFF (Continued)                HEALTH EDUCATOR
                                                (Mss) Elba Roman

                                                ADMINBTRATOR
                                                Orlando Nieves

































































                                             -175-





                                                                     ROCHESTER - I

          NAME OF PROGRAM                       Rochester Regional Medical Program

          GEOGRAPHICAL REGION                   Rochester, New York and 10 surround-
                                                ing counties

          EST@TED POPULATION                    1, 300, 000

          COORDINATING HEADQUARTERS             Rochester Regional Medical Program
                                                University of Rochester Medical Center
                                                260 Crittenden Boulevard
                                                Rochester, New York  14620
                                                (Tel. : 716/275-4861)

          GRANTEE ORGANIZATION                  University of Rochester School of
                                                Medicine and Dentistry

          EFFECTIVE STARTING DATE               October 1, 1966
          OF PLANNING ACTRVITIES

          EFFECTIVE STARTING DATE               March 1, 1968
          OF OPERATIONAL ACTIVITIES

          TOTAL FUNDING TO DATE                 $1, 995, 859

          FUNDING FOR CURRENT                   $697,670
          YEARIS ACTIVITIES

          CHAIRMAN, REGIONAL                    Frank Hamlin
          ADVISORY GROUP                        Papec Machine Company
                                                Shortsville,  New  York  14548

          PROGRAM COORDINATOR                   *Ralph C.  Parker,  Jr.,  M.D.

          STAFF                                 DIRECTORS


                                                  MULTI]PHASIC SCREENING PROJECT
                                                  Barbara Bates, M. D.

                                                  HEART DISEASE PROGRAM
                                                  Thomas E.  Cardillo,  M.  D.

                                                  CANCER PROGRAM
                                                  Thomas C. Hall, M.D.

                                                  STROKE PROGRAM
                                                  Gaetano F. Molinari,  M.  D.

                                                NURSING COORDINATOR
                                                (Miss) Edith Olson, R. N.

                                                SPECIALIST INCARDIOVASCULAR
                                                NURSING
                                                (Mrs.) Nancy Clark, R.N.


          *Chief Executive Officer          -176-






                                                              ROCHESTER
             STAFF (Continued)              CLINICAL SPECIALISTS

                                              STROKE NURSING
                                              (@ss)Janet Long, R. N.

                                              CARDIOVASCULAR NURSING
                                              (Miss) Rose Pinneo, R.N.

                                            ]PROJECT DIRECTORS

                                              COAGULATION LABORATORY
                                              Robert Breckenridge, @D.

                                              RENAL DISEASE
                                              Richard B. Freeman, NL D.












































                                       -177-





                                                                   ROCHESTER   -   III
           APPROVED OPERATIONAL PROJECTS


           SUPPORT   OF   RECONSTRUCTION   AND    EQUIPPING    OF    FACILITIES    FOR
           USE   AS   A   LEARNING   CENTER   FOR    PROJECTED    TRAINING    PROGRAMS
           RELATED TO HEART DISEASE, CANCER, AND STROKE - HELEN
           WOOD      HALL
           Objectives: To renovate space for training nurses and  physicians  to  use
                        coronary care units, and other continuing education program  s
                        that might be developed.  Self-instructional equipment,
                        resuscitation models, furniture, etc. would be purchased.

           POSTGRADUATE TRAINING PROGRAM FOR PHYSICIANS
           Objectives:  To provide continuing education for physicians in the latest
                        techniques and equipment for preventing and  treating  cardiac
                        patients. In-service training,  short-term  graduate  courses
                        circuit consultation, conferences, etc. will be supported.

           REGISTRY OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
           Objectives:  To analyze  the  informa'tion listed on a standard from re-
                        garding persons admitted to hospitals with  acute  myocardial
                        infarction. This data will be discussed during training  pro-
                        grams and used in evaluating  other  projects.  IBM  computer
                        time will be rented.

           ESTABLISHMENT AND SUPPORT OF A REGIONAL LABORATORY FOR
           THE EDUCATION AND TRAINING IN THE CARE OF PATIENTS WITH
           THROMBOTIC AND HEMORRHAGIC DISORDERS - ROCHESTER
           GENERAL HOSPITAL
           Objectives:  To establish a center where physicians and technicians will
                        receive training and a well-qualified consultancy staff will
                        be available.


















                                           -178-





                                                                       ROCHESTER - IV

                APPROVED OPERATIONAL PROJECTS (Continued)



                INTENSRVE COURSES IN CORONARY CARE NURSING FOR PROFES-
                SIONAL NURSES

                Objectives:   This project will provide training courses for nurses in the
                              management of coronary care units.  Four intensive courses
                              of four weeks duration each will be offered annually.  These
                              courses will be conducted at the University of Rochester
                              Medical Center by the Department of Nursing.  Nurses
                              will be trained both to staff CCU's as well as develop
                              training programs in CCU's within the region.  Instruction
                              will include didactic content, laboratory demonstrations and
                              practice, and clinical experience.


                EARLY DISEASE DETECTION

                Objectives:   To provide multiphasic screening for selected populations
                              throughout the region.  Initial efforts would be implemented
                              at Strong Memorial Hospital and be based in the Outpatient
                              Clinic on a pilot or demonstration basis.  The applicant
                              outlines the service, educational, and research and evalua-
                              tion objectives of this proposal.  A methodology for imple-
                              mentation is also presented.  It is estimated that 5, 000
                              patients will be screened during the first year.


                CONTINUING EDUCATION PROGRAM IN CEREBROVASCULAR DISEASE
                FOR PHYSICIANS IN THE ROCHESTER AREA

                Objectives:  To provide six or more different educational opportunities
                              for practicing physicians in the pathophysiology, symtoma-
                              tology, physical and laboratory diagnosis, complications,
                              management, rehabilitation and prevention of the common
                              types of cerebrovascular and related diseases.  A curricu-
                              lum is presented for what is described as in-service train-
                              ing -to be available at Strong Memorial Hospital.  In addition,
                              continuing education programs, consultation services,
                              special lectures, and conferences or workshops would be
                              inaugurated in peripheral hospitals.














                                                  -179-





                                                                    ROCHESTER -V
           APPROVED OPERATIONAL PROJECTS (Continued)


           REGIONAL CLEARINGHOUSE ON CANCER
           Objectives:  The purposes of this project include the development of a
                        variety of methods for gathering data about cancer, the
                        continuous identification of  unm'et needs, and the establish-
                        ment of different communicative media for the dissemina-
                        tion of cancer information to health care personnel and other
                        appropriate groups.  The data to be gathered will include a
                        broad spectrum of medical, consultative, educational, social
                        service'  community resources and like information.  The
                        Clearinghouse would be administered by the Regional Medical
                        Program with professional staff services provided by the
                        Medical Center.


           STATISTICAL AND EVALUATION UNIT
           Objectives:  The purposes of this project would be to gather and analyze
                        health data for use in program planning, assist in the
                        evaluation of the regional medical  program  in  improving
                        medical care, and consult with individual projects in  the
                        design of evaluation protocols.  The project would be ad-
                        ministered by the regional medical program and staff would
                        be professional supervised through the Department of Pre-
                        ventive Medicine and Community Health.

           TELEPHONE ELECTROCARDIOGRAPH CONSULTATION*
           Objectives: Would provide for long distance  transmission  of  electro-
                        cardiographs.


           DECENTRALIZED REGIONAL CANCER EDUCATION*
           Objectives:  Would support oncology programs in affiliated teaching hos-
                        pitals.  Physician and nursing personnel would be provided
                        to develop activities in tumor boards, teaching clinics,
                        consultation services, and the like.


           DEVELOPMENT OF A STROKE TEAM*
           Objectives:  Stroke teams would be established at Strong Memorial
                        Hospital and at Monroe Community Hospital to provide for
                        continuity of care from the acute phase through  rehabili-
                        tatioix.




            pproved but not funded         -180-






                                                                      ROCHESTER - VI


              APPROVED OPERATIONAL PROJECTS (Continued)




              NEUROLOGIC AND REHABILITATION NURSING*

              Objectives:   Partially decentralized program would be established at a
                            hospital in Elmira which would include bedside teaching
                            opportunities in other community hospitals.  Short-term
                            courses, circuit courses, clinical conferences, and other
                            educational programs are planned.


              PHYSICIAN TRAINING IN CHRONIC RENAL DISEASE*

              Objectives:  Monthly, three-day tutorial programs (for one physician
                            each) would be made available to primary physicians.
                            Information about chronic renal disease, conservative
                            therapy, dialysis, and transplantation would be given.


              CHRONIC RENAL DISEASE NURSING*

              Objectives:  Two one-week courses in transplantation, and two two-week
                            courses in dialysis will be offered annually.  In addition,
                            circuit courses, conference days, and consultation services
                            are planned.


              A PROGRAM FOR PATIENTS WITH DIABETES MELLITUS*

              Objectives:  Program of patient education, professional education, and
                            periodic medical evaluation of patients to assess diabetic
                            control would be initiated.






















              *Approved but not funded         -181-





                                                                  SOUTH CAROLINA - I

           NAME OF PROGRAM                       South Carolina Regional Medical
                                                  Program

           GEOGRAPHICAL REGION                   State of South Carolina

           EST@TED POPULATION                    2,664,000

           COORDINATING HEADQUARTERS             South Carolina Regional Medical Pro-
                                                  gram
                                                 Medical College of South Carolina
                                                 80 Barre Street
                                                 Charleston,  South  Carolina   29401
                                                 (Tel. : 803/723-2771)

           GRANTEE ORGANIZATION                  Medical College of South Carolina

           EFFECTRVE STARTING DATE               January 1, 1967
           OF PLANNING ACTRVITIES

           EFFECTRVE STARTING DATE               August 1, 1968
           OF OPERATIONAL ACTRVITIES

           TOTAL FUNDING TO DATE                 $1,923,942

           FUNDING FOR CURRENT                   $1,490,849
           YEARIS ACTRVITIES

           CHAIRMAN, REGIONAL                    William  M.  McCord,   M.D.,   Ph.D.
           ADVISORY GROUP                        President
                                                 Medical College of South Carolina
                                                 80 Barre Street
                                                 Charleston,  South  Carolina  ?.9401

           PROGRAM COORD@TOR                     *Vince  Moseley,   M.D.

           STAFF                                 ASSOCIATE COORDINATORS


                                                    FOR HEART DISEASE AND STROKE
                                                    Charles P. Summerall, M.D.

                                                    EXECUTRVE ASSOCIATE COORDI-
                                                     NATOR
                                                      i iam  J.  Warlick


                                                    FOR     CONTINUING      EDUCATION
                                                     AND COMMUNICATION
                                                    Charles  D.   Kimsey

                                                 DIRECTOR OF FIELD OPERATIONS
                                                 C. W. Bowman


                                                 DIRECTOR OF PROFESSIONAL
                                                  REI,ATIONS
                                                 J. Walker Coleman

           *Chief Executive Officer          -182-





                                                                 SOUTH CAROLINA

               STAFF (Continued)                   PROJECT ADMINISTRATOR FOR
                                                      ANC@A
                                                   H rry E. Shaw

                                                   DIRECTOR OF COMMUNICATIONS
                                                   Bettye Anne Langdoc

                                                   PROGRAM REPRESENTATRVES
                                                   Blanche Urey
                                                   Patricia NL Westrick
                                                   Howard Surface
                                                   Roger McCants

                                                   STAFF ASSISTANTS
                                                   Janet G. Gresh
                                                   Barbara Ann Auld


                                                   CHIEF ACCOUNTING CLERK
                                                   Sylvia A. Burke










































                                               -183-





                                                          SOUTH CAROLINA - III


          APPROVED OPERATIONAL PROJECTS




          YORK GENERAL HOSPITAL CORONARY CARE UNIT

          Objectives:   Through a new coronary care unit, to improve the care of
                        patients with coronary artery disease, provide a  mode  of
                        continuing education for physicians and nurses in York
                        and surrounding counties.  Also to evaluate the feasibility
                        of using the coronary care unit as a referral center by
                        smaller hospitals in the area.  Sponsor: York General
                        Hospital, Rock Hill.


          GREENVILLE CORONARY CARE UNIT

          Objectives: To establish a coronary care training  program  in  a  large
                        hospital system which supports a major  population  center
                        and subregion of the state.  Sponsor:  Greenville  General
                        Hospital System, Greenville.


          SPARTANBURG GENERAL HOSPITAL CORONARY CARE UNIT

          Objectives:   To improve patient care, to provide  continuing  education
                        for medical and nursing staffs, and to provide a broader
                        scope of education and experience for student  nurses  and
                        house staff.  Sponsor: Spartanburg General Hospital,
                        Spartanburg.


          ANDERSON CORONARY CARE UNIT

          Objectives:   To improve patient care in an acute coronary care unit,
                        through a continuing education program for the medical
                        and nursing staff of Anderson Memorial Hospital and
                        smaller community hospitals in the area.  Sponsor:
                        Anderson Memorial Hospital.


          CORONARY CARE UNIT TRAINING

          Objectives:   To establish in South Carolina a series of training courses
                        designed specifically to prepare nurses to function in
                        coronary care units so that the rapidly  expanding  number
                        of such units will be adequately staffed and able to offer
                        ever improving patient care.  Sponsor: University of
                        South Carolina.








                                           -184-





                                                                SOUTH CAROLINA - rV
               APPROVED OPERATIONAL PROJECTS (Continued)



               SPARTANBURG GENERAL HOSPITAL HEART CLINIC

               Objectives:  To improve the medical care of patients with heart disease
                            in the counties of Spartanburg, Cherokee, and Union 'm the
                            Piedmont sub-region of South Carolina, and to accelerate
                            the dissemination of cardiovascular information to the
                            physicians of the three counties involved.  Sponsor:
                            Spartanburg General Hospital, Spartanburg.


               FLORENCE COOPERATIVE HEART CLINIC PROGRAM
               Objectives:  To expand the role of a community hospital heart clinic and
                            strengthen the relationship of the local program to the
                            heart program at the Medical College of South Carolina.
                            Sponsor: South Carolina State Board of Health.


               CARDIOPULMONARY RESUSCITATION TRAINING
               Objectives:  To instruct physicians and allied medical personnel in
                            cardiopulmonary resuscitation procedures through hospital-
                            based training programs in each county in South Carolina.
                            Sponsor: South Carolina Heart Association, Columbia.


               CERVICAL CANCER SCREENING

               Objectives:  Will demonstrate the feasibility and benefit of routine
                            Papanicolaou ("pap") smears; stimulate wider use of the
                            test; indicate the vital need for a school for training
                            cytotechnologists; prove the practicability of screening for
                            cervical cancer; initiate a public health program in South
                            Carolina designed to save the lives of females who are in
                            the prime of life, and to unffy the efforts of health, welfare,
                            medical and other community agencies in seeking a solution
                            to a common problem.  Sponsor: South Carolina State
                            Board of Health, Columbia.


               COOPERATIVE PROGRAM ON CARCINOMA OF THE CERVICK
               Objectives:  Development of a cooperative regional program for the
                            improved screening, diagnosis, therapy and management
                            of patients with carcinoma of the cervix.  Sponsor: Medical
                            College of South Carolina.






                                              -185-






                                                              SOUTH CAROLINA - V

          .APPROVED OPERATIONAL PROJECTS (Continued)



          PEDIATRIC CANCER EDUCATION AND SERVICE PROGRAM

          Objectives:   To establish a post-graduate education program that will
                        bring new information in pediatric cancer diagnosis and
                        therapy to the physicians of the state; to form a state-wide
                        "tumor board" that will encourage co-operation between
                        cancer clinics and the Medical College of South Carolina
                        and provide a two-way learning or consultation service for
                        cancer patients; disseminate consultant advice directed
                        towards more uniform care for pediatric patients.  Sponsor:
                        Medical College of South Carolina, Charleston.


          DEMONSTRATION PROJECT FOR THE DETECTION OF CANCER OF
          THE GASTROINTESTINAL TRACT

          Objectives:   To demonstrate to the physician the value of coordinated
                        diagnostic procedures through presentations to medical
                        groups and through clinical demonstration to the individual
                        physician; also, to serve as a pilot program for technician
                        training, to establish an orientation center for other cancer
                        detection projects and to offer a community education pro-
                        gram through cooperative arrangements with local health
                        societies and agencies.  Sponsor: Columbia Hospital of
                        Richland County.


          GREENVILLE'COBALT THERAPY PROGRAM

          Objectives:   To improve cancer therapy for the population in the north-
                        western area of South Carolina and to increase the education
                        potential for radiology residency and radiologic technician
                        programs in the 849 bed Greenville General Hospital System.
                        Sponsor: Greenville General Hospital System, Greenville.


          ACUTE STROKE DEMONSTRATION PROJECT

          Objectives:   To establish in the central region of South Carolina a hospi-
                        tal-based acute stroke service for the purpose of offering a
                        comprehensive medical program for the management of acute
                        stroke patients, keeping physicians abreast of current diag-
                        nostic and management techniques, training interns and res-
                        idents, establishing teaching programs for related para-
                        medical personnel, soliciting involvement and support of the
                        public, and, ultimately, demonstrating to this and other areas
                        of the state the value and feasibility of a coordinated team
                        approach to stroke management.  Sponsor: Columbia Hospi-
                        tal of Richland County.



                                           -186-





                                                                  SOUTH CAROLINA - VI

               APPROVED OPERATIONAL PROJECTS (Continued)



               STROKE REHABILITATION PROJECT

               Objectives:  The gradual conversion of an existing health facility into a
                            facility for the extended care and rehabilitation of stroke
                            patients in the central region of South Carolina with the
                            related objective of demonstrating the feasibility and ad-
                            vantages of such an undertaking to other areas of the state.
                            Sponsor: Columbia Hospital of Richland County.


               CHRONIC HEMODIALYSIS DEMONSTRATION UNIT

               Objectives:  Initial support for organization of a hemodialysis Medical
                            College of South Carolina to treat uremic patients, offer
                            training for medical and paramedical personnel, and act
                            as both a pilot and demonstration project that will culmi-
                            nate in the development of such centers on a regionwide
                            basis.  Sponsor: Medical College of South Carolina.


               HEALTH, EDUCATION AND RECRUITMENT PROJECT

               Objectives:  To expand and refine information on the availability and
                            need for educational programs and to assist hospitals and
                            the health industry in the recruitment of trainees and the
                            development of educational programs.  Sponsor: South
                            Carolina Hospital Association, Columbia.



























                                             -187-





                                            SUSQUEHANNA VALLEY
        NAME OF PROGRAM             Susquehanna Valley Regional Medical
                                     Program
        GEOGRAPHICAL REGION         Z7 counties in Central Pennsylvania
        ESTIMATED POPULATION        2, 140, 000
        COORDINATING HEADQUARTERS   Susquehanna Valley Regional Medical
                                     Program
                                    3806 Market Street
                                    Post Office Box 541
                                    Camp Hill, Pennsylvania 17011
                                    (Tel. : 717/761-3Z52)
        GRANTEE ORGANIZATION        Pennsylvania Medical Society
        EFFECTIVE STARTING DATE     June 1, 1967
        OF PLANNING ACTIVITIES

        EFFECTIVE STARTING DATE     April 1, 1969
        OF OPERATIONAL ACTIVITIES

        TOTAL FUNDING TO DATE       $984, 216

        FUNDING FOR CURRENT         $616, 075
        YEARIS ACTIVITIES

        CI-IAIRMAN, REGIONAL        Raymond C. Grandon, M.D.
        ADVISORY GROUP              Secretary
                                    Dauphin County Medical Society
                                    131 State Street
                                    Harrisburg, Pennsylvania 17101


        PROGRAM COORDINATOR         *Richard B. McKenzie

        STAFF                       FIELD SERVICES
                                    Herbert J. Toy, Jr.

                                    RESEARCH AND APPLICATION
                                    ACTIVITIES
                                    Robert A. Ranberg

                                    COMMUNICATIONS
                                    Robert M. Fisher

                                    SYSTEMS ANALYSIS
                                    Martin Ferrante








                                 -188-
        *Chief Executive Officer





                                                        SUSQUEHANNA VALLEY

             STAFF (Continued)                AREA REPRESENTATIVES
                                              John Hoffmann
                                              James Smith
                                              Frank Williams
                                              Richard Wright

                                              STATISTICIAN
                                              Thomas Boone


























































                                           -189-


                 356-998 0-69-13





                                                         SUSQUEHANNA VALLEY - III


            APPROVED OPERATIONAL PROJECTS




            EVANGIELICAL COMMUNITY HOSPITAL CORONARY CARE UNIT

            Objectives:  A four-bed unit is planned.  Six nurses from the Lewisburg
                          Hospital will receive subsidized training at  the  Geisinger
                          Medical Center.



            SUNBURY COMMUNITY HOSPITAL CORONARY CARE UNIT

            Objectives:  This proposal will provide a three-bed coronary care unit,
                          including equipment and  renovations,  and  one  month's
                          training in coronary care at the Geisinger Medical Center
                          for six nurses.



            SHAMOKIN    STATE    GENERAL    HOSPITAL    CORONARY     CARE     UNIT

            Objectives: A three-bed unit is  planned.  Four  nurses  will  be  trained
                          at the C;eisinger Medical Center.


            A. C. MILLIKEN HOSPITAL (GOOD SAMARITAN) CORONARY CARE
            UNIT

            Objectives:  Nine nurses will be trained in coronary care at the Reading
                          General Hospital in order to staff the four-bed unit in this
                          proposal.


            MEMORIAL    HOSPITAL    OF    BEDFORD     COUNTY     CORONARY     CARE
            UNIT

            Objectives: This hospital seeks funds to establish  a  four-bed  unit  and
                          to train six nurses at Altoona Hospital.


            CORONARY CARE UNIT NURSES TRAINING PROGRAM AT THE
            GEISINGER MEDICAL CENTER

            Objectives:   Coronary Care Unit at this institution is presently the only
                          established unit within an eight  county  area.  Several
                          neighboring community hospitals are establishing or plan-
                          ning to establish coronary care  units.  These  institutions
                          need a conveniently located  nurses'  coronary  care  train-
                          ing program to provide facilities for training to  their
                          nursing staff.  Support is requested to train 20 students
                          in a one-month course.






                                             -190-





                                                           SUSQUEHANNA VALLEY - rV
               APPROVED OPERATIONAL PROJECTS (Continued)


               STROKE CARE UNIT - MERCY HOSPITAL, ALTOONA
               Objectives:  Stroke Unit will be established in the Appalachian-Highland
                            sub-area to serve as a consultation and training resource
                            for practicing physicians, nurses, physiotherapists and
                            other personnel involved in caring for stroke patients.  A
                            stroke advisory committee will be organized to oversee the
                            project.


               HOME HEALTH CARE PROJECT
               Objectives:  Susquehanna Valley Home Health Services, Inc., -will pro-
                            vide training and home health services for the counties of
                            Snyder, Union and part of Northumberland which do not
                            now have service.


               REGIONAL MEDICAL PROGRAM INFORMATION SERVICE
               Objectives:  To develop and maintain a medical library service -for
                            practicing physicians and hospitals.




























                                             -191-





                                            TENNESSEE MID-SOUTH - I

        NAME. OF PROGRAM            Tennessee Mid-South Regional Medical
                                     Program
        GEOGRAPHICAL REGION         Tennessee and Southwestern Kentucky

        ESTMIATED   POPULATION      2,750,000

        COORDINATING HEADQUARTERS   Tennessee Mid-South Regional Medical
                                     Program
                                    I 1 00 Baker Building
                                    1 10 Twenty-first Avenue, South
                                    Nashville, Tennessee 37203
                                    (Tel. : 615/244-2960)
        GRANTEE   ORGANIZATION      Vanderbilt University
        EFFECTRVE STARTING DATE     July 1, 1966
        OF PLANNING ACTRVITI]ES

        EFFECTRVE STARTING DATE     February 1, 1968
        OF OPERATIONAL ACTRVITIES

        TOTAL FUNDING TO  DATE      $5,333,285

        FUNDING FOR CURRENT         $2,777,149
        YEARIS ACTIVITI]ES

        CHAERMAN, REGIONAL          Thomas P. Kennedy, Jr.
        ADVISORY GROUP              Post Office Box 449
                                    Nashville, Tennessee 37202
        PROGRAM COORDINATOR         *Robert M. Metcalfe (Acting)
                                    *Paul Teschan, M. D. (Effective
                                     August 1, 1969)

        STAFF                       ASSISTANT DIRECTOR FOR
                                     ADMINISTRATION
                                    William Yates (Acting)

                                    SECTION HEADS


                                      ALLI]ED HEALTH SERVICES
                                      Richard 0. Cannon, M.D.

                                      HOSPITALS
                                      Hugh Vickerstaff

                                      SOCIOLOGICAL STUDIES
                                      William A. Rushing, -Ph.D.

                                      EPIDEMIOLOGY
                                      Ruth Hagstrom, M. D.


        *Chief Executive Officer  -192-






                                                        TENNESSEE M]ID-SOUTH - II

              STAFF (Continued)                   NURSING
                                                  (Mrs.) Millie S. Sprofkin (Acting)

                                                  COMMUNITY HEALTH
                                                  Leslie A. Falk, M.D.

                                               INFORMATION OFFICER
                                               Ernest Conner
























































                                           -193-





                                                     TENNESSEE   MID-SOUTH    -    III


           APPROVED OPERATIONAL PROJECTS



           CONTINUING MEDICAL EDUCATION FOR PHYSICIANS                 MERARRY
           MEDICAL COLLEGE

           Objectives:   To provide refresher courses for practicing minority group
                         physicians in methods of diagnosing and treating  heart  dis-
                         ease, cancer  and  stroke.  To  provide  postgraduate  educa-
                         tion through the use of rnore-effective means of  audiovisual
                         education.  To develop methods to insure the phyi3ician's
                         participation in the program.


           CONTINUING EDUCATION PROGRAM - VANDERBILT UNIVERSITY
           SCHOOL OF MEDICINE

           Objectives:   To improve the opportunities of physicians in the Region
                         for continuing education and developing skills in caring  for
                         patients with heart disease, cancer, stroke &-nd related
                         diseases throughout this region.


           HOPKINSVILLE    EDUCATION    CENTER    -     JENNIE     STUART     MEMORIAL
           HOSPITAL, HOPKINSVILLE, KENTUCKY

           Objectives:  To improve and develop opportunities for continuing educa-
                         tion for physicians in Hopkinsville, Kentucky and its sur-
                         rounding communities.


           CHATTANOOGA EDUCATION CENTER - BARONESS ERLANGER
           HOSPITAL, CHATTANOOGA

           Objectives:  To improve the opportunity for physician education for
                         residents and practicing physicians in  Chattanooga  and  its
                         surrounding communities.


           SPECIAL      TRAINING      FOR      PRACTICING      RADIOLOGISTS-VANDERBILT
           UNIVERSITY SCHOOL OF MEDICINE

           Objectives:  To provide the opportunity for practicing radiologists in
                         this region to improve their knowledge and skills in the
                         newer techniques of diagnostic and therapeutic radiology.


           CARDIAC NURSE TRAINING PROGRAM - MID-STATE BAPTIST
           HOSPITAL, NASHVILLE

           Objectives:  To provide a training program for coronary care unit
                         nurses--approximately 30 nurses, three times a year.



                                           -194-






                                                        TENNESSEE MID-SOUTH - IV

               APPROVED OPERATIONAL PROJECTS (Continued)



               SCHOOL OF X-RAY TECHNOLOGY - M.EHARRY MEDICAL COLLEGE

               Objectives:  To establish a School of X-Ray Technology at Meharry
                            Medical College.


               X-RAY TECHNOLOGIST TRAINING PROGRAM - VANDERBILT
               UNIVERSITY SCHOOL OF MEDICINE

               Objectives:  To plan, implement, and evaluate an expanded radiology
                            technologist training program at Vanderbilt University
                            in cooperation with community hospitals.


               NUCLEAR MEDICINE TRAINING PROGRAM - VANDERBILT UNRVER-
               SITY SCHOOL OF MEDICINE

               Objectives:  To provide a training program in techniques of Nuclear
                            Medicine for physicians and technicians of the Region.


               EXPANSION OF SCHOOL OF MEDICAL TECHNOLOGY - ERLANGER
               HOSPITAL, CHATTANOOGA

               Objectives:  To expand the School of Medical Technology at Erlanger
                            Hospital and develop a school for certified laboratory
                            assistants.



               VANDERBILT UNIVERSITY CORONARY CARE UNIT - VANDERBILT
               UNIVERSITY SCHOOL OF MEDICINE

               Objectives:  To aid in the establishment of coronary care units distant
                            to metropolitan communities.  Vanderbilt will serve as an
                            information source and important hub in a coronary care
                            network.  Advice will be provided through direct telephone
                            communications with four other units and, indirectly,
                            through its faculty, with all participating units.


               FRANKLIN CORONARY CARE UNIT - WILLIAMSON COUNTY
               HOSPITAL

               Objectives:  To establish a two-bed acute coronary care unit in a 100-
                            bed hospital located 30 miles from a relating major medical
                            center and to evaluate its feasibility in such an environment.






                                              -195-





                                                       TENNESSEE MM-SOUTH - V
           APPROVED OPERATIONAL PROJECTS (Continued)


           HOPKINSVILLE, KENTUCKY, CORONARY CARE UNIT - JENNIE
           STUART MEMORIAL HOSPITAL
           Objectives:  To establish a four-bed coronary care unit communicating
                        with a medical school hospital and staffed with well-trained
                        nurses and informed physicians, and to establish the capa-
                        bility for providing training for nurses and continuing educa-
                        tion for physicians in Hopkinsville and surrounding smaller
                        hospitals in the management of patients with acute myo-
                        cardial infarction.


           CLAR@VILLE CORONARY CARE UNIT - CLARKSVILLE MEMORIAL
           HOSPITAL

           Objectives:  To expand facilities and improve the quality of care in
                        the acute coronary care unit at the Clarksville Memorial
                        Hospital with electronic communication to Vanderbilt
                        University.


           NASHVILLE GENERAL CORONARY CARE UNIT - NASHVILLE
           METROPOLITAN GENERAL HOSPITAL
           Objectives:  To improve the care of the indigent population of Metropoli-
                        tan Nashville by expanding and improving the facilities for
                        acute coronary care in the Nashville General Hospital and
                        to participate in the training program for nurses in coro-
                        nary care units distant to the metropolitan community.

           MEHARRY MEDICAL COLLEGE CORONARY CARE UNIT - MEHARRY
           MEDICAL COLLEGE, NASHVILLE
           Objectives:  To improve care of patients with myocardial infarction at
                        Hubbard Hospital and throughout the region through the
                        influence on training programs for medical students, house
                        officers and nurses who receive their training at Hubbard's
                        Hospital.  To develop the potential for providing the com-
                        munications and training programs necessary to aid in the
                        establishment of coronary care units in smaller community
                        hospitals in this part of the region.  (two beds)








                                          -196-





                                                           TENNESSEE    MM-SOUTH    -    VI


                APPROVED OPERATIONAL PROJECTS (Continued)



                MURRAY    CORONARY     CARE     UNIT     -     MURRAY-CALLOWAY     COUNTY
                HOSPITAL

                Objectives:   To improve patient care, to  provide  continuing  education
                              for medical and nursing staffs, to develop methods of
                              communication with other institutions and to provide a
                              broader scope of education and experience for student
                              nurses in a local school of nursing.  (two beds)


                CHATTANOOGA CORONARY CARE UNIT - BARONESS ERLANGER
                HOSPITAL

                Objectives:   To develop the necessary nurse training staff and cadre
                              of physicians concerned with acute coronary care to allow
                              this 700-bed teaching hospital to aid in the  establishment
                              of coronary care units in smaller hospitals neighboring
                              Chattanooga, Tennessee.


                BAPTIST HOSPITAL CORONARY CARE UNIT - MIID-STATE BAPTIST
                HOSPITAL,     NASHVILLE

                Objectives:   To expand the existing coronary care unit at Baptist
                              Hospital in order to meet  patient  care  demands,  provide
                              necessary personnel and facilities for the  training  program
                              for coronary care unit nurses, and aid in  the  establishment
                              of on-line communication with coronary care units at
                              Tullahoma and Crossville, Tennessee.  (four beds)


                CROSSVILLE CORONARY CARE UNIT - UPLANDS CUMBERLAND
                MEDICAL CENTER

                Objectives:   To establish a two-bed coronary care unit  in  the  110-bed
                              Uplands Cumberland Medical Center  to  serve  a  large  rural
                              population in  east-central  Tennessee.  To  determine  the
                              medical, financial and sociological feasibility of operating
                              acute coronary care units in rural areas of the  region  in
                              cooperation with a Metropolitan Medical Center that is
                              not formally affiliated with a medical school (Mid-State
                              Baptist).










                                                -197-





                                                      TENNESSEE MID-SOUTH - V.U

           APPROVED OPERATIONAL PROJECTS (Continued)



           TULLAHOMA CORONARY CARE UNIT - HARTON MEMORIAL HOSPI-
           TAL

           Objectives:  To establish a two-bed coronary care unit at the 100-bed
                         Harton Memorial Hospital in  Tullahoma  and  relate  its
                         personnel training and operation to the demonstration unit
                         at Mid-State Baptist Hospital in Nashville.


           MEHARRY SUPER-VOLTAGE THERAPY PROGRAM
           Objectives:   To improve cancer therapy for a large indigent population
                         and increase the education potential for undergraduate and
                         graduate radiology programs at Meharry Medical College.
                         (Includes assistance in acquisition of cobalt high  energy
                         source.)


           HEALTH EVALUATION STUDIES ONA DEFINED POPULATIONGROUP
           MULTI]PHASIC SCREENING CENTER AT MEHARRY MEDICAL
           COLLEGE

           Objectives:   To establish a multiphasic screening  laboratory  with  an
                         Office  of  Economic  Opportunity  sponsored   Community
                         Health Center and to evaluate its effectiveness on
                         screening and treatment of heart,  cancer,  and  stroke, on
                         a defined inner-city population group.


           PATIENT CARE MODEL - VANDERBILT UNIVERSITY HOSPITAL, ST.
           THOMAS HOSPITAL, MID-STATE BAPTIST HOSPITAL, NASHVILLE
           Objectives:   To test, refine and implement a model designed to improve
                         the efficiency and the quality of patient care.  Nurses will
                         perform only clinical tasks, and administrative functions
                         will be handled by persons called stewardesses.  Patient
                         units will consist of approximately 5 clinical units, 25
                         patients, 5 nurses, 5 stewardesses, and physicians.
                         Trained nurse specialists must be among the nurse group
                         to counsel other nurses. The underlying concept  is  of  a
                         cohesive group which will have the capability for maximum
                         effectiveness in patient care.










                                           -198-






                                                             TENNESSEE MU)-SOUTH - VIIII

                APPROVED OPERATIONAL PROJECTS (Continued)



                A MEDICAL-SURGICAL NURSE SPECIALIST GRADUATE EDUCATION
                PROGRAM TO IMPROVE NURSING CARE OF PATIENTS WITH HEART
                DISEASE, CANCER AND STROKE - VANDERBILT

                Objectives:  The purpose of this project is to develop medical-surgical
                               nurse specialists in order to improve the nursing care of
                               heart, cancer, and stroke patients.


                CORE PROGRAM

                Objectives:  To support administrative and planning function.


                CONTINUING EDUCATION PROGRAM IN INTENSIVE CARE NURSING
                FOR REGISTERED NURSES AND TECHNICIANS - EAST TENNESSEE*

                Objectives:    To provide formal education and clinical experience for
                               nursing service personnel of patients with cancer, heart
                               disease, stroke and related diseases requiring maximum
                               or intensive nursing care; and to prepare nursing personnel
                               to staff Intensive Care Units in community hospitals.


                CARDIAC     SCREENING     OF     SCHOOL     CHILDREN     -     SOUTHEASTERN
                TENNESSEE*

                Objectives,.   Proposes  that  the  Chattanooga  Area   Heart   Association
                               study the effectiveness of a program for the mass
                               screening of school children, many from underprivileged
                               rural communities, for heart defects by use of the @hono-
                               Cardio-Scan, an electronic screening instrument.


                A DEMONSTRATION PROJECT IN SPEECH THERAPY AT A
                COMMUNITY HOSPITAL*

                Objectives:    Nashville Memorial Hospital proposes a pilot feasibility
                               project: (1) to primarily demonstrate the financial%
                               and functional practicality of providing a speech rehabili-
                               tation center for aphasics and laryngectomees in a
                               community  hospital;  (2)  to  provide  this   comprehensive
                               rehabilitation center in a  side  area  of  Nashville  which
                               presently does not have close access to both speech and
                               physical therapy at one location; (3) to provide a source
                               of training and education through observation and partici-
                               pation for students and nurses.




                *Approved but not funded            -199-





                                                     TENNESSEE MID-S<)UTH - I:K

          APPROVED OPERATIONAL P-ROJECTS (Contin@)



          HEALTH COMMUNICATION SYSTEM - SOUTHWESTERN KENT-UCIKY
          AREA*

          Objectives:  Four community hospitals will establish an inter-
                       institutional communication system with Jennie Stuart
                       Memorial Hospital in Hopkinsville -as the area hospital
                       center, and with Vanderbilt Uiaiversity Medical School as
                       the Regional center.










































          *Approved but not funded       -zoo-






                                                                TEXAS - I


            NAME OF REGION                Texas Regional Medical Program

            GEOGRAPHICAL REGION           State of Texas

            ESTIMATED POPULATION          Regional Medical Program of Texas
                                          Post Office Box Q, University Station
                                          2608 Whitis
                                          Austin, Texas 7871@Z
                                                 -1 2/471-181 1)'
                                          (Tel  5

            GRANTEE ORGANIZATION          The University of Texas System

            EFFECTIVE STARTING DATE       July 1, 1966
            OF PLANNING ACTRVITIES

            EFFECTIVE STARTING DATE       July 1, 1968
            OF OPERATIONAL ACTIVITIES

            TOTAL FUNDING TO DATE         $3, 928, 194

            FUNDING FOR CURRENT           VI, 943, 569
            YEARIS ACTRVITIES

            CHAIRMAN, REGIONAL            Nicholas C. Hightower, M.D.
            ADVISOR'Y GROUP               Scott and White Clinic
                                          Temple, Texas 76501

            PROGRAM COORD@,T4)R           *Charles B. McCall, -M.D.

            STAFF                         ASSOCIATE COORDMTOR
                                          Stanley Burnham, Ed. D.

                                          DIRECTOR OF HEALTH CARE
                                          DEMONSTRATIONS
                                          Jimmie C. Hocker


                                          DERECTOR OF ADMINISTRATIVE
                                          SERVICES
                                          (Mrs. Louise Miller














            *Chief Executive'Officer   -201-






                                                                               TEXAS  -  II

           APPROVED OPERATIONAL PROJECTS




           MEDICAL GENETICS

           Objectives:   This is a project to increase understanding by general
                         practitioners of the important role that genetic factors
                         may play in certain cancers and the relation of applying
                         genetic knowledge of early cancer detection.  Lectures,
                         presentations of exhibits at county medical societies,
                         referrals of patients to the M. D. Anderson Genetic Clinic,
                         and field consultation and examination trips by medical
                         genetics  teams  to  community  locales  are  procedures  planned.
                         The M.D. Anderson Hospital has been providing limited service
                         in this area. Funds are requested  for  adding  a  medical  social
                         worker to the team, secretarial service,  travel  (12  team  field
                         visits a year) and exhibits.


           ESTABLISHMENT OF AN EAST TEXAS HOSPITAL TEACHING CHAIN
           Objectives:   The Division of Continuing Education of the  University  of  Texas
                         Graduate School of Biomedical  Sciences  proposes  to  assist  the
                         staffs of seven Catholic hospitals in the East Texas area in
                         strengthening their medical educational  programs  in  heart  dis-
                         ease, cancer, stroke, etc.  Four  two-hour  teaching  sessions  in
                         cancer and cardiology will be held annually in each hospital.
                         Teams of two physicians from each hospital  will  be  provided  an
                         opportunity twice a year to visit Houston  and  observe  the  man-
                         agement of referred patients or specific  institutional  programs,
                         or receive special tutoring in some phase of patient manage-
                         ment. Two annual  two-day  courses,  one  on  cancer  and  one  on
                         cardiology w4l be held at the St.  Joseph's  Hospital  in  Houston
                         for physicians in practice.  The  Division  of  Continuing  Educa-
                         tion will coordinate the training sessions  and  develop  suitable
                         educational materials.


           HELPING HOSPITALS ORGANIZE AND STRENGTHEN INHALATION
           THERAPY PATIENT CARE PROGRAMS

           Objectives:   To develop or improve inhalation therapy programs in communi-
                         ty hospitals for the care of patients with cardiorespiratory  dis-
                         eases, Four 2-day inhalation therapy institutes will  be  held  in
                         different geographic areas,  to  acquaint  approximately  200  ad-
                         ministrators, nursing directors and potential  inhalation  therapy
                         employees with the principles, organization  and  clinical  appli-
                         cation of an organized inhalation therapy  program.  Then  a  con-
                         centrated 1 -month clinical experience will be  provided  for  two
                         employees selected by each of the hospitals in that particular
                         area, interested and able to develop  a  program.  Forty  students
                         will receive the 1-month training, ten per session.  Three
                         months after the clinical experience, visits will be made  to  the
                         hospitals to plan any follow-up education and training that is
                         indicated.
                                              -202-






                                                                            TEXAS - III

              APPROVED OPERATIONAL PROJECTS (Continued)



              REGIONAL CONSULTATION IN RADIOTHERAPY

              Objectives:   To raise the level of radiotherapeutic treatment in Texas by
                            strengthening the consultation ties between practical radiolo-
                            gists and M. D. Anderson Hospital radiation therapists and by
                            making available Anderson' s highly specialized equipment and
                            gamma ray sources to selected closely affiliated hospitals;
                            and to advance knowledge of the most efficient and progres-
                            sive treatments for cancer sites, through development of
                            uniform treatment data and pooling of data from cancer pa-
                            tients throughout Texas.


              REGIONAL PROFESSIONAL CONSULTATION SERVICE IN MEDICAL
              PHYSICS


              Objectives:   Aims to improve the quality of medical physics in Texas
                            which is required for quality radiotherapy.  The program
                            consists of two phases: (1) the extension of full services
                            and responsibility by M. D. Anderson to the Houston hospitals
                            aff iliated for clinical service will be accomplished by station-
                            ing physicists at the collaborating institutions and central-
                            izing computing by graphical transmission of data via tele-
                            phone lines; (4) providing consultation in physics at com-
                            munity hospitals and physicians' offices relating to radio-
                            therapy, nuclear medicine and diagnostic radiology together
                            with a system for mailing radiation dosimeter readings for
                            verifying machine output.  It is planned to organize a Texas
                            Regional Medical Physics Unit.


              SURVEY OF CANCER INCIDENCE AND RESOURCES IN TEXAS

              Objectives:   Will continue a planning survey in which every known case
                            of cancer in rexas from 1944 to 1966 will be abstracted by
                            name and address of patient, name of physician will be
                            checked for fact and date of death, and will be taped for com-
                            puter handling, and for figuring trends, adjusted incidence
                            and survival rates, by site, by region and by three ethnic
                            groups.  A mechanism will be established for notifying, with
                            minimal delay, each physician of developments in the re-
                            searchandclinicallaboratorieswiththenames andaddresses
                            of his living patients who might be benefitted. . Hospitals,
                            clinics, laboratories, dermatologists' offices and group
                            practices are surveyed for the basic data.  To date, three
                            of the 21 Hill Burton Hospital regions in Texas have been
                            completed, surveyed and two are partially completed.





                                               -203-





                                                                           TEXAS  -  IV

           APPROVED OPERATIONAL PROJECTS (Continued)



           STATIE-WEDE CANCER REGISTRY SYSTEM

           Objectives:   A central repository and origin of'dissemination  for  a  pre-
                         determined    amount''and type  of  cancer  patient  information
                         is to be established at the School of Public Health, which  is
                         being developedinhoustonas part  of  the  Universityof  Texas.
                         Registry systems already operative  in  the  Texas  State  De-
                         partment of Health, the M.  D.  Anderson  Hospital  and  other
                         smaller units will be channeled into the  central  respository
                         system.        Additionalhospitalsandotherhealthdatacollection
                         stations will be encouraged to participate on  a  voluntary
                         basis.  Forty-six cancer registries now exist in Texas.


           STROKE    DEMONSTRATION    UNIT    FOR     PROGRESSIVE     PATIENT     CARE*

           Objectives:   To establish and staff an intensive stroke demonstration unit
                         at Presbyterian Hospital, Dallas,  under  the  supervision  of
                         the University  of  Texas  Southwestern  Medical  School,  has
                         been funded under an  earmarked  supplement  to  the  planning
                         grant. The unit will serve the  metropolitan  area  of  Dallas
                         and  Tarrent  Counties,  Hillsboro  and  Kilgore.  Specialized
                         training programs will be  developed  and  new  methods  of
                         communication with the practicing physicians will be explored.


           AREA-WME TOTAL RESPIRATORY CARE

           Objectives:   This is a project under direction of Baylor  University  to
                         render total respiratory care in an area of 12 counties,  uti-
                         lizing the organizational structure of the San Jacinto Tuber-
                         culosis and Respiratory Disease  Association  and  a  State
                         Health  Department  Region.  Public  and  professional  educa-
                         tion, area-wide screening  for  tuberculosis  and  respiratory
                         network of respiratory care facilities are parts  of  the  ap-
                         proach to total  care.  Model  programs  of  respiratory  care
                         will be assisted to serve as teaching  and  training  centers.
                         The first center to be assisted will be  the  Jefferson  Davis
                         Hospital which serves an urban indigent  population  basis  in
                         Houston. The VA  Hospital  and  the  Methodist  Hospital  will
                         also be utilized to provide a broad base for education, train-
                         ing, and patient care.








           *Approved but not funded         -.204-






                                                                                  TEXAS  -   V

                APPROVED OPERATIONAL PROJECTS (Continued)



                REGIONAL REHABILITATION PROGRAM - PART A: BAYLOR
                UNIVERSITY

                Objectives:   Baylor  has  selected  the  community  of  Wharton,  which   has
                              two hospitals, the  Caney  Valley  Memorial  Hospital,  and  the
                              Gulf Coast  Medical  Center,  which  need  rehabilitation  serv-
                              ices for their patients.   This project will  develop  a  shared
                              core rehabilitation staff for both hospitals  and  a  program
                              for home health care.



                REGIONAL    REHABILITATION    PROGRAM    -    PART    B:     UNIVERSITY     OF
                TEXAS MEDICAL SCHOOL AT SAN ANTONIO

                Objectives:   The San Antonio Medical School will work in the New
                              Braunfels  Community  which  has  a  new  rehabilitation  center
                              under construction adjacent to  a  home  for  the  aged.  The
                              Schoolwillprovideprofessionalguidanceinthe         initiationand
                              development of  a  rehabilitation  program  for  the  community.


                REGIONAL    REHABILITATION    PROGRAM    -    PART    C:     UNIVERSITY     OF
                TEXAS SCHOOL OF MEDICINE AT DALLAS

                Objectives:   The Dallas School of  Medicine  will  assist  the  community  of
                              Kilgore which  has  an  on-going  East  Texas  Rehabilitation
                              Center  interested  in  refining  and  improving  rehabilitation
                              techniques. An addition, the  School  of  Medicine  will  assist
                              the Caruth Rehabilitation Center  in  Dallas  in  training  home
                              rehabilitation aides and in establishing  a  program  to  assess
                              and evaluate the potential and capacity of  the  stroke  patient
                              for vocational endeavor.



                CARDIAC WORK EVALUATION FOR REHABILITATION

                Objectives:   As another  phase  in  the  development  of  a  comprehensive
                              rehabilitation  program  in  Texas,  an  existing  cardiac  work
                              evaluation unit supported  by  the  Heart  Association  will  be
                              moved  to  the  Baylor  University  College  of  Medicine.   The
                              professional staff will  be  expanded  to  serve  more  patients
                              from the Houston area and  to  provide  training  to  medical
                              students, physicians, social workers, vocational counselors
                              and rehabilitation teams from other hospitals.  The unit will
                              also send its team  to  Wharton,  Texas  to  serve  patients  in
                              that area. The mobile unit experience  will  be  utilized  to
                              establish a prototype for other  institutions  collaborating  in
                              the Texas rehabilitation program.




                                                   -ZO5-





                                                                          TEXAS   -    VI

           APPROVED OPERATIONAL PROJIECTS (Continued)




           ERADICATION OF CERVICAL CANCER IN SOUTH TEXAS

           Objectives:   To  extend  and  improve  a  mass  cytologic  screening  program
                         developed  inbexar  Countyto  other  areas  aroundsan   Antonio;
                         to develop a school of cytotechnology and  support  training  of
                         cytotechnologists; to provide training in  exfoliative  cytology
                         for pathologists and colposcopy  training,for  gynecologists;
                         to expand the central screening laboratory and reference
                         laboratory to the Bexar County Hospital  District;  and  to  de-
                         sign an information system  for  automatic  data  processing.
                         A screening  program  for  indigent  women  has  been  supported
                         by a  PHS  community  cancer  demonstration  grant  since  196Z.
                         Information is being gathered  regarding  nature  and  level  of
                         present support. The goal is to include 7001o of  the  women  in
                         a routine screening system and  eventually  to  create  a  self-
                         supporting, self-perpetuating detection -,and follow-up system.


           CORE    STAFF    FOR    COORDINATION    OF    PLANNING    OPERATIONS    AND
           FISCAL MANAGEMENT

           Objectives:   The core staff of  the  Texas  RMP  will  be  greatly  augmented
                         in line with  RAG  recommendations.  In  addition  to  the  pro-
                         gram coordinator, positions are requested to coordinate
                         public relations, evaluation,  manpower  training,  health  data
                         systems and hospital liaison.


           PLANNING FOR SOUTHWEST TEXAS AREA

           Objectives:   To continue a third year of planning  RMP  activities  in  South
                         Texas, with headquarters at the New University of Texas
                         Medical Ichool at San Antonio.  This  group  is  utilizing  con-
                         sultants and faculty from  College  of  Business  Administration
                         at Austin in developing a systematic  approach  to  planning.
                         PPBS  (Planned  Programming  Budgeting   System)   has   been
                         utilized to develop the Rehabilitation Part B proposal  and  the
                         Cervical Cancer proposal.














                                             -zo6-






                                                 TEXAS VII


          APPROVED OPERATIONAL PROJECTS (Continued)




          PLANNING FOR DALLAS AREA

          Objectives: The University of Texas Southwestern Medical School at
                  Dallas is headquarters for planning in this -area of Texas.
                  Plaianing to-date has involved studies of health manpower,
                  hospital facilities, a stroke demonstration and regional re-
                  habUitation services, and public and professional informa-
                  tion., The Stroke Demonstration Unit For Progressive
                  Patient Care, funded under the earmarked category, and
                  Part C of the Regional Rehabilitation Program, have been
                  developed out of this planning office.


          PLANNING FOR GALVESTON AREA

          Objectives: The University of Texas Medical Branch at Galveston is the
                  headquarters for planning in that areai To date this group
                  has been instrumental in coordinating the development basic
                  degree curricula within a School of Allied Health Sciences,
                  which is nearing final approval status,'and in planning the
                  establishment of a coronary care demonstration unit and a
                  stroke demonstration unit.



          PLANNING DENTAL ACTIVITIES IN TEXAS REGIONAL MEDICAL
          PROGRAM

          Objectives: Planning to date has centered on building cooperative ar-
                  rangements among the various dental educational and pa-
                  tient care institutions, expending maxi-Ilo facial prosthetic
                  service within the Region, and developing an effective com-
                  munication modality for dentists, particularly those prac-
                  ticing in isolated areas.


          PLANNING - THE UNIVERSITY OF TEXAS GRADUATE SCHOOL OF
          BIOMEDICAL SCIENCES AT HOUSTON DIVISION OF CONTINUING
          EDUCATION

          Objectives: This group has been coordinating planning for the regiona-
                  lization of a broadbased, multimedia communications system
                  for Texas to provide all program units with assistance in
                  consultation, production and distribution. The establish-
                  ment of an East Texas Hospital Teaching Chain is an
                  operational proposal developed by this group.







                               -207-






                                                                     TEXAS - VIII

           APPROVED OPERATIONAL PROJECTS (Continued)



           PLANNING OF REGIONAL CANCER PROGRAM

           Objectives:  The University of Texas IvL D. Anderson Hospital and Tumor
                        Institute at Houston is the headquarters for this planning
                        effort.  Several of the activities formerly included in plan-
                        ning are now operational projects.  Additional planning is
                        .needed during this transition stage and funds requested are
                        primarily to support a planning coordinator and secretar-
                        ial support.

           PLANNING FOR A SCIENCE FIELD STATION

           Objectives:  The University of Texas M. D. Anderson Hospital and
                        Tumor Institute is headquarters for planning the Buescher
                        Science Park, a Z, 000 acre plot of land in central Texas
                        which will be developed for a number of educational, rec-
                        reational, and experimental projects.  Funds are requested
                        for architectural and advisory consultation to develop a
                        master plan for development of meeting facilities, field re-
                        search areas, and animal breeding and raising facilities.
                        Planning funds have been requested for this study.


           PLANNING     13-AYLOR UNIVERSITY COLLEGE OF MEDICINE

           Objectives:  This is a request for continued support of planning activi-
                        ties centered at Baylor University related to (1) feasibility
                        study of the establishment of television and data communi-
                        cations systems between perimeter hospitals and Texas
                        Medical Center,  (2) postgraduate medical education,  (3)
                        extension of regional rehabilitation program,  (4) develop-
                        ment of a model neighborhood health center in Houston.
                        Planning to date has resulted in the operational proposal
                        for Area-Wide Total Respiratory Care, Part A of the
                        Regional Rehabilitation Program, and the operational pro-
                        posal for Cardiac Work Evaluation For Rehabilitation.


















                                          -208-





                                                                              TEXAS   -   IX

               APPROVED OPERATIONAL PROJECTS (Continued)



               PLANNING FOR ALLIED HEALTH TRAINING

               Objectives: . The Methodist Hospital has been headquarters for planning
                             allied health training activities, involving  Baylor  Universi-
                             ty, South Texas Junior College and  21  hospitals  and  organi-
                             zations.  The operational proposal for Inhalation Therapy
                             Training is an outgrowth of planning by this group.  In
                             addition, assistance has been provided to develop curricula,
                             clinical affiliation and faculty for the Division of Allied
                             Health Science at South Texas JuniorCollege.  Other plan-
                             ning activities have been focused on continuing education
                             needs and resources and cardiovascular and neurological
                             nurse specialist training.


               DISSEMINATION OF CANCER LITERATURE*

               Objectives:   Would expand and extend to all accredited hospitals in the
                             region, a weekly bibliography of articles on Neoplasia
                             culled from journals received in the M. D. Anderson
                             Library the previous  week.  The  service  is  now  distributed
                             to the Hospital staff and to any physician or library request-
                             ing it.  Full texts of any report cited in the bibliography will
                             be mailed within 24 hours after the request is received.


               COMMUNICATION STUDY*

               Objectives:   Request for two-year funds to continue a communication
                             study by  the  Department  of  Medical  Communications,  M.  D.
                             Anderson Hospital, which began  in  April  1967  with  planning
                             grant funds: microwave communications between the Ander-
                             son Hospital and the Medical Branch in Galveston, and radio-
                             therapy consultation through TV are operational proposals
                             growing out of the study thus far.













               *Approved but not funded         -209-





                                                      TRI-STATE - I

        NAME OF PROGRAM             Tri-State Regional Medical Program

        GEOGRAPHICAL REGION         States of Massachusetts, New Hampshire
                                     and Rhode Island

        ESTIMATED POPULATION        7, 085, 000

        COORDM&TING HEADQUARTERS    Tri-State Regional Medical Program
                                    Medical Care and Education Foundation,
                                    Inc.
                                    Two Center Plaza, Room 400
                                    Boston, Massachusetts 02108
                                    (Tel. : 617/742-7280)

        GRANTEE ORGANIZATION        Medical Care and Education Foundation,
                                     Inc.

        EFFECTRVE STARTING DATE     December 1, 1967
        OF PLANNING ACTIVITIES

        EFFECTIVE STARTING DATE     February 1, 1969
        OF OPERATIONAL ACTIVITIES

        TOTAL FUNDING TO DATE       $2,410,686

        FUNDING FOR CURRENT         $1,386,781
        YEARIS ACTRVITIES

        CHAIRMAN, REGIONAL          William B. Reid
        ADVISORY GROUP              Executive Director
                                    New Hampshire Heart Association
                                    54 South State Street
                                    Concord, New Hampshire 03301

        PROGRAM COORDINATOR         *Leona Baumgartner, M. D.

        STAFF                       ASSOCIATE DIRECTORS

                                      FOR ADMINISTRATION
                                      Alfred F. Popoli

                                      FOR DATA  COLLECTION
                                      C5sler Peterson, M. D.

                                    ASSISTANT DIRECTORS

                                      FOR DATA  COLLECTION
                                      Benedict J. Duffy, Jr., M.D.
                                      John Pearson, M.D.

                                      FOR COMMUNICATIONS
                                      Greer Williams



        *Chief Exec-utive Officer -210-





                                                       TRI-STATE - III

          STAFF (Continued)           ASSISTANT TO EXECUTRVE DIRECTOR
                                      Adam Yarmolinsky

                                      STATE COORDINATORS


                                        MASSACHUSETTS
                                        Rolf Lium, M.D.

                                        NEW  HAMPSHIRE
                                        Cornelia Walker, M. D.
                                        15 Pleasant Street
                                        Concord, New Hampshire 03301

                                        RHODEISLAND
                                        Henry S. M. Uhl, M.D.
                                        Brown University Program of Medical
                                        Science
                                        Providence, Rhode Island 02912

                                      UNRVERSITY COORDINATORS


                                        BROWN UNIVERSITY PROGRAM OF
                                        MEDICAL SCIENCE
                                        Henry S. M. Uhl, M.D.

                                        BOSTON UNIVERSITY
                                        SCHOOL OF MEDICINE
                                        Thomas R. Dawber, K D.

                                        DARTMOUTH MEDICAL SCHOOL
                                        Dean Seibert, M.D.

                                        TUFTS UNIVERSITY SCHOOL OF
                                        MEDICINE
                                        John M. Tyler, K D.

                                      COORDINATOR FOR EVALUATIONS
                                      Harold W. Keairnes, M. D.

                                      SPECIAL PROJECTS COORDINATOR
                                      (Miss) Claire Farrisey

                                      COMMUNICATIONS AND CONFERENCE
                                      SECRETARY
                                      (Miss) Catherine Toll





                                                                         TRI-STATE - III

           APPROVED OPERATIONAL PROJECTS




           PROGRAM OF CONTINUING EDUCATION FOR QUALI]FIED PHYSICAL
           THERAPISTS*

           Objectives:  To provide an opportunity for  graduate  physical  therapists  to
                        increase their knowledge and understanding of the more recent
                        advances in their specialty in the treatment  of  heart  disease,
                        cancer,  stroke  and  related  diseases.  The  Boston  University
                        Sargent College of Allied Health Professions and Boston-Bouve
                        College of Northeastern University propose a two year coopera-
                        tion program.  Simmons College (no funds requested) will par-
                        ticipate in the operational phase  of  the  proposed  courses.  A
                        series of evening and  summer  courses  is  planned  both  within
                        and outside the Greater Boston area.



           EXPANSION    AND    CONSOLIDATION    OF    CORONARY    CARE    TRAINING    FOR
           THE NORTHERN PORTION OF THE TRI-STATE REGION TO PROVIDE
           STATE-WIDE SERVICE

           Objectives:  To expand the Coronary Care Training Unit at the Mary
                        Hitchcock  Hospital,  Hanover,  New  Hampshire,  to   help   meet
                        the unmet need for the training of personnel, to provide leader-
                        ship and guidance to other local  programs  and  to  explore  new
                        methods of training at the community level.


           ESTABLISHMENT     OF     A     COMPREHENSIVE     INTER-UNIVERSITY      CARDIO-
           VASCULAR   PROGRAM   IN   THE   DEPARTMENT    OF    HEALTH    AND    HOSPITALS
           IN THE CITY OF BOSTON

           Objectives:  To establish a clinical-cardiovascular program to provide com-
                        prehensive in- and out-patient care for  indigent  patients  with
                        heart disease in the primary service area,  to  make  this  level
                        of care available to patients referred by physicians throughout
                        the Region, and to insure continuity of medical care and follow-
                        up in Boston City Hospital.


           COMPREHENSIVE REGIONAL MEDICAL PROGRAM IN CANCER

           Objectives:  Proposed by  Boston  University  Medical  Center,  project  envi-
                        sion,s two goals in its operational approach:  (1)  Resources  of
                        the Boston University Medical College and  7  hospitals  will  be
                        utilized to create a teaching, training and  patient  care  atmo-
                        sphere; (2) Provision of a geographically distinct and  identifi-
                        able cancer unit at the University Hospital.




           *Approved but not funded           -212-





                                                          VIRGINIA - I

           NAME OF PROGRAM             Virginia Regional Medical Program

           GEOGRAPHICAL REGION         State of Virginia

           ESTIMATED POPULATION        4, 595, 000

           COORDINATING HEADQUARTERS   Virginia Regional Medical Program
                                       700 Building - Suite 1025
                                       700 East Main Street
                                       Richmond, Virginia 23219
                                       (Tel. : 703/644-1907)

           GRANTEE ORGANIZATION        Medical College of Virginia, Health
                                       Sciences Division, Virginia Common-
                                       wealth University

           EFFECTIVE STARTING DATE     January 1, 1967
           OF PLANNING ACTIVITI]ES


           TOTAL FUNDING TO DATE       $1,052,400

           FUNDING FOR CURRENT         $506,946
           YEARIS ACTRVITIES

           CHAIRMAN, REGIONAL          A&ck 1. Shanholtz, M.D.
           ADVISORY GROUP              State Commissioner of Health
                                       State Department of Health
                                       James Madison Building
                                       Richmond, Virginia 23219

           PROGRAM COORDINATOR         *Eugene R. Perez, M.D.

           STAFF                       DEPUTY DIRECTOR
                                       David K Pechmann


                                       COMMUNICATIONS AND PUBLIC
                                       INFORMATION OFFICER
                                       (Mrs.) Ann S. Cann

                                       NURSE OFFICER
                                       (Mrs.) Faye @ Peters, R.N.

                                       PROJECTS DEVELOPMENT OFFICER
                                       Clark 0. Martin


                                       ALLIED HEALTH OFFICER
                                       (Miss) Mary E. Campbell

                                       SURVEY OFFICER
                                       (Mrs.) @rga.ret,W. Proctor




           *Chief Executive Officer -Zl3-

             3N-998 0-69-14





                                                                      VIRGINIA - II
          STAFF (Continued)                   COMMUNITY LIAISON OFFICERS
                                              Frederick @ Beamer, Jr.
                                              (Mrs.) Wilma W. Schmidt

                                              HEART DIVISION OFFICER
                                              Thomas S. Edwards, M.D.

                                              CANCER DIVISION OFFICER
                                              Carrington Williams,  r., M. D.

                                              STROKIE DIVISION OFFICER
                                              David W. Scott, Jr.    D.

                                              MEDICAL SCHOOL REPRESENTATRVES

                                                MEDICAL COLLEGE OF VIRGINIA$,
                                                RICHMO@D
                                                M. PinsoiFNeal, Jr., M. D.

                                                UNIVERSITY OF VIRGINIA,
                                                CHARLOTTESVIL,LE
                                                William B. Hunt, Jr., M.D.




































                                          -214-





                                                WASHINGTON - ALASKA - I

           NAME OF PROGRAM               Washington-Alaska Regional Medical
                                         Program

           GEOGRAPHICAL REGION           States of Washington and Alaska

           EST@TED POPULATION            3,552,000

           COORDMTING HEADQUARTERS       Washington/Alaska Regional Medical
                                         Program
                                         500 "Ull District Building
                                         1107 Northeast Forty-fifth Street
                                         Seattle, Washington 98105
                                         (Tel. : 206/543-8540)

           GRANTEE ORGANIZATION          University of Washington

           EFFECTIVE STARTING DATE       September 1, 1966
           OF PLANNING ACTRVITIES

           EFFECTRVE STARTING DATE       February 1, 1968
           OF OPERATIONAL ACTIVITIES

           TOTAL FUNDING TO DATE         $2,864,516

           FUNDING FOR CURRENT           $1,449,938
           YEARIS ACTIVITEES

           CHA'ERMAN, REGIONAL           Donal R. Sparkman, M.D.
           ADVISORY GROUP

           PROGRAM COORDMTOR             *Donal R. Sparkman, M. D.

           STAFF                         ASSOCIATE  DIRECTORS


                                           CONTINUING EDUCATION
                                           Robert C. Davidson, M. D.

                                           PROGRAM PLANNING AND
                                           DEVELOPMENT
                                           Tasker & Robinette

                                           PROGRAM ADMINISTRATION AND
                                           SUPPORT
                                           William R. Thompson

                                         ASSISTANT  DIRECTORS


                                           FINANCE
                                           Lee D. Carey

                                           DATA AND INFORMATION
                                           Edward Freedman



           *Chie Executive Officer    -215-





                                           WASHINGTON - ALASKA - II

       STAFF (Continued)             EVALUATION
                                     Richard A. Gilberts, Ed. D.


                                     CONTINUING  EDUCATION


                                         Production and Wormation
                                         Marion H. Johnson

                                         Distribution and Fipld Coordina-
                                         tion
                                         Richard R. Reimer


                                     RESEARCH AND DEVELOPMENT
                                     Lawrence J. Sharp, Ph. D.

                                     CONTINUING NURSING EDUCATION
                                     Louise Shores, R. N.

                                   PLANNING OFFICERS


                                     HEART
                                     Stephen R. Yarnall, M. D.

                                     CANCER AND STROKE
                                     Ann Carter, K D.

                                   AREA COORDINATORS


                                     EASTERN WASHINGTON
                                     Larry Belmont
                                     1130 Old National Bank Building
                                     West 422 Riverside Avenue
                                     Spokane, Washington 99201
                                     (Tel. : 509/TE8-8553)

                                     SOUTHEASTERN   ALASKA
                                     Jack & Lesh, M.D.
                                     Gustavius, Alaska 99826

                                     CENTRAL-SOUTHCENTRAL
                                     ALASKA
                                     *John Aase, M.D.
                                      Room 200
                                      519 Eighth Avenue
                                      Anchorage, Alaska 99501
                                      (Tel. : 907/277-6891)








       *Effective September 1, 1969 -zl6-





                                                           WASHINGTON-ALASKA - III


              APPROVED OPERATIONAL PROJECTS




              CENTRAL WASHINGTON

              Objectives:   To improve  communication  between  the  Seattle  academic
                            complex and Yakima and  from  Yakima  to  its  surrounding
                            communities; to promote an exchange of teachers and prac-
                            titioners; to provide audio-visual instruction from  Seattle;
                            to connect internists in Central Washington to Yakima
                            cardiologists via EKG telephone hot-line.


              SOUTHEASTERN ALASKA PROJECT

              Objectives:   To improve  communication  between  the  Seattle  academic
                            complex and Southeastern Alaska, particularly with respect
                            to consultations and postgraduate education and  training  of
                            medical and paramedical personnel.  Radio, telephone,
                            television, individual cartridge-load film viewers, visits to
                            Seattle, etc.


              POSTGRADUATE PRECEPTORSHIPS FOR PHYSICIANS

              Objectives: To provide the opportunity for  practicing  physicians  to  re-
                            turn to major medical centers for one week periods or more
                            of continuing education.


              TWO-WAY RADIO CONFERENCE WITH SLIDE PRESENTATION (Rad-
              Tel-Con)

              Objectives:   To prepare and broadcast via two-way radio-telephone slide
                            conferences pilot programs of heart, cancer and stroke
                            topics with a two-way discussion to as many physicians and
                            hospital staffs in the Pacific Northwest as is  feasible.  To
                            determine subjective and objective  evidence  of  consumer
                            reaction.  To explore potential for continuing network series
                            with local and remote origins.


              INFORMATION AND EDUCATION RESOURCE SUPPORT UNIT

              Objectives:   To ive medical  communities  skilled  assistance  which  will
                               9
                            help them identify their educational needs and  develop  pro-
                            grams to meet them; to establish a  central  production  unit
                            .for audio-visual materials, and printed information for
                            WARMP projects; to create  a  distribution  system  for  this
                            information which can penetrate the vast reaches of the
                            Region.  Radio, television, telephone, videotape, films, art-
                            work, advisory committees, etc. will be used.



                                               -217-





                                                       WA.SKINGTON-ALASKA        IV

            APPROVED OPERATION&L PROJECTS (Conti"ed)



            CORONARY CARE UNIT COORDINATION

            Objectives:  To coordinate a number of CCU-related projects, and to
                         initiate cooperative projects directed at improving CCU
                         operations and training programs.  Particular attention is
                         given in the first year to development of 'Irnockup" coro-
                         nary care unit to be used in nurse and physician educational
                         programs. Audio-visual self-instruction materials will be
                         produced and evaluated.


            CONTINUING EDUCATION AND ON THE JOB TRAINING OF LABORA-
            TORY PERSONNEL

            Objectives:  To establish a training, supervision and continuing educa-
                         tion program for medical, laboratory technicians.


            CARDIO-PULMONARY TECHNICIAN TRAINING PROGRAM - SPOKANE
            COMMUNITY COLLEGE

            Objectives:  To develop a formal educational program to train cardio-
                         pulmonary technicians.


            ALASKA MEDICAL LIBRARY

            Objectives:  To develop a community medical library at the Alaska Na-
                         tive Medical Center, Anchorage, Alaska.


            ANCHORAGE CANCER PROGRAM

            Objectives:  To improve the treatment of cancer in Alaska by providing
                         a super-voltage radiation therapy unit.  Accumulating data,
                         clinical conferences, and stimulating interest in establish-
                         ing cancer registries will be included.


            PATTERNS OF HEALTH CARE OF CHILDREN WITH CANCER
            Objectives:  To carry out a detailed study of cases of childhood cancer
                         in Washington and Alaska.  Data will be collected via
                         physician interviews of physicians and recorded on IBM
                         cards for analysis.







                                          -218-





                                                               WASHINGTON-ALASKA - V

                APPROVED OPERATIONAL PROJECTS (Continued)



                RADIATION PHYSICIST CONSULTANT TO RADIOLOGISTS IN THE
                WASHINGTON-ALASKA REGION
                Objectives:  To provide a radiation physicist consultant whose ability will
                              improve the use of existing facilities and will enhance post-
                              graduate education for radiology residents and paramedical
                              trainees outside the university system.


                COMPUTER-AIDED INSTRUCTION IN HEART DISEASE, CANCER,
                STROEE AND RELATED DISEASES(CAI)
                Objectives:   To develop and evaluate CAI as a complementary and supple-
                              mentary method of education of physicians, nurses and
                              allied health personnel.  To acquaint physicians, nurses
                              and others with the use of computer terminals with inter-
                              action between the user and the computer.


                CYSTIC FIBROSIS: EARLY DETECTION AND IMPROVED PATIENT
                CARE

                Objectives:   A one-year feasibility study in a new method of detection
                              of patients with cystic fibrosis.  It is based at the Children's
                              Orthopedic Hospital and Medical Center in Seattle.  The
                              objective is to study the feasibility of mass screening for
                              cystic fibrosis using neutron activation of toenails.  The
                              center has experimented with this technique of bombarding
                              toenails with neutrons, and feel that they are able to detect
                              the electrolyte abnormalities in the toenails peculiar to
                              cystic fibrosis.


                LABORATORY EVALUATION OF RENAL AND ADRENAL HYPER-
                TENSION*

                Obj ectives:  This proposal would offer a new laboratory test for renin
                              and aldosterone in the region that previously has been
                              difficult to obtain.  The tests would be made available on a
                              region-wide basis and evaluated by a hypertension study
                              group which also advises the Regional Medical Program
                              concerning this disease process.  The physicians in the
                              region will receive periodic information about the labora-
                              tory diagnosis of hypertension as well as the latest informa-
                              tion about other aspects of renal and adrenal hypertension.






                *Approved but not funded          -219-





                                                        WASHINGTON-ALASKA - VI
           APPROVED OPERATIONAL PROJECTS (Continued)


           COOPERATIVE PROGRAM FOR STROIKE EDUCATION AND PERSONNEL
           DEVELOPMENT*

           Objectives:  Provides for the development of new personnel and for pro-
                        grams of Post-graduate Education using neurologists,
                        physiatrists and ancillary medical personnel to  provide  a
                        needed continuing education out-reach  to  selected  com-
                        munities of the Washington/Alaska Region.


           STROKE REHABILITATION NURSING PROGRAM*
           Objectives:  This proposal would expand a  training  program  in  stroke
                        rehabilitation nursing initiated in September, 1967, by the
                        Washington State Heart Association at Good Samaritan
                        Hospital in Puyallup, Washington, a 154  bed  general  hos-
                        pital, and only comprehensive rehabilitation center outside
                        of University-affiliated hospitals.  The present program of
                        five two-week courses a year would be expanded to six
                        courses per year, training 50 plus nurses as teachers, hir-
                        ing of one additional instructor, and would provide follow-
                        up by course instructors to the home hospitals of the train-
                        ees.  The total budget for the project is shared with
                        the Washington State Heart Association.  This project with.
                        the other three stroke related proposals, will be  included
                        under the  surveillance  of  a  Washington/Ala@  Regional
                        Medical Program Stroke  Coordinators  Office  to  structure
                        relationships and future developments in the regional
                        stroke pl@


           DENTISTRY CIRCUIT COURSES IN ORAL CANCER*
           Objectives:  One year of support is requested for ten circuit  courses
                        for dentists in the detection of oral cancer.  The project
                        will be co-sponsored by the University of Washington
                        School of Dentistry and  the  Washington/Alaska  Regional
                        Medical Program.  Evaluation  will  include  an  assessment
                        of the impact of tl%ese courses on screening for oral cancer.








            pproved but not funded          -220-





                                                       WEST VIRGINIA - I


           NAME OF PROGRAM              WestVirginiaRegional MedicalProgram

           GEOGRAPHICAL REGION          State of West Virginia

           ESTIMATED POPULATION         1, 802, 000

           COORDINATING HEADQUARTERS    West Virginia Regional Medical
                                        Program
                                        Room 2237, University Hospital
                                        West Virginia University Medical
                                        Center
                                        Morgantown, West Virginia 26506
                                        (Tel. : 304/293-2601)

           GRANTEE ORGANIZATION         West Virginia University
                                        Board of Governors

           EFFECTIVE STARTING DATE      January 1, 1967
           OF PLANNING  ACTRV!.I,Izs

           TOTAL FUNDING TO DATE        $658,773

           FUNDING FOR CURRENT          $378,045
           YEARIS ACTIVITIES

           CHAIRMAN, REGIONAL           Clark & Sleeth, M.D.
           ADVISORY GROUP               Dean, School of Medicine
                                        West Virginia University Medical
                                        Center
                                        Morgantown, West Virginia ?.6506

           PROGRAM COORDINATOR          *Charles D. Holland (Acting)

           STAFF                        @ORMATION OFFICER
                                        James R. Young

                                        BEHAVIORAL SCIENTIST
                                        David S. Hall, Ph.D.

                                        BIOSTATISTICIAN
                                        Joseph Costello

                                        ADMINISTRATIVE ASSISTANT
                                        (Mrs.) Phyllis J. Popovich











           *Chief Executive Officer
                                     -zzi_





                                                WESTERN NEW YORK - I
        NAME OF PROGRAM               Western New York Regional Medical
                                      Program

        GEOGRAPHICAL REGION           7 Western New York counties and Erie
                                      County in Pennsylvania

        EST@TED POPULATION            1, 940, 000
        COORDINATING HEADQUARTERS     Western New York Regional Medical
                                      Program
                                      2929 Main Street
                                      Buffalo, New York 14214
                                      (Tel. : 716/835-0728)
        GRANTEE ORGANIZATION          Research Foundation of the State
                                      University of New York
        EFFECTIVE STARTING DATE       December 1, 1966
        OF PLANNING ACTIVITIES

        EFFECTIVE STARTING DATE       March 1, 1968
        OF OPERATIONAL ACTIVITIES

        TOTAL FUNDING TO DATE         $1, 877, 838

        FUNDING FOR CURRENT           $955,685
        YEARIS ACTIVITI]ES

        CHAIRMAN, REGIONAL            Herbert E. Joyce, M.D.
        ADVISORY CIROUP               3435 Bailey Avenue
                                      Buffalo, New York 14215
                                      (Tel. : 716/833-4431)
        PROGRAM DIRECTOR              *John R. F. Ingall, M.D.
        STAFF                         ASSOCIATE DIRECTOR
                                      Jerome 1. Tokars, hC D.

                                      ADMINISTRATIVE ASSOCIATE
                                      Spero Moutsatsos

                                      ADMINISTRATRVE ASSOCIATE FOR
                                      BUSINESS AND PERSONNEL
                                      (Mrs.) Marion Sumner

                                      DERECTOR, NURSING AFFAIRS
                                      Patricia Shine, R. N.

                                      DIRECTOR OF COMMUNICATIONS
                                      Anthony Zerbo, Jr.

                                      RESEARCH ASSISTANT
                                      Elsa Kellberg


        *Chief Executive Officer 222




                                                    WESTERN NEW YORK - II
           STAFF (Continued)             ADMINISTRATIVE ASSISTANT
                                         Sohn Winston

                                         PROJECT DIRECTORS

                                            CORONARY CARE PROGRAM
                                            (Mrs.) Betty Lawson, R.N.
                                            TELEPHONE LECTURE NETWORK
                                            Joseph Reynolds


















































                                      -ZZ3-





                                                      WESTERN NEW YORK - III

         APPROVED OPERATIONAL PROJECTS




         TELEPHONE LECTURE NETWORK

         Objectives:   A two-way telephone communication network would link
                       hospitals of Western New York and Erie  ounty, Pennsyl-
                       vania to the Continuing Education Departments of the State
                       University of New York at Buffalo and the Roswell Park
                       Memorial Institute.  Equipment would be leased from the
                       New York Telephone Company.  The network could serve
                       several purposes, such as continuing education for
                       physicians, nurses, and the health-related professions,
                       public education, administrative communication, consulta-
                       tion with experts, and contacts among blood banks.


         CORONARY CARE PROGRAM

         Objectives:   The proposed coronary care program would test a training
                       technique for providing qualified nurses who will be re-
                       quired to staff developing coronary care units in the Region.
                       Approximately 80 nurses (4 groups of 20).have been selected
                       from all parts of the Region for a combined academic and
                       clinical course.  Additional nurses will be trained.  In
                       addition, physicians would receive a condensed course to
                       include that given to the nurse plus an opportunity to study
                       physical, legal and administrative requirements of coronary
                       care units.



         CHRONIC RESPIRATORY DISEASE PROGRAM

         Objectives:   Funds are requested to develop a model regional compre-
                       hensive pulmonary care program.  A nine point program
                       is presented, including correlated educational activities
                       for physicians, nurses, and allied health personnel.  Other
                       selected program aspects are: early case finding, out-
                       patient and in-patient care, rehabilitation services, inten-
                       sive care for acutely ill patients, and extended care services.
                       Maximum use would be made of existing service, teaching and
                       research resources.  Four major hospitals will participate
                       in this cooperative program.  A site-team which can be any
                       combinations of chest physicians, respiratory nurse
                       specialist, and/or a blood gas technician will be available to
                       all hospitals in the region upon request.  This will act as
                       support consultation for problems of diagnosis, management,
                       in-service education, staff conferences, or whichever will
                       serve the local purposes.






                                          -224-





                                                            WESTERN NEW YORK - IV

              APPROVED OPERATIONAL PROJECTS (Continued)



              IMMUNOFLUORESCENCE SERVICE AND TRAINING*
              Objectives:   This proposal would make available immunofluorescent anti-
                            body tests for diagnostic purposes on a regional basis.
                            Physicians in the region would be given information on the
                            applicability of these tests.  A teaching program for pathol-
                            ogists and laboratory personnel from regional hospitals
                            would be offered so as to decentralize routine tests away
                            from the host facility.


              PILOT STUDY PROGRAM IN NUCLEAR MEDICINE

              Objectives:   This is a pilot or feasibility study of cost-effectiveness and
                            patient service aspects of a nuclear medicine unit in a small
                            community hospital.  Funds are requested to equip such a
                            program... Program objectives include provision of diag-
                            nostic services, educational programs for practitioners as
                            to the potential of this procedure, and the development of a
                            training program for isotope technicians.


              A TEST OF TWO CONTINUING MEDICAL EDUCATION TECHNIQUES*

              Objectives:   The. purpose of this proposal is "to define a research
                            strategy which will measure the effectiveness of the central
                            tape library and the medical juke box as teaching and con-
                            sultation tools for physicians and subsequently for para-
                            medical personnel... This study will evaluate the educa-
                            tional advantages and cost-effectiveness of: (a) central
                            tape medical library, (b) juke box medical recording, and
                            (c) central tape versus juke box.


              DIALYSIS AND KIDNEY PROGRAM*

              Objectives:   Funds are requested to improve the level of care of patients
                            with acute and chronic renal disesae.  Four hospitals in
                            Western New York and one in Pennsylvania would partici-
                            pate and thereby expand the number of beds available for the
                            treatment of renal disease patients.  Activitiesaimedtoward
                            the prevention of renal disease include appropriate screen-
                            ing procedures and educational programs for physicians,
                            nurses, and technicians.







              *Approved but not funded         -225-





                                                         WESTERN NEW YORJK - V;

          APPROVED OPERATIONAL PR,04F.CTS (Contz'nued)



           CORE PLANNING AND ADMINISTRATION

           Objectives:  To continue and complete certain surveys, communication
                       and community involvement activities already inaugurated or
                       planned; and to support professional core staff dur' the next
                                                                     mg
                       program period.





                                                 WESTERN PENNSYLVANIA - I

             NAME OF PROGRAM               Western Pennsylvania Regional Medical
                                           Program

             GEOGRAPHICAL REGION           Pittsburgh.. Pennsylvania and 28 sur-
                                           rounding counties (Western
                                           Pennsylvania.)


             EST@TED POPULATION            41 200, 000

             COORDINATING HEADQUARTERS     Western Pennsylvania Regional Medical
                                           Program
                                           508 Flannery Building
                                           3530 Forbes Avenue
                                           Pittsburgh, Pennsylvania 15213
                                           (Tel. : 412/621-1006)

             GRANTEE ORGANIZATION          University Health Center of Pittsburgh

             EFFECTRVE STARTING DATE       January 1, 1967
             OF PLANNING ACTIVITIES

             TOTAL FUNDING TO DATE         $573,125

             FUNDING FOR CURRENT           $445,392
             YEARIS ACTIVITIES

             CHAIRMAN, REGIONAL            James A. Rock, M.D.
             ADVISORY GROUP                Lee Hospital
                                           320 Main Street
                                           Johnstown, Pennsylvania 15901

             PROGRAM COORDINATOR           F. S. Cheever, M. D.
                                           Vice Chancellor for Health Professions
                                           University of Pittsburgh
                                           M-240 Scaff e Hall
                                           Pittsburgh, Pennsylvania 15Zl3
                                           (Tel. : 412/621-3500, ext. 320)

             STAFF                         PROGRAM DIRECTOR
                                           *Robert R. Carpenter, M. D.

                                           ASSOCIATE DIRECTORS


                                              MEDICAL LIAISON
                                              E. Wayne Martz, M.D.

                                              COMMUNITY INVOLVEMENT
                                              Howard E. Hough

                                           ASSISTANT DIRECTORS


                                              EVALUATION
                                              David E. Reed, M.D.


             *Chief Executive Officer
                                        -227-





                                                     WESTERN PENNSYLVANIA         It
           STAFF (Continued)                     PROFESSIONAL AND PUBILIC
                                                 RELATMM
                                                 Gir@m W.    Wtird

                                                 FISCAL AFIP     s


                                                 MSING !*MN
                                                      Goldbets. Ph. D.
                                              AREA LtAlSOt4 REPRESENTAT@U
                                              P&ML J. M&rtija

                                              RESEARCH ASSOCIATIC
                                              Manuel @toi

                                              ADMINISTRATIVIC ASSLSTANT
                                              Ltri. E]Iin R.- maione






































                                          -228-






                                                            WISCONSIN - I

             NAME OF@ PtkOGRAM            Wiscon @ Regional Medical Program

             GEOGRAPHICAL REGION          State of Wisconsin

             ESTD4ATED POPULATTON         40221,000
             fOORDINATWi IMADQUARTERS     Wisconsin Regional Medical Program,

                                          I 10 East Wisconsin Avenue
                                          Milwaukee, Wisconsin 53202
                                          (TeL : 414/272-3636)
             GRANTEE ORGANIZATION         Wisconsin Regional Medical
                                          Program, Inc.
             EFFECTIVE  STARTING  DATE    September 1, 1966
             OY PLA     Amrrms-
             EFFECTIVE  STARTING  DATE    September 1, 1967
             OF OPERATIO@R,  ACTRVITIE.S

             TOTAL FUNDIKG TO DATE        $1, 870, 218
             FUNDRLG FOR CLJRRENT         $1, 023, 504
                     T_
             YEAR IS AC IVITMS

             CHAIRMAN REGIONAL            Rodney Lee Young
                     4         -
             @]ORY GRO@                  County Judge
                                          County Court Chambers
                                          Rusk County
                                          Ladysmith, Wisconsin 54848
             PRESIDENT, WISCONSIN         T. A. Duckworth
             REGIONAL MEDICAL PROGRAM     Senior Vice President - Secretary
             INC.                         Employers Insurance of Wausau
                                          Wausau, Wisconsin 54401

             PROGRAM COORDINATOR          *John S. Hirschboeck, M. D.

             STAFF                        ASSISTANT COORDINATOR
                                          (PROGRAM)
                                          J. D. Kabler, M.D.
                                          University of Wisconsin
                                          Madison, Wisconsin

                                          DIRECTOR OF PUBLIC INFORMATION
                                          Peter A. Kirsch


                                          NURSING COORDINATOR
                                          (Mrs.) Norma M. Lang, R. N.

                                          EVALUATIONS COORDINATOR
                                          Charles W. Lemke
                                          University of Wisconsin
                                          Madison, Wisconsin


             *Chief Executive Officer -229-






                                                                WL'5CONSIN - II

          STAFF (Continued)                ASSISTANT PROGRAM COORD@TOR
                                           Peter J. Sheldon


                                           PLANNING COORDMTOR
                                           Paul C. Nutt


                                           CONTINUING EDUCATION
                                           COORDMTOR
                                           William J. Sheeley

                                           ASSOCIATE COORDINATOR
                                           James H. Sullivan

























































                                       -Z30-





                                                                               WTSCONSIN - IU

                 APPROVED OPERATIONAL PROJECTS




                 CORE PROGRAM

                 Objectives:   Funds requested would support the core planning and basic
                               operations over the next five years.  Approximately 75,lo of the
                               budget is for personnel.  These  funds  would  permit  continued
                               program growth and  development,  support  the@planning  of  new
                               and the monitoring of approved operational activities, and allow
                               for the expansion and strengthening of regional as well as
                               extraregional cooperative arrangements.


                 STUDY    PROGRAM    FOR    UTERINE    CANCER    THERAPY     AND     EVALUATION

                 Objectives:   To develop a  Study  Program  for  Uterine  Cancer  Therapy  and
                               Evaluation which will have as its primary  objective    improve-
                               meat in the quality of uterine cancer therapy in the  region  by
                               the introduction of new techniques for review and evaluation of
                               current therapy and long-term results.  Includes physician
                               education.


                 A     PILOT     DEMONSTRATION     PROGRAM     FOR     PULMONARY     THROMBOEM-
                 BOLISM - MARSHFIELD CLINIC

                 Objectives:   To  demonstrate  a  comprehensive  program  which  will   encom-
                               pass diagnostic, preventive, therapeutic and rehabilitation
                               procedures for patients, postgraduate education, a rapid
                               transportation system for patients  from  Northern  sections  of
                               the state, cooperation between the Clinic  and  other  hospitals
                               and medical schools in the region,  collaborative  research  be-
                               tween the Center and the medical schools in  basic  research  in
                               blood coagulation and thromboembolism,  and  evaluation  of  the
                               capability of Marshfield-Wausau to  function  as  a  subregional
                               medical center of the WRMP.


                 CANCER CHEMOTHERAPY FOR ADULTS

                 Objectives:   This will be a three-year cooperative program.  It is proposed
                               to build a  collaborative  chemotherapy  service  program,  upon
                               the resources of an established university medical center
                               Division of Clinical Oncology, and the experience of  practicing
                               chemotherapists located in different parts of the  Region  would
                               form the initial group of principal  collaborators.  An  overall
                               objective is to favorably influence morbidity and mortality
                               rates for cancer, and a number of activities will be initiated to
                               achieve this.  Cooperative activities will be developed with the
                               Cancer Committee of the State Medical Society, division of the
                               American Cancer Society,VeteransAdministrationHospitals, and
                               the Milwaukee CountyHospital. It is estimated thatabout 10,  000
                               new cancer patients might benefit from this project annually.


                                                   -231-






                                                                     WISCONSIN   -    IV

           APPROVED OPERATIONAL PROJECTS (Continued)




           POSTGRADUATE EDUCATION FOR HEALTH PROFESSIONS

           Objectives:   A self-supporting program would acquaint practicing
                         physicians with research  and  other  programs  in  heart  dis-
                         ease, cancer, and stroke.  The following proposals are
                         planned: (1) single concept filrns.- (2) dial access tapes  for
                         physicians; (3) dial access tapes for nurses;  (4)  the  develop-
                         ment of from five to, ten continuing education  centers  to  be
                         located throughout the Region.


           INTERRELATED    PROGRAMS     IN     RADIOLOGY     AND     NUCLEAR     MEDICINE*

           Objectives:   A combined program in radiology and nuclear medicine
                         which  would  (1)  coordinate  radiotherapy  programs.  (2)  pro-
                         vide specialized consultation services, and (3) establish
                         training  programs  for  physicians  and  technologists.   This
                         program is established  to  promote  the  availability  of  im-
                         proved medical care for the patient population involved through
                         through the cooperative and efficient utilization  of  existing
                         resources.



           THE PREVENTION,. DIAGNOSIS, AND TREATMENT OF CARDIO-
           VASCULAR DISEASE*

           Objectives: (1)  a  program  which  would  increase  regional  capability  in
                        -coronary angiography; and (2) a proposal which would focus
                         on improving service training and consultation in pedi-
                         atric cardiology and would be directed by Marshfield
                         Clinic.



           CANCER CHEMOTHERAPY PROGRAM FOR THE METROPOLITAN
           MILWAUKEE AREA

           Objectives:   This program would complement a previously awarded
                         cancer  chemotherapy  program  for  adults,  and  would   focus
                         on Southeastern Wisconsin,  including metropolitan
                         Milwaukee.  This  project  would  make  available   to   larger
                         patient groups the results of clinical studies in chemotherapy
                         Marquette School of Medicine, St. Mary's Hospital, St.
                         Joseph's Hospital as well as a  number  of  other  hospitals  and
                         agencies  participating.  Efforts  would   be   made   to   co-
                         ordinate  chemotherapy  provided  by  physicians  and  to  dis-
                         seminate information through organized teaching programs.
                         Study protocols a s well as diff erent types of training pro -
                         grams for physic  ians and nurses are outlined.



           *Approved but not funded           -232-






                                                                       WISCONSIN - V

               APPROVED OPERATIONAL PROJECTS (Continued)



               TISSUE TYPING PROGRAM

               Objectives:  Support is requested to develop a regional resource for
                            tissue typing and compatibility testing of tissue trans-
                            plantation.  This resource would provide a means to im-
                            plement new techniques as they are developed, as well as
                            provide a program from which to train physicians and
                            technicians in recent advances in this field.  The project
                            would be based at the Milwaukee Blood Center which has
                            served Southeastern Wisconsin for twenty years.


               UTERINE CYTOLOGY SCREENING PROJECT*

               Objectives:  This project is co-sponsored by the University of Wisconsin,
                            Marshfield Clinic, Division of Health of the Wisconsin
                            Department of Health and Social Services, and the
                            Milwaukee Health Department.  It seeks to demonstrate
                            the validity of cell-sizing by use of the Coulter Counter,
                            using standardized criteria for interpretation, as a pre-
                            screening procedure for cervical cancer.  The study
                            population would have Pap smears performed at the same
                            time specimens are obtained for the size distribution
                            analysis.


               AN OPERATIONAL PROGRAM FOR NURSE TRAINING

               Objectives:  This project is jointly sponsored by the- University of
                            Wisconsin and Marquette University.  Part One provides
                            for the preparation of inactive nurses returning to practice.
                            Part Two is a continuing education program for nurses on
                            the treatment of the patient in shock.
















               *Approved but not funded        -Z33-





                                                            0238


                                INDEX



           The INDEX is a first attempt at identifying by type of activity and dis-
        ease all the approved operational projects of Regional Medical Programs
        described in this Directory. The listings made are by no means com-
        prehensive or specific, but refer to the apparent primary focus of the
        projects, as interpreted by the Division of Regional Medical Programs'
        Office of Health Data on the basis of information available to them.



           The INDEX is divided into two parts. Listings are made by Type
        of Activity including....

                  * Continuing Education and Training
                  * Demonstration of Patient Care
                  * Research and Development
                  * Planning, Coordination and Evaluation

        and by Disease Orientation including....

                  * Heart Disease
                  * Cancer
                  * Stroke
                  * Related Disease
                  * Multicategorical



        NOTES:
              -Each of the projects listed under Disease Orientation is further
              subdivided according to the Type of Activity.

              References are made in encyclopedic style with a page number
              followed by a letter of the alphabet which indicates where the
              description is located on the reference page... first (a), second
              (b), third (c), fourth (d), or fifth (e).

              "Planning, Coordination and Evaluation" includes core support
              and feasibility and planning studies when they are funded through
              the operational grant.
















                                 -234-





                           APPROVED       OPERATIONAL       PROJECTS        INDEXED        BY

                                                 TYPE      OF      ACTIVITY

                    CONTINUING       EDUCATION       AND       TRAINING

                         4a,  4b,  4c,  7a,  7b, 7c,  8a,  13b,  13c,  13d,  14a,  14b,  14c,  15a,   15b,
                         15c,  16a,   Zla, 21b,  Zlc,  Zld,   22a, 22b,   22c,  2 3b,     23c, 24b, 24c, 28a,
                         28c,  28d,   29a, 29b,  29c,  29d,   30a, 33c,   34a,  34b,  35a,  35b,   35c,
                         35d,  39a,   39b, 39c,  39d,  40b,   40c, 41a,   44b,  44d,  45b,  46b,   46c,
                         49a,  49b,   49c, 49d,  49e,  50a,   50b, 50d,   51a,  51c,     55a, 55b,   55c,
                         55e,  58b,   58c, 58d,  59a,  59b,   59c, 60a,   60b,  65a,     65b, 66b, 69b, 69d,
                         70a,  70b,   70c, 71b,  71c,  72b,   75d, 75e,   76b,  76d,     79a, 79b,   79c,
                         79d,  80b,   80c, 81a,  81b,  81c,   82a, 82b,   83a,  83b,     83c, 84a,   84b,
                         84c,  85a,   85b, gla,  91c,  91d,   92a, 95a,   95c,  95e,     96a, 101d,    102a,
                         103c,  106c,   106d,  107a,  107b,   107c,   108a,  108b,  108d,   110c,  110e,
                         lllb,  112a,   117b,  118c,  120d,   121a,   122a,  122b,  122c,   123c,  127b,
                         127d,  133a,   133b,  133c,  133d,   134a,   134c,  135a,  135b,   138a,  138b,
                         138c,  138d,   138e,  138f,  143b,   143c,   144a,  144b,  144c,   144d,  144e,
                         145b,  145c,   145d,  146a,  146d,   153c,   156b,  156c,  157a,   157b,  157c,
                         161a,  161b,   161c,  163b,  163d,   164a,   164b,  167c,  168a,   168c,  169b,
                         169c,  171a,   172b,  172c,  172d,   173a,   173c,  178b,  178d,   179a,  179c,
                         180d,  181a,   181b,  181c,  181d,   184b,   184c,  184e,  185c,   186a,  190a,
                         190f,  191c,   194a,  194b,  194c  194d,  194e,  194f,   195a,   195b,   195c,
                         195d,.196a,    196d,  197a,  197b,  198a,   198b,   Igga,   199c,   200a,   Z02a,
                         202b,    202c, 203a,  203b,  209a,  209b,   209c,   212a,   212b,   212d,   217a,
                         Z17b,    217c, 217d,  217e,  218a,   218b,   218c,  218d,  219a,   219d,  220a,
                         220b,  220c,   224a,  224b,  225a,   225c,   232a,  232c,  233a,   233c

                   DEMONSTRATION       OF       PATIENT        CARE

                         4d,  8b,  8c,  8d,  8e,  ga,  22d,  23a,  24a,  24d,  28b, 33b, 38c, 40a,
                         45c,  50c,  50e,  51b,   55d,   64b, 64c,  65c,   70d,   70e,   71a, 72a, 72c, 75b,
                         75c,  95b,  95d,  96b,   96c,   96d, 96e,  97a,   97b,   97c,   97e, 101a, 101b,
                         101c,  102b,   102c,  102d,  103b,   106a,   106b,  107a6, 107b,   113a,  117a,
                         117c,  117d,   119a,  120a,  120c,   120e,   121b,  123b,  124a,   127c,  128a,
                         134b,  139a,   139c,  145a,  153a,   156d,   167b,  168b,  169a,   171b,  171c,
                         171d,  172a,   173b,  178c,  179b,   180c,   180e,  184a,  184d,   185a,  185b,
                         185d,  185e,   186b,  186c,  186d,   187a,   187b,  190b,  190c,   190d,  190e,
                         191a,  191b,   195e,  195f,  196b,   196c,   197c,  197d,  199d,   204b,  204c,
                         205a,  205b,   205c,  205d,  206a,   212c,   218e,  219c,  224c,   225d,  231b,
                         231c,  231d,   232b,  232d,  233b

                   RESEARCH          AND          DEVELOPMENT

                         38a,  41d,  44a,  44c,  45a,  45d,  46a,  64d,  66a,  73a,  80a,   80d,   91b,
                         92d,  97d,  110b,  lllc,  Illd,  112b,   118a,   118b,   119b,   119c,   119e,
                         123a,  143a,  143d,  163c,  180a,   198d,   203c,   204a,   208c,   Z18f,   219b,
                         225b








                                                         -235-




            PLANNING, COORDINATION AND EVAWATION

                9b, 13a, 23d, 29e, 33a, 38b, 41b, 41c, 41e, 51d, 52a, 58a, 64a,
                69a, 69c, 7?d, 75a, 76c, 82c, 85c, 92b, 92c, 103a, 108e, 110a,
                110d, llla, llzc, 112d, 118d, 118e, 119d, 120b, 121c, 127a, 138g,
                146c, 153a, 156a, 163a, 167a, 173d, 178a, 180b, lggb, 206b, 206c,
                207a, 207b, 207c, 207d, 208a, 208b, 226a, 231a


















































                                         -236-





                        APPROVED     OPERATIONAL     PROJECTS     INDEXED     BY

                                      DISEASE ORIENTATION

                 HEART DISEASE

                     Continuing Education and Training

                     4c, 13b, 13c, 13d, Zla, Zlc, 22b
                                                      , 1, 22c, 24b, 29a, 40a, 44b, 44d,
                     46c, 49c, 504,  Slc,  SSa,  55b, Sft, 59bp 59c, 60a, 69d, 70a, 70b,
                     70c, 72b, 75d,  75e,  76d,  79d, 80b'914, 95c, 95e, 96a,  101d,@ lOza,
                     103c, 106c, 107b, 107c, 108d, Ilee, 120d, 122a, 127b,     133a, 133'b,,
                     133c, 133d, 134a, 138a, 138b, 143b, 145b, 145c' 145d,     156b, 156c,
                     161a, 172b,  172c,  173a,  178b, 17$d, 179a, 184b: 184c,  184e, IgSc,
                     190a, 190f,  194f,  196a,  196d, 19Ta, 197b, 198a, ZOZC, Z 1 2b, 2 17a,
                     218&,  218c,  224b,  232c,  Z33a

                     Demonstration  of  Patient  Care
                     8b, 8c, 8d, 8e, 45c,  50c,  50e, 70d, 70c, 7Za, 95d, 96b, IOZC, 102d,
                     113a, 120a,  120e,  IZ4a,  134b, 139c, 145a, 146b, 153b,  167b,  178c,
                     180c, 184a,  184d,  185a,  185b, 190b, 19*c, 190d, 190e,  195a,  195f,
                     196b, 196c,  197c,  197d,  199d, Z05d, Zl?-c

                     Research and Development

                     44c, 45a, 45d, 64d, 73a, 80a, 119e

                CANCER

                     Continuing Education and Training
                     14a, 14b, 15b, 15c, 23b, Z8c, 29c, 35a, 50b, 51a, 58c, 76b, SZb,
                     84c, 106d, lIZa, 134c, 144b, 146d, 157a, 169c, 173c, 180d, 186&,
                     194e, 195a, 195b, 195c, 198b, 202a, ZOZB,  Z03a,  203b,  209b,  Z09c,
                     Z12d, 219a, 2ZOa

                     Demonstration  of  Patient  Care
                     4d, 9a, 33b, 71a, 101c, 121b, IZ3b, IZ7c,  IZ8a,  168b,  169a,  185d,
                     185e, 186b. 186c, 206a, 218e, Z31b, Z31d, 232b, Z32d, Z33b
                     Research and Development
                     66a, 97d, 123a, 143d, 180a, 203c, 204a, Zlgf, ZZSB
                     Planning, Coordination and Evaluation

                     108c, 208a







                                                 -237-






            STROKE

                 Continuing Education and Training

                 71b, 81b, 81c, 83a, 83b, 118c, 121a, 138d, 144e, 146a, 157b, 161b,
                 179c, 181a, 220a, 220b

                 Demonstration of Patient Care

                 24d, 28b, 64c, 72c, 75b, 75c, 96c, 96d, 96e, 97b, 97c, 101a, 106a,
                 106b, 107a, 107b, 120c, 171b, 171c, 171d, 172a, 173b, 180e, 186d,
                 187a, 191a, 199e, 204b, 205c

            RELATED DISEASES

                 Continuing Education and Training
                 23c, 29b, 34a, 34b, 45b, 49b, 60b, 107a, 110e, 135b, 143c, 167c,
                 169b, 181b, 181c, 181d, 219d

                 Demonstration of Patient Care

                 22d, 23a, 51b, 55d, 97e, 102b, 156d, 187b, 204c, 219c, 224c, 225d,
                 231c

                 Research and Development

                 46a

                 Planning, Coordination and Evaluation

                 173d


            MULTI-CATEGORICAL
                 Continuing Education and Training

                 4a, 4b, 7a, 7b, 7c, 7d, 8a, 14c, 15a, 16a, Zlb, Zld, 22a, 24c, 28a,
                 28d, 29d, 30a, 33c, 35b, 35c, 35d, 39a, 39b, 39c, 40b,  40c, 41a,
                 46b, 49a, 49d, 49e, 50a, 55c, 55e, 58b, 58d, 65a, 65b,  66b, 69b,
                 79a, 79b, 79c, 80c, 81a, 82a, 83c, 84a, 84b, 85a, 85b,  91a, 91c,
                 95a, 108a, lllb, 117b, 122b, 122c, 123c, 127d,  135a,  138c, 138e,
                 138f, 144a, 144c, 144d, 153c, 157c, 161c, 163b, 163d, 164a, 164b,
                 168a, 168c, 171a, 172d, 187c, 191c, 194a, 194b, 194c, 194d, 195d,
                 199a, 199c, 200a, 212a, 217b, 217c, 217d, 217e, 218b, 218d, 224a,
                 225a, 225c, 232a, 233c

                 Demonstration of Patient Care

                 24a, 38c, 40a, 64b, 65c, 95b, 103b, 117a, 117c, 117d, llga, 179b,
                 191b, 205a, 205b





                                           -:238-




                                              Research    and    Development

                                              44a,      91b,      9Zd. llllc, Illd,                  I 12b,       118a, 118b, 119c, 143a, 198c, 1984,
                                              219b

                                              PlAnning,            Coordination and tmluatiois

                                              51d, 76a,             92c,   103a,   112d




















































                                                                                                     -239-



                                                                                                                                   U.S. GOVSRNMENT PRINTING OFFICE: 1969 0-336-994