e

*

MAY/,llJX 1974. RJ:V Lril?
                -I"

$2,648,439
Reqliesi,:

Conuni.ttce I!ecominc!nti;~t.ic,rr: $2 ,028,383
-----l_---     ----.---

Although it is not unique to this region, the Alabama Regi.onal 1$dica.l
Program is continuin~~ r to attempt. to equalize j.ts minorj.ty representation
cm program staff, project staff and its committee memberships.

The reviewers arrived at the reduction in the recommended funding level
(from $2,648,439 requested to the recomnendcd $2,028,389) by considering
some of the p"o~galns , ?)oth continuing and new, to be of a low priority in
a one year time-frame.  For example, the Trophob1.a.stj.c Disease request) the
                                                               -..--
requests for Cervical Cancer Sc.reeni.ng ailil.oi-lourescence for
Renal. Eiolsies were consi.d@kcd. of low priority.`-%?%-.. Stage Of
           --
fuW"devclopment ) the revj.ewers believed the project request for  Audio-Visual
                                                                           --
,kssistance in Educ.ati.ny ~~yi-r,erteJlsives  should not be fund.ed and t-m
-.-        __-----
requesF?X--$X51,000 for>SJ&>Xn-be reduced by $100,000.

JUI,Y/AlJG'UST REVIEW
        --.

Estimated Request as of May 1974: 1 .lm

DRMI?/DOD '
SCOB/6-5-74


MAY REVIEW STAFF SUMMARY

ALABAMA REGIONAL MEDICAL PROGRAM
1108 South 20th Street
Birmingham, Alabama

Margaret Klapper, M.D., Coordinator

Full-time Professional Staff:   8 ---_-_I
Part-time Professional Staff: 0
Full-time Other               :   3 -------
Part-time Other            : 0

FUNDS REQUESTED:

Total costs   - $2,648,439
Program Staff -   ($600,494)
Continuation -   ($565,005)
New       - ($1,482,940)

Prepared by: Joe .lewelJ.
              _____-_ -.--

    On duty since 7/l/73

-------'l'otr~l l'1-opos'd: 11

--------Total I'rc1posed: 9

Target Figure $1,891,872 (7/.1/74-
6130175)
Estimated July Request - l.lm

Period of Time Requested:  Currently all activities are to terminate 6130175,
                      or before.  However, if permitted,  several activities
               may benefit by being extended (lag time etc.),in
               time only,via a contract route.

EMS PROJECT:
-..--__

No new EMS proposals.  There are requests for continuation of

3, #54, & #55.   None of tllesc

five currently-funded programs: #42; #43, ii
exceed by 15% the annualized previous budget.

PSRO:
-_

ftlO3 is an information and training program for persons who will be
required to supply data etc.for PSRO purposes.

KIDNEY:
-.-

No renal activity currently supported.i/lOO,although entitled renal, is
aimed primarily at cancer.

CHP COMMENTS:

The top of Alabama Health Planning Agency (page 77) endorsed a proposal
from the Alabama Health Systems Foundation (North Alabama Health Information
and Education Program).  The proposal was disapproved by the RAC as not
a high priority as it relates to the region's current objectives.   The
district IV "b" agency in Gadsden, Alabama endorsed five proposals which
RAG approved.  A sixth proposal, (Health Resource Planning), was endorsed
by the planning agency but failed to pass RAC who preceived it as being
a basic CHP function.


Page 2

Alabama May Review Staff Summary

The CHP "A" agency director's review, appears on page 84.   He is il
member of RAC.  He noted some of the projects sent to him for review
"DO not conform with the current RMP mission; however, that decision
is the business of RAC."  Staff notes that the current submission
did not include all of the 35 projects referred to and since Mr. Blanks
sits as a member of RAC, we believe his objection was overcome by
the actions taken by the members of RAC.

DRMP/DOD
SCOB:5/15/74


a-
M       974

a   d
       REQUESTED F     LISTING
         COMPONENTS BY REGION

- --.- __

hLk3AYA

PROG YR. 05

bb/-f4 COUNCIL

TH CENTRAL     CDXP                COHPONENT TITLE                        DIRECT
             MO _.-                                                          INDIRECT
^. -.. .- ^    _                                                         REQUEST      REQUEST

coca   PROGRAM STAFF

466*984

L33r510

co10  MULTI MEDIA LF-APNING SKILLS LIf?RARY                    60,500            0

042


O43


053


054


055


059


C&f+


066


071

c72


073

c;77

_- .-
E M S DEMO BIpM;NGHAH


ALAEAMA E M S P

E CFNTRAL ALA E M S
.-                   .-
WALA EMSSYS
N E A-LA E H S    ,

                        73r355       7,726
  1                         449600            0

                         55,397           0

                         37,130            0

                          25,390             0

MOSP ?.ASED CARDIAC OUTREACH                            15,420            0

PFDIAT2 It Pi!LX                         ' 39*779            0

STRENGTHENING LDCAL PLAN                              22t764        ;     0

HLTH FXTENSION LFARNING                                24,396       71970
                                  `.
DlSTRlCT 12 E M S CljUNCIL ORGAN                          24,144            0

C!XvT t-D DETECT HYIjT                                  49,934      161335

ALA TfIKRIG6EE AREAWIOE C H P                         56,375            0


SURVEY (3EV  HYPT  15 CDUXTIES                            5rooo            0


A V ASSIST  53UC  HYpT                                  61991         762

A?:Ftic;:: U'dlV BASED HYPT ED                             24,607       7,967

DkF;  ,   STRi5NGT!+NI>!G  LOCAL PLNG DIST  12  ANYISTON                18,963            0


C96  ,C;;LL!lk:d CNTY  DENT HLTM                                 14,550            0


207    TELt C>`.:!4 SYS  HLTH PRGF                                24,760       4,725


islp    T&l; NCCYATAL XNT ChkE                               37~280       99450

0 9 9    FORMATION STATE'rlICE AGSRY CDCR CDUNCIL HYPT              27~323       1~332

TOTAL
REQUEST

6009494

bOv500

81~081

449 600

55v397
37vl30

25~390

15~420

39v779

221764

32~366

249 144

66,269

56v375

5vooo

7,753

321574

189963

14v550

299485

46v730

28,655

.


  cl,
REQUESTED FUN     STING
C3MPONENTS BY REGION
    0.5174 COUNCIL

LA&AMA         PROG YR 05

c EN?Q AL     CCMP                 COMPONENT TITLE
.-... ^ ..-_    NO ..-. - _ .     __

           100   IMMUNffFLUORESCENCE RENAL 316


            101   ALA UlfR0C,ER.V CA SCREENING
_ __.. -- ._- ..-..    -_
          102    WEST ALA MED CARE STUDY GREENE CNTY

103    P S R 0 REG TRNG
                                   I
104    GADSbEN STATE JR CCLL HYPT CNTRL

_..__ - _... -.. .,     _.

105

105A
iO6

!4ULTI i-~iSCIPLIh%RY HLTH ED

\ MULTI GISCIPLINARY HLTH ED

321, LEV:L CARE HYPT AND HT GIS

T 4 ;,: r,  `-LTH F.RCFS HYFT


T?f.jS t.;!lP.SG !-!Cl'dE PERS

CYTCTiCHY3L TRNG SCH


W &LA n0SP CF\r

""ci:_: CO CA CC!?EEI4I"IG
.-(

?-,;EIieE CO H;Gt! B P EDUC

MOSILE CO HLTH EYER CMNC

HLT~ I'sP:;IR ~JTTLIZATICN & DEV PL%G

~E;~~E!%i.Siil? Th:.G  XUKSG SERV AGMTN

REGICN 111 COST CCNTAIN3?ENT CONF

RkAF! FACILITY FEAS STUDY

135~ PIL,:T HYPT CrdTRL

HCSP FACSUILE IF!FS SYS


ItJVEYTCkY PROF hEA I!`iFtl SERV

.



49,725

114*010
       ---
4,680

151,701

. 3t942
559866. -

561666

          17,932

           62~546

16,706

14~592
      .-'
39,955

75,000

26,620

351610

9,657

259000

142,530

67,403

59,887

DIRECT     INDIRECT       TOTAL
REQUEST - REQUEST   _ REQUEST

.  . .

Se730


    0

  702


    0


    0

20~372

17,415

    0

39564


     0


    0


    0


    0


    0


    0


    0


    0


    0


    0

79470


    0


169012

58r455

114,010

5,382

151r701

39942
76,238 -

74,081

17r932

66,110

16r706

149592
39,955 -

75,000

68,737

31?000

26,620

35,610

9,657

25,000

15c,ooo

67r408

75,699


-.

PLAEAUrA        PtiOG YR -05

rh CENTRAL

REEUESTE!, F      ISTING

CO%PCNENTS B? REGXON
  06/74 COUNCIL

coxp                COMPONENT TITLE                         DIRECT
NO                                                        INDIRECT
                                                      REQUEST    REQUEST



121   TxcJPH39LAST DIS ENDCCRINE OX & FOLLOW UP                 10,788         720

122   INDIVIDUALLY PACED TRNG MCDlJLES HEA ADMIN                36,545       4,050
"123 -~ MAP ABSTRACT HEA STAT ALA i971                       8,422       11264

124   ANAL EVAL REFINITION NURSG SERV JORS                   37,196            0

,F CCIHPDNENTS. _ 48                               REGION TOTALS        29378,363     .270r076    2,6488r439

.

c

TOTAL
REQUEST

11,508

40,595

9~686 *

37,196



RMI?    ALBANY      -_I_
    c_--

ru4 000 04
      -I

CrJ.ti.que: The reviewers believed the Albany RMP to have:

Excellent program leadership
Experienced, competent staff
A strong, active, dominant RAG
Excellent past performance
Goals and objectives realistic and based on identified needs
Proposed activities are consistent with goals and objectives

(No CHP-b agencies'in this area)

_JUJ,Y/AWlST RJ?VIEI{
Estimated request as of May 1974:
                       $455,000
                                                      :



of the Region


RM 00004

   l      .
e
    ALBANY           Regional Medical Program

Coordinator:  Girard J. Craft, M.D.              On duty since: I'!06
                                                                           -- __-_._
                                    (Coordinator since 1/73

Staff:   Full Time Prof.                7.7      Proposed: 9 -7

Full Time Other              10.2                 10.2

Funds Requested:

Total  ...................   1,066,175

Continuation .............  ( 732,461 > (projects>; 333,714 Program Staff

Period of Time Requested: July 1, 1974 to June 30, 1975

Activities Proposed:

Refer to Management Information Systems (XL'S) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


List any continuation project or staff acti.vity for which substantial incrcasc
over annualized current funding is requested.

HMO project: ~005 - 11,140 - This activity wil.1 facilitate tl~e deve.iopmeut
of an HMO in the Capital District area predicated on capitation and the
provision of comprehensive and continuous range of services as a viable
alternative to existing health care plans,                              I

EMS project: CO11 - Emergency Medical Servic*ct Feasii)ility Strlrly - 5:!,')20 -
This represents a cooperative endeavor which relates to the conduct of
Project #45.
Project #45 - Upgrading EM Care in the ARMP Area - 138,600 - The goal. of
this activity will be to establish and support the expansion and improvement
of existing communications facilities                                 I
                                                                          I

PSRO: C003 - 15,800 - This activity is to provide technical assistance

0 in the development of four PSRO's in the ARMP region

Kidne :
158,157  Project 1'144 - N.E. New York Program for FndTstage Kidney Dise;~sc~ -
    - This program will provide adequate therapy to patients wit11
end-stage kidney disease by expanding the patient base, facilities and
trained personnel for their care,

CIIP comments:  There are no approved operational CHP "b" agencies
exclusive to the ARMP.  This application was submitted to the Upper
Hudson Regional CHP Agency for their considered information.  The
application was also submitted to the CHP "a" agency.

E0/5/20/74


MA

._ ._ .

AL8ANY   PROG YR 07

ERN

CONP
_ _ NO

coo0

           coo3
-.---- .-- -
            coo4
       co05

           to11
-.. .I.----- __- cob

CO17

            020
_.  I --_ --- - - -. 021
       .022
--. .
          029
-- -.. - -_. .-. .^
            039

044

          045
- :..   _ .
            047

04s


049

PPDG STAFF

PSRO FEAS
--CiiP FFAS -
-HHO FEAS

E M S FEAS

_



CO%PONENTS BY REGION
Ok/74 COUNCIL -

COMPONENT TITLE

COMMUNITY HYPT FEdS .

DEVELOP HLTH SERV, AGY FEAS

3-4 END CGtWUNITy HLTH CTR

CARVER COYPRE COMMUNITY HLTH CTR

TRNG DEL HOME CARE

CG?l~QyITY HLTH EDUC SERV
`-EXPbr!%D CONCEPT HOME HLTH CARE -
-NF NY PROG END STAGE KIDNEY `DIS
UPGRADING EMERG HED CARE'
RURAL HLTk! ACCESS STATION -

SUODEN HEATH

HLTH CARE COHPUTER RESOURCE
_. _

,

DIRECT     INDIRECT
REQUEST     REQUEST

            222,763     1101951

              101250       5*550
   -.                     -.
             16,200       6r1a0

               7r150       31990

   32,700      17r220

   ar1501       41140

   17,300       9.270

   24,833       7t200
.               --.
   '  24,000       6,000

   29rooo       lOI
                  ;

57,445      17,018

37e716

106,242      51,955

138~600             0

Llr160     '3,492

10~875       5,775

29,510        91330

REGION TOTALS         783,954

282,221

           



TOTAL
REQUEST

333,714

15r800

2zr3a0

11,140 '

49~920
12,290 -

26,570
                  I
32,033 -
30rooo

39*010

74,463
51,856

158,197

138,600

149652

16,650

38,900

X,066,175



.

Rcqucst: $l.,351,128 '

Committee? Recommendation:   $860,000

@,rcralf assessment by individual reviewers:   Below average

Critique:

Arizona is considered below average for several reasons, none of
which is of recent origin.  Non-compliance with DRMP guidelines
concerning grantee-RAG relationships has made it necessary to
withhold certification of the review process of the Region. It
appears, also, that individual representatives of the grantee
may unduly influence the programmatic direction of,ARMP, includ-
ing program staff, activities.  Finally, the leadership ability
of the Coordinator is questionable.

The RAG membership,
Medical School, has
appears stable.

which is 'appointed by the Dean of the
recently been increased by six.  The staff

I

To the Review Committee, this appeared to be a pedestrian appli-
cation.  Future support of the continuing education program is
still under study.  The region needs encouragement to move out
of the urban areas and to focus on rural health problems.

The Regional Advisory Group is scheduled to meet on June 20, 1974
to review new by-laws.  ARMP staff will be in contact with the
Region to determine what progress is being made in this regard.

The Committee recommends approval of the application at a reduced
level of $860,000, pending final.resolution of the RAG-grantee
relationships and verification of a review process.

JULY/AUGUST REVIEW
Estimated request as of May 1974:$35p,ObO,                        :
                                  -425,000

6/6/74
WOB


SmFF SUMMARY FOR MAY 1 REVTEW
                 . ..--.-- ---.-

ARIZONA REGIONAL MEDICAL PROGRAM: RM00055-04

University of Arizona School of Medicirrc

COORDINATOR:  Dermont W. Melick, M.D. - since 1967

STAFF: (FTE) Total - 16                  PrQpOSt-!d :  20

Professional: 11
Other:         5

Professional:   21)
Other: 7

FUNDS REQUESTED:   Total (D.C. & i.d.c.)     $1,351,128

Program Staff (Administrative)
Staff Components  (3)

665,400
389 790
.,-...z-
1,055,130.

Projects:  (3) total                                        -.. 295,938
                               total brldget  - $ 1,351,128

Continuation: 2 - K28, 29
New           1 * 822

             ,
CHP COMME;NTS_ .

CHP comments have been received and have receive-d replies from AKMP,   7% e
one "b" agency that has not commented on the application is the Health
Planning Council of Pima County.

OTNER COMMENTS FOR REVIEWERS ATTENTION:

1.  None of the activities proposed appear to conflict with other FPdcral
  grant programs such as HMO, PSRO, Kidney and EMS.

2.  The Program staff budget includes several discrete activities.  The
  largest of these, Expansion of Health Service Sites, is to devel<)p fi
  network of health services in underserved pri.msrily remote areas of
   the state.  This activity was the result of ARMP's working with CHP
  ereawide agencies to determine areas of need.

DRMPIDOD
WOB 5/21/74


Component

coo0
---a
COOL
coo2
coo3

I  Program Admin.

22 (new)   Reduction of Strep.
        Infec.  in 2 counties

27 (cont.) Hypertension

28 (cont.) EMS

20

Develop.  of Health
Inform, Systems

REGICNAL MEDICAL PROGRAM OF ARIZONA

       Funding Information
oL& yr , #it y,'3'         May request


331,259            665,400
               339,690
                20,100
                30,000

  "--a            88,077


26,945             140,261

37,855             67,600

103,526  *

$499,585          $1,351,128

Connoents

(1) Central Regional Services
  Activities which include:
  coo1 - Expansion of Health
        Service Sites.
  coo2 - Efanpower recruitment
  coo3 - Self provider education

Total amount invested in these
three from 10/l/73 to 6/30/74
was $229,700 for C901;
34,600 for COO2 and 77,000 for
coo3.

*This is from FY 73 restricted funds

WOB- R.Sadin
5/16/74


  NAY 15rl.974                             REQUESTED FUNDS LISTING
                                   COMPONENTS BY REGION
                             .-..             Ocf-74 CGUNCIL

iti1 ZONA         PROG YR 04

IRN           CDYP
-_... -_. ._ _._   .,    N3

C&l

COCL

    co32
-
    coo3


    022

_ .- .__.__ _
          027


           028

..CDMPDNENTS _ 7'

         COMPONENT TITLE                        DIRECT
- _                   _ ^       ..^          REQUEST

PROGRAM STAFF                                       551~823

EXPAN HLTH SERV SITES                              339 9690

EXT MED MNPWR UNDERSERVED AREAS PROG STAFF              20,100

SELF PROVIDER HLTH EDUC                            30,000

REDUCTION STREP INFECTION TWO COUNTIES                  84,255

COMMUNITY HYPT CNTRL METRO AREAS                      140,261
EMS                                              67r600
  .

- .-_ -.          - . .     REGION TOTALS      tr233.729

-.-.-_.- _.. _ _

* ^

. _-

.



INDIRECT
REQUEST

113,577

      0
.
      0


      0

  3,822

      0


      0

117,399


   ;



OSM-PWBOlO-23

TOTAL
REQUEST

665,400

339,690

20,100

30,000

88,077

140,261

67,600

lr351.128



RMP ARKANSAS

e   MAY/JUNE 1974 REVIEW

RM 000 52

e

Request:  $1,830,751

Committee Recommendation:  $1,500,000

Overall Assessment by Individual Reviewers:
The primary and secondary reviewers rated the overall assessment of
the Program as average at this point in time.

Critique:

This Region had been considered above average while it was under the
direction of Dr. Charles Silverblatt.  However, Dr. Silverblatt resigned
in February 1974.  Reviewers were concerned that the present staff would
not be able to significantly expand the Program beyond the current
dollar level of operation.  The Search Committee has not yet recommended
a replacement for the Coordinator but has appointed Mr. Roger Warner in
an acting capacity.  (Mr. Warner is one of the four candidates being
considered.) He has been with the Program for four years and has
demonstrated expertise in the monitoring and evaluation aspects of the
Program. The RAG remains intact with relatively little turnover.
Relations with the CHP, the Grantee, the Arkansas Health Systems
Foundation (EHSDS~Program) and the other health provider institutions
appeared to be most satisfactory.

Programmatic thrusts covering the 10 identified "umbrella activities"
were considered ambitious.  Several new project proposals such as
sickle cell, audiology and stroke rehabilitation were questioned as to
the possibility of obtaining impact in a one-year period. Twelve other
new project proposals were included in the application.

A clear evaluation protocol was not included in the application. More
information in this area is to be expected in the July 1 application.
Also, a clearer staffing pattern is expected in the n&t application.    -.

JULY/AUGUST REV1 EW:
Estimated request as of May 1974:  $800,000

MC0 6/4/74


STAFF SUMMARY FOR MAY 1 REVIEW

ARKANSAS REGIONAL MEDICAL PROGRAM:    RM 00052-05

Little Rock - Univ. of Arkansas Med. Center

COORDINATOR:  Roger Warner, Acting - since 2115174   On Duty Since J~I!Y I t)h'!

STAFF:(FTE) Total - 16.6                     Proposed:   ;! '-I . 0

Professional: 11.1
Other:        5.5

Professional 21.1
Other:       8 .5

FUNDS REQUESTED:

Total (D.C. & I.D.C.) $1,830,751

Program Staff(Administrative)             173,785
Staff Components (10) - 5 new activities     716,715
Total Program Staff & Components           890,500
Projects:  (17) total                 940,251
Continuation (2)                    157,630
New (15)                         782,621

CHP COMMENTS:

e CHP "A" and 7 of the 8 funded CHP "B" agencies have submitted comments.   'Trarisntitt~~
   letter reveals that all activities were reviewed by all CHP agencies since each was
   involved in the drafting of those proposals within their respective iocal juris-
   dictions; is interesting to note that of the 6 activitie-s receiving unfavor~~bIe
   comments from the N.W. CHP "B" agency, the RAG disapproved $ of them and requi.red
   administrative changes in the other 2 before giving them approval; CHP "A"
   prioritized activities which can be compared with the RAG's prioritized !isting.

ITEMS FOR 'REVIEWERS ATTENTION:

.  EMS - Project #82, Burn Center and Project #JO, Q.A., EMS Dept.  Personnel.
might be considered new EMS activities - however, DRMP st!aff has checked-wit11
Dr. Larry Rose and Mr. Reardon and find there is no conflict or duplicntic`rn 1~1
activities being funded with H.S.A. funds to Arkansas.

. HMO and PSRO - no problems anticipated;  activities labeled C072, 71 and ')O deal
with Quality Assurance but are not funded to either HMO or PSRO organizations.

Continuation Activities

. Only one of the seven continuation activities request more than twice the amount
as was funded for a six month period in the l/1/74 award.  Project 1171, Quality
Assurance, Arkansas Nursing Homes had been budgeted for $49,000.  The current
request for this activity is $127,630.

e Target Funding, Amount (140% of the annualized level) = $2,210,742



     . May 1 application requests $1,830,751; expect $800,000 request in July I
    application.


REQUESTED FU

COMPilNENTS BY REGION

. _--    -.-      - . . .      _        06/74 COUNCIL

RRKAFISAS         PROG- YR 05

CONTINENT cow
-__    .- .- .._.  NO _..

COMPONENT TITLE

`CGSO   ADMfhl                                            167,700

CDORD CUAL ASSUR PROG ACTIV
--COOi' LOCAL PLAN PROCESS ACTIV
                                .

Ef4.S SUPPORT ACTIV

COOP HYPT CNTtiL ACTIV

CA SERV SUPPCIP.T AiTIV
\

h2TYRIT IS. SE2V SUPPORT ACTIV

FHYS EXTENQER SUPPORT ACTIV

COOP SYS OEVELcP

HT SERV SUPPljRT ACTIV

QuhL ASSUF? ARK :JUSSG k:CMES

DIRECT     INDIRECT       TOTAL
REQUEST     REQUEST      REQUEST

75*000

140*000

25,000

30rGOO

.SOrOOQ

50rooo

50,000

50,000

150*000

80*000

639300

30,000

1271630

124~925

54,375

54,020

33,475

549950

27rE58

S3rlGO



  6,085

  1,801

  3r352


    593


    730

  1,186

1,186

  1,186

  lrl86

  3,560

  I.915


      0


      0


      0


      0


     0


      0


      0


      0


      0


      0


      0



-. ,-, ,..-_.
-a -_ ,-
                        k

OSH-WB010-23

173,785

  76,801

143r35.2

25T593

30,730

51~186

51,1&6

51*186

51,186

153,580

81,915

63,300

30,000

127,630

124,925

54,375

5c,oto

33,475

54,350

27,ELi

53,lCC

389150


                                   -.------ - .-
c         0
     15rf914                              KEQUESTED FUNOS LISTING
                                         COd?!PONtNTS fiY REGION



52  A!W ANSP. S         PROG YR C5

kIC CCNTINENT     CD!-fP                CO?PONFNT TITLE
- __. I. _ _ ._.  . _ -  Na. -I

                 09(!   C:UAL ASSUK EMERGY DSPT PER;

               091  SCF: hW."NItA PFIYSlOLOG OYSFUNCT
. . A -.-._ . .._ _---- ..-.        -_
               002   HLiH SCf! COUNSEL CLINICS EL6ERLY

094    J?9 ATTITUOE

C'96    EkTERCSTONAL
\

NO CF COMPONENTS     ze

I

SURVEY UTILIZ RN

THRPY PT NUtlSG ED

- -___ _... -. - _._    - - _ _   _ 1    

.                      _

I

C6/74 COUNCIL

   DIRECT     INDIRECT      TOTAL
REQUEST      REQUEST      REQUEST

52;656

98,865

54,645

23,115

9,615

39,552

REGION TOTfiLS

i,a07,951



22,800

oswwaOiob-23

52r656

9a,E!a5

549 645

23,115

9,615

39,552

l.830.751

__ .



RM 000'56

MAY/JUNE 1974 REVIEW
_  . . .   - .   _
Request:   $1,129,608

Committee Recommendation:   See Below                           .

Overall Assessment by Individual Reviewers:  Average to below average

Critique:

The reviewers were disturbed that the Program has not substantially
addressed the problems of accessibility and availability of care
except for EMS, nor have they addressed themselves to the needs of
minority groups with the exception of Project #55, Health Services
Recruitment of Minority Groups, nor to health delivery systems.
-It was recognized that the Program was in a very difficult situation
because they are attempting to provide a program for the rural area
of Southern Illinois as well as the Metropolitan area in St. Louis.

The proposed two new project activities do not appear to conform with
the document entitled, "The Health Needs of Bi-State RMP Region as

identified by Joint RMP and CHP Planning Conference" which met in
February, 1974.  Reviewers expressed hope that the new activities
proposed in the July 1 application will more adequately reflect upon
those identified needs.

Reviewers were surprised that the Bi-State RMP Regional Advisory Group
had disbanded and had relinquished its responsibility to a 15-member
Executive Committee.  Hope was expressed that a larger Regional
Advisory Committee should provide stronger leadership. Reviewers
rated Program leadership as minimally satisfactory.

Although reviewers did not recommend disapproval of Project #54 -
Graduate Follow-up Study, they were not in sympathy with this
particular activity.

Program staff performance was considered satisfactory. Reviewers
felt the Bi-State RMP Program Staff request for additional secretarial/
clerical assistance is out of proportion to the professional staff
complement.

Recommendation:

7.  Review Committee recommended $800,000 which is 63% of the target
and $329,608 under the requested amount.        --

2, Review Committee reaffirmed the November 1973 National Advisory
Council recommendation that membership of the Bi-State RMP Regional
Advisory Cormnittee should be increased in size and become more
  involved in the decision making-process.

JULY/AUGUST REVIEW:

Estimated request as of May 1974:  $410,000         MC0 6/4/74
      


STAFF SUMMARY FOR MAY REVIEW

e    BI-STATE REGIONAL MEDICAL PROGRAM:   RM 00056

COORDINATOR: William Stoneman III, M.D. - since March 1968

STAFF: (FTE) Total - 8.2

Additional proposed: 5.5

Professional: 6.2                    Professional: 1.5
Other:       2                    Other:       4

FUNDS REQUESTED:   Total (D.C. & I.D.C.)  $1,129,608

Program Staff                    553,605
Staff Components                         0
Projects: (17) total                576,003
Continuation (15)                 532,765
New (2)                       43,238

Target Funding Amount: (140% of annualized level) = $1,223,758

CHP COMMENTS:

The Comprehensive State Health Planning Agency of Illinois and tk
Missouri Office of Comprehensive Health Planning ("A" Agencies) have
submitted positive comments.  In addition to CHP comments on pages
99-104 of the application, the CHP(b) agency, Central Illinois Health
Planning Council, Inc. has not qeveloped Standards or Criteria or a
project review mechanism necessary for the review of these proposals
and, therefore, unable to provide the Bi-State RMP with a requested
review and comment.  The May 1, 1974 letter should be included as part
of the application and be considered RS page lC5.

Items for Reviewers

         1.







         2.

         3.




         4.

e

Dr. Stoneman will be leaving 6-30-74.  The KAC Scil rch Commi ttec
has nominated Robert ti. Felix, M.D. to be new Coordinator.
Dr. Felix was former Dean of Saint Louis University, School of
Medicine and former Director of the National Institute of
Mental Health.

Deputy Coordinator, A Stephen Coburn joined staff 5-l-74.

Health needs of Bi-State RMP Region were identified by Joint RMP-CHP
Planning Conference February 7, 1974 and are listed on page 38 of
app? icatioh.

July 1 expected request - $410,000.


MAY 15.1974

RECUESTED FUNGS LISTING
COMPUNENTS GY REGION

_   _. ._-_ ._   .- _ . _ .-_                        06/74 COUNCIL

.BI STATE    P?.OG YR 05

COYTINENT     COW?
-          ._. NE

       `COG0


            017
._.- ._._ .-_- ---..-    -.
            018


            021


            030

._ _. _.. ..-._
             036


             031


             044
_.,.   _-  --..  . ..- 045`  -



             047


             O/+F

_ _   _
          049

C~Y!?PCNENT TITLE

PROGRAM STAFF

EMS

HLTH SERV AIDE EOUC

HLTlj CARE STANDARDS AYBULATORY PTS

CA CHEMOTHERAPY SUPPORT

CC:~IXUNITY 6ASED ttNPd< EDUC COMS3riTIUM

CC~PUTERIZEG 8ClJEL SISTRIEUTION HLTH MNP#R    .,

COMPUTE2 SUPPGRT PSKO

DEV PUS PARTICIPATION EUS PLAN

USE AUXIL XED FEf'.S IN HLTH CTF.

E CGI3:J TCTALS          816,199     313,410    l.lZ9tCC6

DIRECT
REQUEST

3589546

78,807

14t685

2ar086

llt750

49,464

15t439

211075

a.455

42 (340

9,082

17,115

33t954

25;570

15,960

51t623
23,;3CI

20,717

. . . I.











o- t
        .

OSH-PWBOlO-23

INDIRECT       TOTAL
REQUEST     REQUEST

195,059

     0


     0

99910

6t120

12t770

     0

8t272

21380

26,520

     0

6t000

18,14e

2t920


     0

15t920

3,467

5.924

553t605

78*607

149685

379996

17r870

629 234

15t439

299347

l-,835

68,bSO

9 , c L. 2

_.

23,lli

52,102

28,890

15,960

67,543

16,597
\

26,641



lil~ll'  California
    .-- _-_____I -..---.__I

This application requests continued support for staff and '75
ongoing projects.  Based on an analysis of the application alone,
the reviewers noted,that program activities had been developed
around six program goals with priorities defined by the IZAG,  The
staff appeared strong and very active in program development,

.

The RAG seemed to be'a stable group which depended on the well-

*  develcped review process and three special committeesn
  The RMl? has a,good track record regarding continuation of activi-

ties after grant support is ended.

The reviewers were uncertain about CBP relations and had quest-
ions about the effect of the closing of area offices and the        I
elimination of the area advisory groups.

Staff who had recently spent considerable time in California,
studying the review process and CHI? relations, explained that
relations with most of the,CHP(b) agencies were' good but very
strained in the Eay Area and San Diego.  The staff also explained
the long history of the area offices and the fact that the DHEW *
audit recommendation was to close them.  Previous site visit' .
teams had also stressed the importance of stronger central direct-
ion which,is possible under the present organization.
Panel D at first recommended that the application be approved at
the requested level.  Bowever, in its review of actions on 25        .
RMPs, changed the recommendation to approval at the reduced.level
of $7,353,000.  The Committee concurred.

JULY/AUGUST REVIEW:                                 
Estimated request as of May 1974 $5,8_29,533 _
                   WOB G/6/74


STAFF SUMMARY FORLaY 1 REVIEW

CALIFORNIA REGIONAL MEDICAL PROGRAM: RM 00019

California Medical Education and Research Foundation

COORDIUATOR :  Paul D. Ward - since 1967

STAFF :  (FTE) Total - 54                    ?r:>posied :   99

Professional: 38                              Profess i ona 1. :   52
Other:        16                             Other: 18

FUNDS REQUESTED:  Total (D.D. & i.d.c.)      $8,170,374

Program Staff (Administiation)                1,309,727
Staff Components                       29t, 582
                                                        ---. -
Projects : (75)                   -i,601,309-

                   total budget     6,56p,O65
                          $ 8,170,--3~

Continuation: All
New:           None

CHP COMMENTS:

CCRMP has a log of applications mailed to CHPs and comments received.
Negative comments such as the following have been responded to:
(1) CHP "b" coamients on 146B EMS Statewide Data Coordination req*.lest
                                                             --
    the sddition of Staff for all CHP "b"s throughorft the State.
    The objective of this project was to help produce a statewide
    data system by 6/30/75.  The addition of steff to CIIP "b"S a? this
    time would be to plan for new activities which are now not permiss ble,
    It would also more than double the httdget. CHP and CCRMP arc now
    in the process of working out agreements.

(2) 146E - Central Valley EMS. The Project Dircct.or and the Central
  Valley CHP "b" Directorand Mr. Campbell, the CCRMP Coordinator for
  EMS, are now rewriting the objectives and restructuri.ng the proposal.

(3) CHP had negative conxnents on 8111, San Bernardino hs/ea; #112 S.rln
  Diego hs/ea and 8105 Santa Clara hs/ea.  A letter of understanding
  has been worked out between #lo5 hs/ea Director) and the CHP involved.
  Program audits have been conduted, as requested by CHP, on projects
   111 and 112.

    All the above CHP comments were heard at the tic mee1:i.q: on Apri.l. 17, 1.974.
    The RAC reconnnended that all appeals be in writing; that they, be presented
    to the Evaluation Committee of the RAC which meets June 4, 1974; that all
    involved parties be present at that meeting to rlresent their case. As
e  noted above, the issues are being worked on by staff and may be res<rlvc*d
    before the meeting of the Evaluation Committee.


CALIFORNIA SUMMARY
Page 2

OTHER ITEHS FOR RE'JIEXERS A`l?TENTION:
             -

(1) The budget request far #LO4 Redwood Health Consor! i vrm SPC~~W 1. i ~`ii
  compared to the first 6 month request.  Therrr are Gc!rsl reasocls
   for this - a)  former project f/275, Family J'racti.cc, I'CSF has heen
  added to the budget of project #lo4 for two months (b) a project to
   train Indian health aides in Eureka has also heen added to #104,

(2) The budget request for 146A EMS Regional Coordination is hei ng r~rliicccl~
                                            -l_---_--

DRMP/DOD
wnn-s/17/74


-.__ -_-- -.-- -

I___----I ------1__-_---
.-w ,e
        H&Y 15.1974

19 CALIFORNIA

          

PRCIG YR 06

REQLIESTW FUNDS LISTING
COMPDNI-NTS BY REGION
    Ob/?4 COUNCIL

._  WESTEI;(N           COPP               CO?IPCNENT TITLE                       DIRECT     INDIRECT       TOTAL
                   NC                                                REQUEST     REQUEST     RECUEST

           coot


            009

          GE3

           CR6A

          OR-T&

          067D

P90GRAM STAFF

COMPRE CARE RESP DJs PTS
-FREE CLINIC COllRD      .

KIDNEY 01s INFOK t EVAL S'fS

GREATEI? L A ORGAN PRUCUR

RFG TRANSPL .

kEG TRANSPL & C)RGAN PSOCUR
-G,FG ORChN Pi?OCUR

c.Ft TSAIJSPL E nRGAN PROCU"!

Sk'i d"ki!:XV VAL tit.TH tf?NS!X'TXUM

l,BOLr319

  16,079

  81559

  24,646

  2~145

  2r300

  2,628

  3,227
4,9;1

  2,467

  3,439

  2,368

  25,007

  59*080

426 ~242

396,790

164,500

221,550

238,430

211?000

2BO?63U

146t334

   0

51499

   0

   0

  078

le173

  210

1,104

It699

T72

lrl76

   0

3ra01


   0


   a


   0


   0 ,

   0

   0

   a

   6

   Q

1,6Olr319

  211578

   St559

  24rb4b

  38023

  3r473

  2,838

  4r331 ,

  6,650

  3,239

  4r615

   29368

  2E *cv"s

  59rCRO

426,242

39t:*7$5

164*560

221$555

238*(r3C

ZLlrCSO

Z1;.Ctci3R

t46r334


                                        1
a 25.1974

19 CALIFORNIA

COflPONENTS BY REGXiN
  06/74 COUNCIL

`dE STERN
     ..- . ~ -_ _ _



PROG Y? 06 '

CO?IP

COMPONENT TXTLE

SD SAN JOAQUXN VAL HLTH MNPWR. CUNSDAtIWM

TEL HEDo

-SUPERjOR CALIF HLTH YNPWR COUNC1.L
POMONA i SAN GABRIEL HS/EA,
QUAL CARE ccm~

PT CARE AUDIT

PRO6 OEVFLOP
EGUC NbRS6 ASSESS
REG PIED itECDR# ADHIN `COORD

QUAL CARE

                  _._ __.   ._ ,_
&AL CARF RFG EtUC

ciUAL CARE REG E@UC

WJAL CAilE RtG EGUC

OUAL CAkC KEG ESUC
`PT CAKE APPRAISAL



145M 4  OUAl. CARE REG EDUC

145N -ClJAL CAKE RLG E-DUC

1450 .  WAL Chkt! KEG EDUC

14&A   REG t'JOQ.fj E;:S

- .    _

lirh.3   s7ATcdICE DbTA COLLECT & REGIONAL12

141;o   SbNTA CLAkA EMS

DIRECT     INDIRECT
REQUEST     REQUEST

118r030            a

10,337           0

200 9450         . 0

118,048            0

129~164            0

336r216      9q?b-?

2359872      55,195

163a373            0

60,lll      16q312

681804      25,716

66,848      14r03r3

69a460      140726

76r600      26q 197

70qOOQ      5qboD

76#537      13,777

tioqo44      llr847

66,490      22r569

67~863       13r255

789636       69291

2159840            0

17be2f.36           0

42,430          0

OSH-F'WBOlO-23
"orf -

TOTAL
REQUEST

118q030

10,337

2OOt450

118~048

129,164

345~983

291~067

1639373

76r423

94t520

60~886

84,186

102r797
75r60ij

9cq314

91,891

89q059

81r118

84,927

215rti40

1i'CtZhb

42,430


REt2uksTEDe s LISTING

CCMffCNENT% BY REGION
  Ofi/74 COUNCIL

COHP                COMPONEt'iT TITLE                         DIRECT     INDIRECT
NO                                                  REQUEST     REQUEST

14bE   CENT VAL EMS SYS DEVELOP                             113rooo

146F   INY3 MONO EMERG HED CARE
   __-
14hG   EHS DFVEtnP

14hFf   BAY AREA ME0 SERV

1461   t A COUNTYWIl?E EMS
146J                                    -
     LrnilG OEACH MORL E%ERG UED CARE

I4tK  C!4S TRNG HO3L ,

14&i   6RNc CLINICAL INSTRUCTORS` EMERG CARE

35 r480

65,566

82,392

212~303

52,566

112r000

18,252

--.-._.. - ____ __...
           146Y   YED HGMT AUbIT HOSP EnERG DEPfS                   ' 92,625

           144N   CALTf EMS CDtf'UYER EnUC                          27rQ59

            1460   E-ERG CARE CRfTTCeLLY TLC NEWWRN & PEPlATRTC PT         681ir85
- -~.-...- .._
           1474  `HYPT coni32                                   15Er92-t

             1473   PITTS3UkG HYPT CttTRL AND EOUC                       12f564

            14x  MODEL HYPT EDUC AMRULATCkY CARE                       12tooo
-.-.`L--- . _.
              147F   HYPT 0ITF.L 13 RURAL CNTY                                4*400

             147r(   CCIfl~CAt CDUC SYS HYPT CNTRL                            14,409

             147J   IWI?UV HYPT Ci!TQL VOL ACT                              141433

          147v,   HYPT AM(;NG CHINESE AKER                                 41900

f47L   HYPT CNTiL STI~UCATING CO?`.PtXANtE                        4rl65
     *

147"1   Cctrwr:I TY t-fYF7 XNTE~VENTICN                            13 r270


?47N -HYPT TANG CLINIC                                     2~157

1470   HYPT CLINIC riOME FOLLOW Tl-.RU                           51,626

    0


    0


    0

4s 828


     0

9.462


     0

lr460

    a

    0

281362

    a

    a

    0


    0


    0


    0


    0


    0


    0


  172


    0

TOTAL
REQUEST

113rooo

35r480

65r566

87,220 '

212,303

62,028

112r000

19,712

92,625

07?959

97,6cr7

1521927

lir,5tb

12*000

4r4GO

14r409

14,433

4,900

4* lb5

13,273

5,329

51,826


147P

                14711
.- .
                 I47R

                147s

                1471
   

               ,    14F


. . i!                  I.49


                 150

1 5 P

1152

$!YPT CHYLDREN c YmJTti

YYPT CNTRL

FXTEN(1EO HYPT

I

t-iYPT t PALO ALTn/nF?lLO PMK

CUMtW41 TY COilPD CCILIIIC IL HYPT CNTRC

5tCTIGN 1122

SO CENT-L A HLTti CUNSORTZUM

IYGLCWOOD CENTINELA SO BAY t4AREOR WS/EA

Jl-'.ANGE C:qTY LONG !3EACH WS/EA

TRI CNTY CHP COUNCIL

      REGION TOTALS

DIRECT     INDIRECT       TOTAL
REQUEST      REQUEST      RECUEST

11 to13

11~964

7~924

12,388

. \0~074

100,000

b54,030

6?944

9,100

8,750

     0

     0

     0

     0

     0

     0


     0

1,390


     0


     0


,73)-r&76

11 to13

11~964

71924

32,388

10?094

l@Of 000

154-r 033


*

     EMS Component; " .'     05 yr.

a .146A              I -an aaK1

      B  EMS -Reg. Coord. 10/l/73 1;~7~9
        Statewide data Col.         0

Page 0    .

     D
     E
     F
     c
1~     Ii
   . I
  :
     L
     M
     N

C
E

Ind.Cli.' '83'
Venturr   100
Sec.1122 148
Resp.Dia. 69
Tel-Med   137

     86.4
     87A
o     ???
     a7c
     87-d
     871
     875
     87X
     89A

1

Santa Clara MS
Zentral Valley EMS
Inyo-Non0
:entura
Bay Area       .

>.A. County
,ong Beach .
EMS Training     'I
Training Instr.Drew
Audit Hosp. Em.Depts.
Consumer Educ
Critically Iii Newbor b
feLnhbarhoo.d EMS      .
                  I

20,345,
67,730
18,180 .
31,084
32,643
75,000 .
55,252
50,000
25,000 , .
35,000
14,179
-o-
65,248

,     Total  I     504,590

          Begin date
REAL-i-~ RESOURCES I  l/73     .48,995
PUNNING   I  9/71      56,027
"AcceE8"       10173     12,000
            9/71     49,789
           l/73 71,716

22,270
25,017
70.000

19;910
31,000

Total             238,527     168.197

  KIDSEY      i Begin date
Info. h Etral. System 1   9/71
Greater L.A.Organ Pro@. 9171    106,886
                      37,484
Reg.Trans. L'CSF
tl 11            9/71    42,171
         USC  i   9171    45,280
II  u Organ.Proc.      9171    48,093
8,        irvt
  " Presv. San Diegp  9171
          i 9/71    47,578
I,  " Proc. USIA             49,712

.68,805        24,646 (2mos.)
8,361          3,023    "
11,506          3,473
8,513         2,838
13,123          4,331
15,654         4,615
11,299         6,650
8,576          3,239
6.663          2,368

I  10173   ..61934
  9/n     42,510

Total         426,938

Ital-$3,937,316    Total-$8,170,374
   l/74 (MIS)

06 yr.
'71,951
78,800
-0 -
-o-
-O-
-o-
-o-
-o-
-o-
-o-
-o-
-O-
-Q-
50,000
-o-

215,840*
176,296
42,430
113,000
35,480
65,566
87,220
212,303*
62,028
112,000
19,712
92,675*
27,959
96,647        I

200,751      ,X,4.56,743

150,000

Comente

EMS Coordination 146A budget was predicated on
14H dollar award.  Budget will be reduced.

1461 - This is the second phase of this project
    It includes all of Loa Angeles county at-8
    has the cooperation of CHP plus the L.A.
    Board of Supervisors.'

146M - This started with the northern hospital
     council.  It now has extended to includ,
    the central and southern hospital count
    to do data analysis of hospital emergen

May rec,uest

8,559 (2 nos)
28,008  (2 n-1
100,030(12 nos)
21,578 (2mos)
10,337  (2 mos)

168,482

55,ia3

Project 100 - This two month requeet is for me
        than level funding.  Budget vas
        back during phaseout and was non
       approved at a prephaseout level.

Except for 87K Regtonal Transplantation at 5%
all other Kidney projects wi:l have had 3 year
funding by g/31/74


 8

          $0.
- _

       147A

           D
        i   E
          P
          I
           H
           J
           K
           L
           H
           N
           0
          R
          S

     Q
s--.- I
      P

:
  .+ ;

    il45A
       B
       C
       D
/.       E
I .
I        F
       G

11
I

o ?        3
          K
  i        L
'.        M
         N
  I        0


. ::
,I
.e .
.:
c

Co~sor.ent :
ikein date IO/l

HYPZRTTKSION Coor,
" Cont. Pittsburg
  " Educ.-Arab. Care
  " Cont. 13 rural (
  " Coord. Count. L
Clin.Educ. ".;. Vail,
Voluntary Action
IIyp. Chinese-America1
" Control-Santa Cl.91
Comm.Intervention
Trng,.Clinic-Drew
Home follosr-thru
Dependency Prev.
E. Palo Alto
ontrol - Drew 1
Hyder.   .-. _ - -
    in ChFLdrene

Totals

Cegln date 10/L/73
Q?&ITY hSSLW.X:CC (
Pt. Care Audit CbiZ?i
idv.Works.-Pacif.Med,
Nursf ng Audit CXA
kd .records librariar
Stanford Comp. Deta
3er!tely Schl.P:B.
Iavis-Ed. Conp.
JSPC Component '
)rcw "
Irvine " +
JCLA Schl. P.ti., : . .
XL4 Med. School
Tan Diego
TE"

`
     Totals

3






n.
.









.__

OS vr.

17,370
35,965
33,soo o
18,500 .
27,595
41,520
41,487
-o-
-O-
-O-
-o-
-o- .'
-O-
-o-
-o-

-o-

2X6,237
.

rd. 45,000
  -o-
    -o-
  79..959
  25,000
    -o-
    -o-.
-o-
. -0.7



. 149,959

06 yr.

84,630
-o-
-o-
-o-
-o-
- 0 -
-o-
~14.650
13,147
33,174
16.636

52,068
24,958
.42,520
37,697
33,040

352,520   I

60,000
171,565
149:375
-o-
-o-
39,';30
34,308
L;n,000
40,000

  35,921
  39,971
39,987
40,475
  39.971
40,000

771,47i

,

b!ay request

152,X7(12 nOs
1122, x&2 y.
4:400 "
10,094 "
14,409 "
14,433 "
4,960 )1
4,165
13,270 "
2,329 "
51,826 ,;;
7,924
12,383 'I
11,964 m
11.013 m

j40,hOS

129.164
345,933
291,067
163.373
76,423 s
94,520*
80,856
84,186 .
102,737*,
75,603
90,314
91,891
89.059
81,119
84,927

1,981,308

-1's" `
I)    .

Cormnts             _ i

Except for 147A, all hypertension requests are for
two months only.  The Hypertension Program Committee
requested that all proposals be rerevieved.and     ,
resubmitted July l/74.

:t *

            .
            .
            . .
e

,145P,Im ceflect high indirect costs
to the universlties.  H-ever,  these are
DHFZW negotiated rates.


              .
    Cc=~ont?nr 3
  HS/ms
R. Cxeer Retention
Redwood RS/ea
Santa Clara
San Joaquin Valley
San Fernando *I
Is&L. A.
San Xereardlno
San Diego
hs/ea Coordination
Kern Co.
Superfor Calif. .
lhmna
South Central
fnglcwood
Orange Co.
Tri-Counties ' .

Z.CCtiiS to cafe L..P.,
    ioCa?S

Prograz Staff




   :   . .
      . _'

  04y r.
Begin date ?/l/72

  793,759
  273,533
   60,131
  269,367
  157,406
  14L?,290
  20&,650
  112,136.   .
55;525
   65,351
  54,434
   -o-
  .  -o-.
-0;
-o-

,2,211,563

    05 yr.
   10/l 173
28,054
   -o-
   -5-
78,000
   -o- :
   -o-
It;, CSQ
133,000
101 .coo
EO.OG3
95,895
8S,OGO
73,000
  -Q-
  -5-
  -o-

- * 753.995

2.283.501

c

06 1-r.
11x174
-o-
145,943
1d:,m
`-o-
105,000
68,717
-o-
-o-
52,000
-o-
-o-
-o-
To-
25.CC3

25:GOO/
25.C33
3?4,6%w
1,029,aeo \: .,

1

-.

          :

Kay recuest

59.,oao 8 '
426,242
393,790
164,510
221,550
233,430
211,000
250,630
146 334
.115,030 '
200.450
lL8,048
154 ,C?O
  8,334 (2 nos.
  9,:oo (2 30s.
  8. 750 (2 IT.?+,.

2,763,,378

1,601,309 )
I

.'

            Conx?n:s
. .

(I) Budget requests ate approxfcately 2117.
  of the 1st 6 Ironths budget for each ?.s/ei

n(2) 6104 budget includes forcer project ;?27S,
  Facily Practice, Ll of C uhich hs Seen
   transferred to the Redoood hs/r;! for fvo

(3) $105 includes a $164,030 subcontract.
Applicant vi11 mail odditiocal icforcatic
(4) i-IS/U cotxittce eectieg Yay 15 vi11 SOSC
  likely trltz.budge:s.

+(2j liltI bndg& COY incluc'cs a indfan health
   trainbg activity in Eureuka. (6104 regu,
   $350,000 : the rest of the budget if for

\

There are a total of 75 prefect acrivirics.

:                  - -'

or* tit of ,FY 73 restricted funds.


CCRMP MAY 1 APPLICATIGN - Staff Summary

Executive Director -   Paul 3. War:] - has be.on with REP
                     since 1967

RAC Chairman

C. John Tupper, M.D. .i&anl U.C. %.vi.c;
Chairman for one year; Vicnc Chairman
for three years

Grantee

California Medical Education and R?se;-rch
E'oundation

Fundinq History

L/1/74 - Q/30/74 - $3, 938, 316  ( ~llCll!C.l~~S
$340,910 unexpended funds from 05 year
plus FY 73 restricted funds of $ti7'7,651)

l/1/73 - 12/31/73 - $3,453,274

FY 73 annualized budge-t prior to phase-
out $8,700,000 (10.96% of all IWP funds)

e Background Information

CCRMP has been on triennial status since August 1.971..   Prior to
June 30, 1974, the organizational  structure consisted of :iin2
area offices,  one at each of the medical schools and a c:i.!n :: (-`I 1.
office in Oakland.  CCRMP had always been considered an inno-
vative avant-garde region with a 70 percent record of con~Cn~-;:ion
funding from other sources after RMP funds have been tcrminat,::t'l.
However, there were some concerns identified by an HZ%7 audit
team,  SARP and others.

CCRMP had the capability of becoming its own gral!'l-ce an':2
did not require CMERF, which served only as a fiscal agel;.L,
to be the grantee.  (2) CCRJ%P RAC was too small and JXCI~
representative enough of the Region.   (3) RAC rcvicwetl
projects on an individual rather than on a proyrammatic
basis.  (4) CCRMP was sometimes unaware of projI'?ctt-'
being developed in the areas until they reached the :;i:C.
This sometimes resulted in the unnecessary expense 02
developing projects that were not feasible.  (5 ) Tiler-2
was inadequate coordination between area offices and


`>
.

lack of attention to regionwide impact 02 proposals.
(6) Proposals were not being monitored and evaluated or1 ct
systematic basis.  (7) CCRMP had decentralized most manac_icment
responsibilities to the nine area offices and permitted th~rr!
to operate with minimum central cjuidancf?, direction or
coordination.  (8) CIIP and RMP relationships were a proi-)lcm
in some areas.

The abolition of the nine area offices 6/3rj/73 resolved those
concerns (4, 5, and 7) relating to the area offices.   RAC memh<::r-
ship was expanded from 35-44 and the nine additional members are
representative of the former areas.  The present LRAC includes
seven members of the public.  All proposals are now reviewad on
a programmatic and regionwide basis.  An Evaluation Committee of
the F!AC has been established which rev' L~~~ all ongoing activities
and a director of Evaluation has been added to central staff to
assist the Committee,  CHP-RMP relationships are being addl:r!ssc<i.
(CCRMP has established a system for the logging in and aclcnow-
ledgement of CHJ? comments.)

e May 1, 1974 Application

CCXMP is requesting $8,170,374 for the support of program stafif,
the continuation of ongoing activities in six program areas ('75
projects) and for the planning and review costs of two new
programs,  arthritis and access to care.  The July I applicatior!
will request approximately 5.8 million for the support of new
activities, which would bring the L'CRMP program level for F1' 75
to approximately 14 million.

The progress of each continuation activity submitted in this
application has been reviewed by a Regional Pro<;ram Element
Committee and the Evaluation Committee of the Kit.   Recomend-
ations from these committees were then considered by the E:reci:tivc
Board of CCRNP and, finally, by the full RAC on April 17, 197%.
Both the Executive Committee of the RAC and the RAC have met
five times during the past 12 months.  (See aforementioned report
for complete description of the CCFMP review process.)   CCrnIP
review process has been certified.


.

@ Proqram Staff (Section III)

Application request is $1,601,319 for program staff.  Th i :';
i.nclu%es 70.75 FTE positions for core personnel, an I;nc~.'c?ase
of 19 from the l/1/74 request.  Core personnel include central
office staff,  northern field office staff and southern field
office staff.  Some of the CRMP staff who are involved in
regionwide coordination of program elements, such as Charl.es
rl;lhite, Ph.D. for hs/ea's, Sam Sherman, M.D. for Quality Care
and Adelbert Campbell for EMS, are not included under core pers-
onnel but.are reflected in the budgets for those specific program
areas.  Key staff such as the Deputy Director and Director of
Program Planning and Evaluation have been with CCRMP three ye:lrs
and one and one-half years respectively.

Included in the program staff budget is approximately $140,000
for feasibility studies, which were reviewed by the Proposal
Review Committee and approved by the RAC.

Goals and Objectives

Following the broad program areas suggested by DEIEX for the
RMPS, CCRMP defined its qoals for each program area and deteirmined
percentage of effort to 40 into each.  The Regional Program
CommitteE then set up specific objectives for each program
element.  The program elements which CCP!IP inc;.udcd in this
application are health manpower, quality of car?, EMS, h.i~.til
blood pressure, kidney disease and assistance to CfIP with t11r>
implementation of the "Section 1122" program.  The procjram ~l.tc;--
ment addressing access to care will be included in the July J.
application.

Health Manpower Element (Section IV)

Request is for $2,763,378 to continue 12 projects for an addi-
tional 12 months and to continue three projects for anotl~z
two months.  Eleven of the fifteen requesting continuation sup--
port received initial fundinc; through FWLPS earmarked funds Jul.1 1,
1972.  Fourteen local consortia have been formed,  ten of wl:.i.cI~
are incorporated;  four are in the development staqe.   ip 11 c)  ;-;&j-e-.
wide project coordinating the hs/ea network of consoctia i1c7c
been used to improve the manaq2ment capability of the hs,/',?a'r:
and to design a statewide data and manpower in'c~ell_igence :-,ys.lcn,.


e CCRMP has invested approximately $3.35 million in hs/en's in
   the past two years.

CHP concerns regarding projects 111, San Eernardinc) hs/e~, 11.2,
San Diego hs/ea and 105, Santa Clara hs/ea were discussed at the
April 17,  RAC which decided to defer action on thz a?:ove proposal";

until these issues were resolved.  This has been accomplished
by letters of understanding between hs/ea project directors and
the CHPs in those areas.

Quality of Care (Section V)

Request is $1,881,308 to continue 15 ongoing projects.   .Prior Lo
phaseout, CCRMP had funded a pilot project in Area I for one
year to develop medical audit workshops. When supplemental
funds became available in the fall of 1973, CCPNP formed a
Program Committee on Quality of Care proposals to develop rfoals
and to monitor funded programs.  This resulted in the submission
of 15 projects which were funded between 10/l/73 and 6/30/74,
for a total of $921,433.  Activities included a Regional Planilin<i
and Coordination Project,  four projects involving patient care
assessment by various health professional organizations, ;ind 10
regional education program development projects sponsored 1);
the medical schools and schools of public health.

The Evaluation Committee of the RAC recommended approval of
the continuation request with advice to reduce the indirect cost:
of many of the projects as well as some of the other bud:;et
requests.  These budgets will be negotiated by CCRMP grants
management staff and the contractor.

Kidney Disease (Section VI)

Present request is $55,183 to continue nine on.going projects for 1' l,r(3:. (
This will provide time for a thorough technical review of tlx::
entire CCRMP kidney program including new projects that may ?E
submitted July 1, 1974.

CCREAP has funded kidney disease projects since September, 1371.
The kidney program was CCRMP's first regional approach to a pro!!j:arn
element using a Statewide Program Kidney Disease Committee to
propose guidelines for the RMP to pursue.  Except for 87 K :*-
ional Transplantation at Davis, all other kidney proposals


.I.

will have had three year funding by S/31/74.   C'ItMP I2a.s d'?VC I-
oped a dialysis cost analysis study which the Social Security
Administration is interested in and is developing a similar
cost study for kidney transplants.

EMS (Section VIII)

The EMS request is for $1,360,096 to continue 14 already funded
projects until 6/30/75.  CCRM.P received $100,000 in EMS earmarkc:.i
funds, 7/l/72 - 6/30/73, for two projects, #91 in Ar-,a VI and
#92 in Area IX.  Two others, #123 in Area II and #I40 in Area IV
received l-year funding out of regular grant funds.  However, it
was not until the fall of 1973, when supplemental funds became
available, that CCRMP embarked on a major EMS program effort. A
committee of 15 persons has guided these EMS programs and estab-
lished priorities of: regional coordination support,  the develop-
ment of community councils, development of systems criteria, con-
sumer education programs, and health impact evaluation.

Of the 14 projects, two are Statewide; six are concerned wi-tll
county level development of %M$ systems;  seven have training
components and six include consumer education.  Since 10/i/73,

approximately $710,000 has been invested in EMS.

The CCRMP Evaluation Committee endorsed the recommendations of
the EMS Program Committee recontinuation support except for
Project 146-O - Emergency Care Critically Ill  - Newborn.   'I% c!
applicant, Stanford University, has appealed the decision of
both the ad hoc Technical Review Committee and the Program
Committee to disapprove this project.  This appeal will be con-
sidered at the next meeting of the Evaluation Committee on
June 4.

CCRMP has received more CHP comments and concerns on &MS than ar!~'
other program element, particularly on the two Statewide pro-j?cis,
#146A and #146B.  IZMS Statewide Coordination, #146B,,is housed in thi:
State Health Department in Sacramento and the Areawide agencic>s arc
concerned about their roles in this EMS effort.  They have requ ?s-t:icl
that CCRMP pay for a staff position for each of the "b" agencies.
This would more than double the present project budget.   .kt its
April 17 meeting,  the RAC directed that decisions on the state-
wide projects plus #146X Central Valley JMS., be deferred ulltil
the issues have been resolved by the parties involved.   1-t
requested that appeals brought before the Evaluation Committee

be in writing.  Division of-Regional Medical Programs has  since


been informed by CRM.P staff that the issues raised Ly CZ may
be successfully resolved before the June 4 meeting of the
Evaluation Committee, at which appeals will be heard.

Hiyh Blood Pressure Control(Section VIII)

Although CCFWP has previously funded several small feasibility
studies in hypertension, this has been essentially a new program
area for California.  A Statewide High Ijlood Pressure Council
was formed last fall, which decided that projects in the followin;
areas would qualify for funding:  (1) establishment of community
councils for HJ3P control (2) organization of ambulatory care scrv-
ices to manage persons with ilBP and (3) development of innovative
education and training programs in HBP Control for consumersand
providers.  Sixteen projects have been funded between lo/73 and
6/30/75 for a total of approximately $570,000.

The present request for $340,608 is to continue this  statewide
coordination project for 12 months and the others for just another
two months because of the decision by the High Blood Pressure
Control Committee that all project sponsors submit new proposals
for complete local and technical review before the July 1 review

* cycle.

   Section 1122 Program (Section X)

Since September 1973,  CRMP has been involved in a State :lc;lltll
Department Task Force study to determine how Section 1122 of
Title Xi, of the Social Security Act should be implemented.   It
has invested approximately $82,000 to date in this effort.   :j'hc
Program Evaluation Committee of the P&C has recommended that this
activity be continued from 7/l/74 - 6/30/75 at $100,000.

Access to Care (Section IX)

This includes a request for $168,482 for continuation of Section 1122
for 12 months and two months continuation of four ongoing projects:
#69, Respiratory Disease; #83, So. California Council of Free
Clinics; #lOO, Ventura Health Network and #137, Tel-bled. Projctct
69 reaches the end of its 3-year authority August 31, 1974.   ?'he
others may request additional extension on July 1, 1974, in which
case they will have to undergo new review and evaluation.

WO,'5,'16/74



Critique:  Reviewers found the CNYRMP RAG to be active and effective.
The Region was noted to omit its Goals and Objectives from its current
application and presented its program in terms of thrusts.  The
present number of staff relative to the multiple number of activities
raised serious questions concerning the Region's monitoring capability. .
However, proposed staffing patterns seem adequate. The Region's
accomplishments in the North County in reference to recruiting sixty
physicians was cited as a remarkable gain.. Also the local matching
identified in the CNYRMP l?MS activity was consider&d deserving of
credit.  The hypertension project's lack of CHP 'comments was found to
be an oversight on the part of the Region and will be corrected by the
next submission. .                                      

                                                     

.                                   









-.

JULY /AIJGUST REVIE\J
JULY /AIJGUST REVIE\J

Estimated request
Estimated request
      \. \.

as of May 1974: 1,150,000


RM 00050

CENTRAL NEW YORK       Regional Medical Program

Coordinator:  John J. Murray                   On duty since:  1972

Staff:   Full Time Prof.                 5

      Part Time Prof.                  1

Full Time Other                  2


Part Time Other                  1
             Total            9

Funds Requested:

Total  . . . . . . . . . . . . . . . . . . .   796,986

Continuation.......U....  (444,755 1

Proposed:

8


1

3            --I

1

13

New....,...,........L....  ( 36,284 )

Period of Time Requested:

All projects core and activities are requested until 6175.

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


.

RMooo50
Central New York

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.
1, Although Project 22C EMS Communication was funded at $107,250 & g9,455,
the Region is requesting 147,515.  The Region now plans to equip rad  OS  in
volunteer and rescue squads.     *2. (See Below)     F
HMO project:      NONE                                        I

EMS project: All facets of the EMS Project 22B, C, F, request increase in
funds.

PSRO:

Kidney:

NONE

NONE

CHP comments: Note:  No CHP comment received on new Project 57 Model
Hypertension Program.  The Coordinator indicated this as a core staff
activity and felt it was not new to the region.  It should however,
had CHP comments.

"2.  Projects j/35,36,37 (mis. numbers 58,59,60) - Health Education Network.
If one refers to the region's efforts in continuing nurse education, as noted
on 15 of the application as the forerunner to the HENS and if one analyzes
the core staff budget & project efforts, the following funds have been set
aside for these types of activities:

Proj. 1 Nurses Continuing Education
COO1 Program Staff Community Based Manpower
Proj. 18 Area Health Education Cooperatives
Proj. 30 Health System North AHEC
Proj. 45 Health Education Network

$639,500 s.t.
31,047
109,024
30,104
52,382
222,557 s-t.
*Q&3 nr;-l +        f---*lA \


RM 00050
Central New York

e   Continued

To invest an additional (19,296, 18,295, 28,000) $66,221. to support projects
which should have been developed a few years ago, most of what they proposed
to do now would seem to be an unwise investment.  The thrust of each project
also appears to have deviated from the major mission of DRMP health service
education activities.


CNT NY SYR       PRDG YR   06

ERN          cow
- ..-  ..- .-^ .- _...._  NO _

coo0

022R

- --.-_ --. . . ..- _.. _
       022c`-

.-
  022F

040

--I-    --- ___
            044
~. --....__.
-     .- -   . OS5   .


          _
           056
- --- - ..-. - -.  057.  -

            058
_
           059
.  .-.__- __._. .._._
       060 ---

COlr,PONENTS 12

---- .-- _----._. _-

.

REQUESTED FUNDS LISTING
COMPONENTS BY REGION

06/?4 COUNCIL

COMPONENT TITLE                        DIRECT

.     -          REQUEST

PROGRAM STAFF

EMS R COUNCILS
EMS C kADI0 COflHUNICATIONS . ..
~PRT

GEORGETOWN SATELLITE CLINICS
-COUNCIL COORD HLTH SERV .

NO ~IXJNTRY CHILDREN'S CLINICS

ADULT SCREENING EXTENSION CLINICS
MODtL. HYPT COMMUNITY
NO COUNTRY HLTH ED& CONSORTIUM

NY PENN AHEC
ioiiAWK VALLEY HLTH 'ED&COUNCIL

- __-.-_- -. . ._-    _    ._ _

248,486

                   861065
.-  .   _    .._      '147,515

41t331

27*000 I
24~386

29 *zoo

           23,037
   _         . .
           30,880

28 rOOD

                  18,925
_-                 19,296

REGION TOTALS      724t121

INDIRECT
REQUEST

6fr461


    0


    0


    0


    0


    0


    0


    0

5,404

    0


    0


    0

72,665

OSM-PWBOlO-23 '

TOTAL
REQUEST

315r947

86 9065

147t515

411331

27,000

24,386

291200

23 t 037

369284

28~000

18t925
19~296

796,906


a


. .                              .' .                       nrn.    ""#"I UU", rr.y"lllI,,r
                                                             -
,., .
: . ,.. .

.`; .                               RM 000 40

           1974 REVIIIW                 . .
                                       :
                                      
-_ _,.'.'
    Request:  $1,879,646

         . .

      Cornn$ttcc Recommendation:    $1,587,644

Overall assessment by. individual reviewers:    Superior - Above Average

          .

I. ,'
. .
. . .
.
Critique:

The Committee concurred with the staff analysis that Dr. Thomas Nicholas,
Executive Director, has provided excellent leadership for the Program.
Past'performance of the Program has been very good. The goals and objectives
have remained constant and have been adhered to by the Program. Health
resources within the region have been utilized and projects are directed
toward health resources planning.  This was considered a commendable feature
by Committee.

Concern was expressed regarding theccancer activities in the application,
especially Project #48, Colorado Cancer Registry, which had been funded by
NIH through June 30, 1974 with additional funding anticipated from NIH in
the late fall.  The kidney projects, #29, Pediatric Hemodialysis Center
for Zhe Rocky Mountain Region, #47, Diagnosis/Treatment, Kidney Stone Disease,
and #50, Pediatric Nephrology Center, raised questions as to any overlap of     ,
activities.

JULY/AUGUST REVIEW

Estimated request as of. May 1974:'

$227,000

MC0 6/4/74


c      I

                 STAFF SUMMARY FOR MAY REVIEW

Prepared by: M.E. Murphy

COLORADO/WYOMING REGIONAL MEDICAL PROGRAM: RMP #40

COORDINATOR:  Thomas A. Nicholas, M.D. - since 7/72

STAFF:  (FTE) Total t7.63 (18 persons)

Professional:  13.63 (14 persons)
Clerical:     4
Requested pos itions:  6 (5 Prof., 1 clerical

FUNDS REQUESTED:

Total (D.C. + I.D.C.):
Program Staff:
  Staff Activities:
  Staff TOTAL:

$1,879,646
673,351
1,012,271
1,685,622

Projects:

        Continuation (2): 98,191
       New (13):      769,184
        Projects TOTAL:   867,375
0 CHP COMMENTS:  Received from 'A' agencies in Colorado & Wyoming and responded
            to by RAG.  Both agency directors sit on C/W RAG. Two funded
           'B' agencies, Big Country CHP Council, Inc.(Montrose, Colo.)
         and Denver agency (without a Director). Big Country CHP Director

CONCERNS:    on RAG, also,, And comments good.
1) EMS Activities:

COO5 Quality Control for EMS, Rural Areas -     15,000
COO6 Regional Planning for EMS, Wyoming    -     25,000
COO7 Regional Planning for EMS, Colorado -     35,000
COO8 EMS Systems Development, San Luis Valley -   35,000

2) Kidney Activities:

f29 Pediatric Hemodialysis Ctr.,Rocky Mt. Region: Continuation   60,000
#47 Diagnosis/Treatment, Kidney Stone Disease: New          35,511
#50 Pediatric Nephrology Ctr.: New                    23,510

Target Funding Amount (140% annualized amt.)    = $1,543,284

  Application request ($1,879,646) is $336,362 above target figure.
Anticipate July l,+)q&&request of additional $227,000 for 4 new activities.


`      .

Mid-Continent Operations
Staff Analysis: Mary E. Murphy

Colorado/Wyoming RMP: ii40

The Colorado/Wyoming Regional Medical Program application requests funding
from July 1, 1974 through June 30, 1975 for Program Staff, 2 ongoing and
13 new activities.

Application Request for $1,879,646 includes:

Staff
Program

COO0 Program Staff

      COO1 Strep Awareness Ed, Prog./Chfcanos
      COO2 Health Program in &io. Schools
     COO3 Maternal/Child Health & Family Planning
      COO4 Hypertension Screening Program
      COO5 Quality Control for EMS, Rural Areas
      COO6 Regional Planning for,EMS, Wyoming
      COO7 Regional Planning for EMS, Colorado
     COO8 EMS Sys. Development, San Luis Valley
       COO9 CWRMP Grand Junction SRO Activities
       CO10 Western Health Educ. Center.
      CO11 Expanding Primary Social Services
      CO12 Extending Primary Care to Rural Communities
     CO13 Health Resources Development Project
0    CO14 Primary Care Development, Western Slope
     CO15 Continuing Education & Training Activities

$673,351
5,000
4,000
1,600
29,500
15,000
25,000
35,000
35,000
33,500
3,000
16,840
6,480
104,000
20,000
5,000

Projects

Total P.S. Activities 1,012,271

TOTAL PROGRAM STAFF  1,685,622

c #29 Pediatric Hemodialysis Ctr., Rocky Mt. Region      60,000
c #35 Quality Control for Ultrasound Facilities         38,191
#38 Pediatric Oncology Ctr.                    53,013
fi39 Quality Control Diagnostic Radiology Facilities     58,566
#40 Electrical Safety in Hospitals                53,030
#41 Bone Pathology Ctr. for Ca. Diagnosis           26,325
#42 Core Prog., Primary Health Care Nurses           72,957
#43 Diagnostic Ultrasound Training                40,172
#44 Quality Control for Ultrasound Facilities         38,191
#45 CEIS Automatic Confirmation System            170,280
#46 Train. Prog./Prim. Care/Inheritable Dis.          79,547
#47 Diagnosis-Treatment, Kidney Stone Disease         35,511
#48 Colorado Cancer Registry                  31,688
#49 Colo. Hosp. Assn., Shared Educ. System          20,000
#50 Pediatric Nephrology Center                  83,510

TOTAL PROJECTS  $867,375


-2-

The Colorado/Wyoming RMP goals for the request year are: 1) to improve
availability, accessibility and the quality of primary health care; 2) to
improve accessibility and maintain quality of secondary-tertiary care to the
people in the C/W region; and 3) to assist in local planning of health
resource development.

The C/W RMP plans to submit a July 1, 1974 application request for approxi-
mately $227,000 for the funding of 4 new projects.

An Arthritis application was submitted for review and requests $362,621.
The proposal is to be critiqued by an assigned body of reviewers.

Analysis of the Colorado/Wyoming Regional Medical Program

The Colorado/Wyoming RMP is in the second year of its triennium. Present
funding (l/1/74 - 6/30/74) is in the amount of $694,541. Project activities
number 19 at a cost of $335,346.

Dr. Thomas Nicholas has served as Executive Director of the Program for
almost two years.  He has exhibited excellent leadership and is supported
by a competent staff of 18 persons (17.63 FTE - 13.63 Prof. & 4 clerical).
The C/W RMP staff prior to phase-out numbered 19(14 Prof. & 5 clerical).
Therefore, staff number has remained stable, but with a slight change in
personnel.

The Regional Advisory Group of the C/W RMP has remained active, maintaining
supervision over all projects and program staff activities.  This has been
accomplished through the cumulative information received through three

mechanisms:  1) Quarterly reports received from project directors, 2) site
visits and subsequent staff reports, and 3) site visits conducted by sub-
committees, and/or technical review committees consisiting of members of th e
RAG, or appointed by them.  RAG recently increased its Executive Committee
from 6 to 9.  Total RAG membership has been increased from 40 to 55 members
This was accomplished for two reasons:  1) to provide more experienced peop
for health care planning and implementation, and 2) to provide a more
comprehensive and better geographic distribution of membership. The RAG

le

distribution is uniform throughout the two states, and every planning region
is represented.  The RAG's relationship with the grantee, the University of
Colorado Medical School, remains good.

The C/W RMP has acted as a coordination point for EMS planning activities in
Colorado.  The Program developed a statewide EMS plan and, in addition, has
assisted local communities with their individual planning and coordination
activities in accordance with the state plan.

The C/W RMP has extensive experience in assisting with local planning for
health resources, as well as data collection. Community organization in
rural areas, as well as health planning, has remained a major Program thrust.
It continues to be apparent that plans must be developed locally, based on an
assessment of local needs.  In Colorado, a wide variation of planning


-                           -3-

capabilities exist.  CHP 'B' agencies are mostly small, understaffed
and underfunded.  C/W RMP has an excellent relationship with most of
the planning organizations.  In the Western Colorado area and the
Western Wyoming areas, these activities will be accomplished in cooperation
with the Intermountain RMP and Mountain States RMP.

Comprehensive Health Planning Agencies 'A' Directors in Colorado and
Wyoming are voting members on the RAG. There are only two funded 'B'
agencies in the two states, located in Colorado, and Denver is presently
without a Director.  Comments received were responded to by the RAG.
The negative aspect related to the brevity of the Form 15s and the short
time period allowed for review of the projects. Colorado comments alerted
the Program to the relationship of the Grand Junction Sub-Regional office
to oil shale development in Western Colorado. Much previous activity
had been expended in that field through the efforts of CHP and the
Colorado Department of Health.

Several of the new project activities are variations of formerly funded
projects: #38 - Pediatric Oncology Epidemiologic, Diagnostic and Surveillance
Center and #15-Regional Pediatric Oncology Center for Research and Training;
#maining Program/Primary Care/Inheritable Diseases and #30-Rural and Urban
Genetic Counseling and Screening; #43-Diagnostic Ultrasound Facilities and
'ieTJ-Tralnlng in Dlagnostlc Ultrasound in Community Hospitals (unfunded).

-   Assurance was given by C/W RMP that the new projects are not mere extensions
   or requests for continued funding.

On all activities to be conducted in areas which overlap with Mountain
States and Intermountain RMPs, written assurance will be submitted that
projects have been reviewed and approved by the three coordinators and
their respective RAG chairmen.


MA

REOUESTEG
COMPONEN

06/74 COUNCIL _

CCL0 WYCHG '   PROG YR 06

3 CONTIN EN1     CCMP
-   -. -   _ _ ..-  NC


      -
             coo0

          COO1

           CC02

           coo3

           COO4
       coo;
         cod
    , -coo7

           COO8

           COD9


           CO10

- - --.---_.-.
          co11

          co12

   .         CO13
       CCLS


           cc.15

COMPONENT TITLE
    

PROGRAM STAFF COLCRAGO WYClMINd RMP
PROGRAM `STAFF DISCRETE. PS 75-01
PROGRAM STAFF DISCRETE PS 75-02 --    ..

PROGRAM STAFF DISCRETE PS 75-03
PROGRAK STAFF GI-SCRETE PS 75-04
-PRLLRAX STAFF XSCREiE PS 75-C5A
-PROGRAM STAFF GISCRETE PS 75-058     `.


PROGRAM STAFF DISCRETE PS 75-05C
PUGGRAM STAFF LISCRETE YS 75-05D -    ___.


PPr-jGiiAM STAFF DISCRETE I'S 75-6A

P4C(;.I(:t! _rT4FF ;ISCkETE PS 75-66
PROGRA?? STAFF DISCRETE PS 75 6C

PRsG?hV, STAFF GISCRETE PS 75 bD

PRC;,kA.%  STAFF CISC?.ZTE PS 75-7

?;\2E?.L:4 STAFF GZXRETE PS 75-8

p.h3SR.LM STAFF 3ISCRETE PS 75-9

DIRECT
REQUEST

       592~200

        5,000
-      4,000-

         1,600

        29*500.

        151000

       25,000

       35,000
  
        35rooo

        339500

         31000

        16,840

         69480

        91,580
_.
        20,000

         5*000

029  ' PEC:IPTRI' i. HE!!I>DIALYSIS CENTER GOCKY MOUNTAIN REGIO        52,872


G35    CU:.LITY CI':<TR:,L F?=R NUCLEAR YtIDICINE FACILITIES           35,547

rs
,. - `,       - I. -I-:,, ,-
       P c . _ r., /     P"`-JL3JY Ct"TER
              ..- -<VI                                        43,187

fYJ;c,  OUALITY C3NTR(!L/DLAGNOSTIC RADXOLOGY FACILITIES          46,158
.c4c    ELttTb.ItAL SAFETY. IN tiOS?ITcLS                        42,737


cJ41    .jC"iC P>.T-!i;L2SY C%TER/Ck%CE?. DIAGNOSIS                  23,220

  INDIRECT
  REQUEST

81r151

0

. 0

0

0

       0


        0

0

       0
_
       0

0

  12,420

       0

    0

71128

99038

9,826

12,408

.   10,293

   3,105



TOTAL
RECUEST _ _. _

_.

6739351

5,000
4rooo --
lr600

297500
15;ooo

25,000

359000

35rooo

33t50G

3*000

16tb40

69480

104r000

20f000

5,000

60,000

44,585

53,013

58,566

53,030

269325


    MAY 15r1074                          REQUESTED FUNDS LISTING
                                            COMPONENTS RY REGION
.-- _-_ .-_ _ . _ .-_ _.                            06/74 COUNCIL

`XL3 WYOMG .   PRDG YR 06

                                
3 CONTINENT.    COMP                 COMPONENT TITLE                       DIRECT
--  - ._.___  _ ._..  NO                                                     REQUEST

              042    CORE PROGKAM/PKIMARY HEALTH CARE NURSES                  57,963


              043    DIAGNCSTIC ULTKASOUNO TRAINING                         36,518
__d_ -._- .-__._ --_ -   .-__                                                      _
              044   QUALITY CONTROL FOR ULTKASOUNd FACILITIES                30 9247
                                                   .
_. .- _ __..  045    AUTOMATIC COMPUTER ASSISTED CONFIRMATION SYSTEM          154~800

              04h    TRAINING PKOGRA%/PRIMhRY CARE/INHERITABLE DISEASES        67r685
- -  .-I -.-.. -..   .__- 047 DIAGNCSIS-TREATM'NT KIDNEY STDNE DISEASE                  359511
                    --
              048    CCLORADO CANCER'REGISTRY                              319688
                     \
             049    CHA SHAKE0 EDUCATIONAL SYSTEM                           209000
_.-   _.._- -  _ .       -.                               ..
             050    PEDIATRIC NEPhROLOGY CENTER                            65 9276

31                                      REGION TOTALS        lr662r109

..- -.   .I . . .._._._   .._._. -.       _ _ _   ._

  _.         .

INDIRECT       TOTAL
REQUEST     REQUEST ._

14,994      72,957

3,654      40,172

7r944      389191

15,480   170t280 '

119862      79,547


    0      35,511

    0      31~688

    f      20,000

18 9234      83,510

;
217~537

OSM-f'WBOlO-23    *

1~879t646

o

                  



JULY/AUGUST REVIEW

Rcquesi: $636,220
         --

Comr+tee Recorruncndation: $510.000
~vcrall assessmnt by- individual reviewers: Below Average to Poor

  i .

Critique:  This application, requesting 12 mont,hs support for an expanded
staff (from 5 to 8 professionals) and two months support for ongoing
activities, lacked substance for the reviewers.  It was agreed that needed
staff competencies in the 'area of fiscal management and evaluation were much
needed, in fact, the Committee noted that the absence of evaluation staff had
been a concern in previous reviews.  The unique characteristics of this
Regional Medical Program, with its emphasis on building long-term university-
hospital relationships was dis.cussed, but the application lacked information
regatding the outcome of the linkages. While grant support for full-time
chiefs of staff in community hospitels has been discontinued, the support
of, and dependence on university resources, including students, still prevails,
Staff leadership was'not apparent to the reviewers, but the argumentative tone
of the RAG Chairman's responses to CHP comments, as well as the CHP comments
themeelves, indicated that the RMP-CHP relationships remain a problem in
Connecticut.  The role of the Regional #;ihrisory Group in relation to the
Committee structure was unclear, as well as the criteria used in priority
ranking.  Because. the Committee realized that concerns of staff leadership,
RAG functioning and cumulative impact of this RMP's unique characteristics
have been delineated by Committee and Council in previous years with little
apparent effect on the RMP, the Committee recommends that reduced funding
of this continuation request may be a more patent message.  The Committee .
recommends, therefore, that this application be approved at the reduced level
of $510,000.

Estimated request as of.May 1974:'    $1.963,780


                                                 RM 00008
e CONNECTICUT         Regional Medical Program           I

Coordinator:  Ed Morrissey

Staff:   Full Time Prof.                 5

Part Time Prof.                 0

Full Time Other                 3

Part Time Other
           Total

Funds Requested:

8

On duty since: 7/73,:      _

Proposed:      8

4 1

n
12 i

Total . . . . . . . . . . . . . . . . . . .    636,220

  Continuation.............   ( 157,040 ) - 9 projects *'k

  flew
e   ,*....I..**.*`.`......   (    -o- )


  Period of Time Requested:  Projects until 8/30/74; program staff until
  6130175.  New projects will be requested on 7/l/74

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)

* Was Deputy Coordinator from 1967 - 1973

** Represents 2 months extension only; new proposals will be requested 7/1/74


                                                        RM  00008
e                                                         Conn.
   List any continuation project or staff activity for which substantial increase
   over annualized current funding is requested.

HMO project:

EMS project:  no significant increase; 2 months extension

PSRO :

Kidney :  no significant change in support; 2 months extension

CHP comments:  At best, CRMP/CHP relatio%s can be described as strained,
particularly between CRMP and the Connectict "a" agency.  In the application,
it appears that all CHP comments were received in time for consideration bq
CRMP.  Copies of correspondence indicate that CRMP appropriated addressed
concerns submitted by the "b" agencies.

The Deputy Director of the "a" agency submitted some rather salty comments
(supposedly representative of the agency, but this is under question)
making general statements charging."waste of money and pork barreling."

                                                    ,
oi

E0/5/20/74


   .-.- ,___

C@NN _

                       REQUESTED FUNDS LISTING
                       COHffONENTS BY REGION
                            _      06/74 COUNCIL

PROG YR  05            .

ERN



Cl-IMP
__ NO

      COMPONENT .TITLE                      DIRECT
-_                                 -               REQUEST

           coo0   PROG STAFF                                        395,727
  _-.- _
          coo1   EMS                                            17,092
-.. _-_ ____ - ..__._
       co02. -. REb kYPi CNTRL   -. _. _       ..-. -_ - _ ._ - _    ..-..
                                                                 38r261
          _.                                                                    ._
           02E2   C~MWJNITY s TUDIES PERS                                8 9493

           02R3   COMYUNITY S TUOIES PERS                                 5~398
-- .- -.._____ .- _._
           028   CONN KIDNEY DIS YALE-NH ME0 CTR                     11,281'

            044    STATE  6 REG HLTHM,ANPOWER DEVELOP CIHHR              - :
                                                               15 q669
                                                 
           06A1   UNIV BASED REG FACULTY                               12q215
-. _I T _ _- .-   
          0681  UNIV BASED KEG FACULTY       -' `.               _.       .
                                                  ' 19,286

: COMPONENTS ~_ 9. '     .._                  REGION TOTALS         523,422


---. -_-- .-.-.- --   .___ ..__ _ __                                                ..-


                     .-                                         1


._

---. -- I. .^^^ -..-. - __. I   _          .-   ._   _ _             -









                                                   -._.
                I


                   `

OSn-PWBOlO-23 %

INDIRECT
REQUEST

TOTAL
REQUEST       - _.

83 q 453

lr548


    0

39753

2r859

2,219

2 q453

fq 247

9t266

479q180
18q64o
38q261 -     _   _

121246 -* .- -.-

8r257
131500 -

18q122

19q462
28q552 '--

li2q798     636q220

. . .-


a


FLORTDA JUXIONAL, l%DICAL I'ROG!?N
RM 00024

I\nfY/,JUW 1.974 RJXTIIW
.-._
Request: !&COO,791

Committee JXecommcndation: $2,700,000
Overall Assessment by Individual Reviewers : Superior
               -

Cri.ti(e_:

Considered by reviewers to be well organized with good leadership,
program staff f exccl.lent MG, excellent past performance and
accornpli.shrnent., good Cl IP rcl.ationships with program activities that
a&tress key issues that are congruent with the region's explicit
priori.tics and areas of emphasis.
Jieduced recommendation made on basis of whether all new activiti.es suggested
could.be successfully completed in the time-frame l.eft for life
of the program or could be continued under other funding.

JUI>Y/NJQJST JEVIEW
Estimated Request as of May 1974: $1.,500,1100
--

DNP/JXN
6/6/74


      I
#L                     MAY REVIEW STAFF SUMMARY

FLORIDA REGIONAL MEDICAL PROGRAM
1 Davis Boulevard, Suite 309
Tampa, Florida 33606

Prepared by: Lee E. Van Winkle
Grant /I:  RM 00024

H. Phillip Hampton, M.D., Coordinator (20%)   On Duty Since: 1969
Granville W. Larimore, M.D., Director (100%) On Duty Since: 1969

CURRENT STAFF                   PROPOSED STAFF

Full-time Professionals - 14           Full-time Professionals  -  18
Part-time Professionals  - 2            Part-time Professionals  -  2
Full-time Other        - 7           Full-time  Other           -  9
Part-time Other        -1            Part-time  Other           -'  1

FUNDS REQUESTED:  (Target Figure $3,232,398)

Total Cost - $3,000,791

Program Staff - $398,792
Continuation - $845,121
New       - $1,756,878

Period of Time Requested: 7/l/74-6/30/75

CHP COMMENTS:

No problems noted.  See page 61-62 of application for working
relationships.  All activities were reviewed by CHP (a) and (b) agencies.
Thirteen projects were recommended for disapproval by CHP agencies
and were subsequently disapproved for funding by the FRMP Review Process
and the FRAC.  Twenty-six applications for multi-media ROCOM which
were approved by the CHP (a) agency director were deferred for action by
the FAAC since the CHP (a) Council  had not submitted a disapproval
action.

ITEMS FOR REVIEWERS ATTENTION:

ii267-A:  MAST Program for West Central Florida.  This does not conflict
     with the Emergency Medical Services Act as interpreted by

Mr. Reardon.  Discussions have been underway between FRMP and the
civilian Coordinator of MAST since December 1973 in the development
of the Logistical Emergency Transportation Support Activity.

DRMP/DOD
SC0B/5-17-74


HAY

:LORIDA         PROG YR 05

i C%TRAt     C@!",P
            YCI


    coo0   PROGRAM STAFF
  C235 FLA PERXNATAL

!lAST PRCG `d CENT

04bS   HDSP INF SURVEIL

124

-. _-  - -._ _
          126

COMHlJrJIlY BASED HYPT CNTRL PALM BEACH
                                        - _-.

_. _..
          131Y

- -I-.  --_...__
      134Y.

162

    -
169

CYS FPUSTPRCIOF AREA MIGRANT WORKERS

SITUATIONAL ANAL HYPT

H&P INFECT SURVETL
-AREA WIDE HLTH PLNG SUPP REG VIII A .-. - -   ___

CHARACTFRISTICS HOME CARE NURSG SERV

T'U9:J RESTSTRY EST STDS CARE
                                               .

CCUKU'4XTy GPCAN UONCR                                29~645

177

179

C31?wNXTY HLTH ADVOCATE                              67,000
                      .  -~ _.
SD DADE HLTH                                      71,080
SYS COKT .::D NURS  _ ._ -    . - -. -. -. .-. .-. - - .- --     . .   100,000


          193

-- ._..   . ..__._ --. I.94 '-,
       .-
           15'6

CV RISK FACTOG REVERSAL

PUB hLTH N`URSG TRNG
                      .__
!-fAR?IING SIGNS STSCKE

      200
- -.-- .-
    _ 207-


      210

                       
CLINICAL NUTRITION
.                                                7,784
CQMMUNITY DIETARY SERV                             36,547
PT FD IN FAU.ILY PEAC SETTING - -   -. _. _   - _
                                               339288

BILINGUAL CYNC SYS                                 85,000

.

iOHPONEMS BY REGION
06174 COUNCIL

C0MPCJNEN.T TITLE                        DIRECT   INDIRECT    TOTAL
                       -.. ._ -      _ REQUEST     REQUEST _ _ REQUEST __   _

398,792

212~482

FLA . ._.      -.        ..-.. . _
                                  9,740

TAMPA .-                   21,493

       32,653
_.
       40,860
    :42,356

    66,718
- -
    'L5,OOO

33,533

111,695

            90*000

            20,000
_-
            41,645

.









. .

     0     398,792

     0      212,482
_         -_.
     D       9t740
         -
2,011      23,504     '~

      ..
2,552      35r205

         --            '.-       .-
      0      40,860
           -
17.644       60,000

13,343      809061
           -.              ..
      0      15tooo

16,467       5OtOOO
  ;
25,876     137,571
         -.              _ _  _    _
129827      42,472
28,763      959763

0      71~080
   -.  100,000      -  -.
0

3,605.      93,605
         -.
    0      20t000
         -              -
129355      541000

2~980    LO.764

2r421       389968

6,658    39,946 -

36t317      121~317


  (111)
REQUESTED FUN     STING
COMPONENTS BY REGION
   06/74 COUNCIL

CENTRAL CO'IP                 COMPCNENT TITLE
        NO                  .

223

230

       232
_..  ._.. -.._
        236

      241


      243
  _~... 24;

249


25c

.       269

MED ONCOLOGY

DRUG INF A>D PUAR RES CTR
--.

VISITDRS NEEDS- FOR-HLTH CARE- - -

HLTtl CARE D3LLAR Ftr)W STUDY
                            , .

iAL:ILy PRACTICE SATELLITE
itiP HLTH CARE ASSESS

I SI,!RGI CTR STU(;Y



STATEItIDE RES HLTH YNPWR

                        .-..       -
kC'5EL 33lT SERV

                                
NURSE HIDbfIFERY SERV

3CL :+ATE?kIAL !iLTH CARE SfRV

CC!?\`T Es C!?AL CA

nCUTE CRITICAL CARE SERV
STATEWJDE'PCCIL ?4ECH TEACH EQUIP AV AIDS
- _.

REGICN TOTALS        2r690.344



DIRECT     INDIRECT       TOTAL
REQUEST     REQUEST     REQUEST :

55r924

19,076
lot321

37,793

75,000

32,474

42r795

150,932

20,000

ifsr589

287,010

10,000

539750

49v675

77,175

69,800

16,600

89,104

125,000

0

69847

0

    0

21~250

4~655

101249

5,541


    0

101896


    0

310,447

_ 188,725 .'
                   .~
  20,000

929436
287,010 '-.

lOt0ao

?5*000

54?330

87~424

75,341

lb*600

100,000

125.000

3r000.791



Request: $3,629,757

Commi.ttcc RrJconunendation:

ApprOV31 at the reyucsted level of $3,629,757.

Overall Assessment by Individual Reviewers :  Eioth reviewers rated t-.he
                  --

Gc0rgj.a R&P as "Superior .`I

:
CRITIQLJE
The reviewers beli.eved the Georgia l?MP to have:
- An excellent experienced coordinator
- A strong Regional Advisory Group and Committee structure
- An adequate experienced program staff
- Good CHP working relationships
- A. well managed and a well administered Regional Medical Program.

*   JUL,Y/AUGUST RJXIEIg
    Estimated Request as of May 1974: None
                                           -

      RMP/DOD
     SCOB/6/4/74
0


                  MY REVIEW STAFF SUMMARY
/

Georgia Regional Medi.cal Program
938 Peachtree Street, N.E.
Atlanta, Georgia 30309

Prepared by: Joe <Jewel 1
Grant #    : RM 00046

J. Gordon Barrow, M.D., Coordinator      On Duty Since : Jan. 1967

Current Staff:

15 Pull-time Professionals
2 Part-time Professionals
9 Full-time Support

Proposed Staff:

15 Full-time Professionals
4 Pa.rt- time Profess ion:~l.s
12 -Full - tilne Support
2 Part-time Support

Funds Requested:  (The Georgia RMP does not intend to compete during
         the July-August 1974 Review Cycle.]

Total Costs   - $3,629,757
Program Staff -   (749,557)
Continuation -   (606,380)
New       - (2,273,820)

Target Figure - $3,588,200

Period of Time Requested: 7/l/74 - 6/30/75

Activities Proposed:  See attached printout.

Items for Reviewers Attention:

Because of the limited time frame allowed in the prq~arat ion o I this
application, the region opted to'utilize its time tested, GM-devclopcd
umbrella program approach.  On March 13th a letter of invitation, listing
the three major GRMP areas (Primary Health Services, Manpower Development
and Utilization, and Specialized Services) was sent to all GRMP past and
current Froj ect Directors, Hospital Administrators, task force members ,
chiefs of hospital medical staffs,
hospitals,               directors of nursing services in
      ad hoc cormnittee members, the RAG, and health agencies,
organizations, and professional groups throughout the region.  Ry Apri 1.
lst, 150 letters of intent had been received (the total now exceeds
270 such letters).  The time lag between May lst, the date of this
application, and the date the region receives its funding level will
allow the various committees, task forces and staff the necessary time
for the development and preparation of the proposals for final considera-
tion by RAG.  The RAG will exercise its program authority and allocate
funds to specific project activities --
of intent                 developed from among the letters
     -- within the umbrella program framework.  Basically this has
been the region's mode of operation during its first triennium.


     .  Pipe 2
0  Georgia Regional Medical Program Summary

G-n June 8-9, 1972, a review process verification site visit was conducted
to Georgia RMP.  The region was found to exceed the mimimum standards.
A management survey is scheduled for May 30, 1974.

EMS:

Georgia has an ENS plan.  Project #55 is to assist in the continllation
and expansion of the service.  During June 1972, GRMP received $100,000
as a supplemental award for emergency medical service.  They utilized
these funds to partially support a model system in DeKalb County, a
bedroom community of Atlanta.
funding.            The system is now operating under local

PSRO :

Project #64A has (and will) provide for the development of `guidelines
for the care of specific diagnoses.
a PSRO agency.            The funds will not be used to support

KTDNEY :

    Project 8698 will provide support, in part, for the further development
   and expansion of the capabilities of tertiary nephrolo_gy centers at the
c vi  two medical schools to include training of personnel, further developent
   of criteria of care, and strengthening relationships with regional and
    national organ procurement and sharing networks.

The region addresses its relationship with the state's planning agencies
in its April 29th cover letter to Dr. Pahl.
of the steering committee,            In addition, at the request
              a report of the CHP review was presented to

the Regional Advisory Group by the Director of the Office of CiTP, who i.s
also a member of RAG.  The report, along with a letter from the same
individual, are included in the section tabbed "CHP Review."

DRMP/DOD
5/17/74


COWCNENTS BY REGION

_.     _.                               06174 COUNCIL

cE=I!tGlA .   PROG YR 06 ..:

`H CENTRAL   &!P
          .^ NC

coo0

             043a
..-.  --__--._  __
            055a

064A

G65a

-.    -.  -- .-.
            Gbba
    -.    .._.  Ok7A

074a

-- .._

: t=!4PLirIEb!TS 15

         COMPONENT TITLE                 DIRECT
-                          _                      REQUEST

PROGRAX STAFF                                  673,208

PT AN9 FAMILY EOUC                                 70,480
_
REGIONALIZATION EMS                               `229,210

STRENGTHENING ClJaL 4SSUR EFFORTS                      139,775

REGIONALIZATION KYPT SERV                            1661915
RiGIONaLIZaTION CV SXRV . -                         319,270

R:GTONCLIZATIGN STRSKE AND ALLIED SERV                  190 r715

t?EGIO!b$LIZATION CA SERV                              249,600
                                               _.
~EGIONALLZATI~?N KIDNEY SERV                          170,230
RE~ICNALILATION RE.iP SERV t                        187,893
                         
ARFA F&GIL FOR DUAL ASSUR                            225,050

9ULL I"IDRI)V ASSIST                                  40rooo

TPhiG %LT% TEAMS kEW CR IMPROV SKILLS                    33 too0
STRFNGTiEN &OMWNXTY HLTH RESCURCES                    496,622
YATERNAL AND INFANT HLTH CARE P -                     -
                                              361,440
                                '

                              R Et ION TOTALS       3r553.408

-- _ .~ _ . ._ ..__ .      _         - .    _

INDIRECT
REQUEST

76,349


    0


    0


    0


    0


    0


    0


    0


    0

    0


    0


    0


    0


    0


    0

76,349

.



OSH-PUBOlO-23

,

TOTAL
REQUEST

749,557

70q480
229,210 *

1399775

1669 915
319,270

190,715

249r600

1709230

187re93

225to50

  40 t 000

33, coo

4969622

             -
3611440

3rb29r757



                                                                           .
Mhy/JUKI: 1974 I?l:Vl1'\~!
----         _----

~cquc.:; L : $2,809,3.08          -

(Jveral.1 :I:-;scr;smcnt by Jntlividunl rcivicwcrs:  Above Average
                                                .___. -__-.,.-

cri.tiquc:  Two reviewers, both of whom had previously site visited this
program, concurred that many improvements have been made and that many
of the prior expressed concerns about this region appear to have been
resolved.

It was noted that the program now has good leadership', a RAG which
(since reorganization and elimination of the Board) now provides the
proper program leadership and direction and a democratically elected
Executive Committee. '

The program's goals, objectives and priorities are consistent with needs
identified in the region as are projects and activities proposed for funding
in this application.

This program appears to have been quite effective in bringing together
providers to improve both quality and accessibility of health care.
Overall relationships with CHP appear good.

,

The review panel did express a concern with the program and recommended this

concern be transmitted to the region.  This concern is not new,
raised by most reviewers and site visitors of the past: namely,
practice of supporting salaries of medical school personnel.

having been
the continued

JULY/AUGUST REVIEW

Estimated

request as of May 1974:
\

$1.386.898


m 00026

GREATER DELAWARE VALLEY    Regional Medical Program

*Central Office (including field staff for 5 subregions)

Coordinator:  *Dean Roberts, M.D.

Staff:

Full Time Prof.

Full Time Other


Part Time Prof.


Part Time Other
            Total

Funds Requested:

Total . . . . . . . . . . . . . . . . . . .  2,809,108

. Continuation.............   (400,624

Newt........,............   (960,147  )13 projects

14

10


0

0
24

> 6 projects

   On duty since: 11/73


Proposed:      17


           11


            0            -


            0
            28

Period of Time Requested:

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)

.

*Is on leave of absence from Hahnemann Medical School, where he served as
this medical school's R&iP "unit coordinator" for several years.


      .
`4                                                 RM 00026

Greater Del. Valle}

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.

#39 Community Hypertension Control

HI40 project:

NONE

EM project: Continuation at same level-of support

PSRO:

NONE

(new). No other resource available

Kidney: 847 - Cont. Ed. of Kidney Disease
for this expanding field. #52 - Reg. Kidney Disease (new). This is the
operational phase of extensive planning done in the past for coordinating
the development of a total kidney program.

CHP comments:  Eighteen of twenty propoI!?als were reviewed and commented
on by CHP in time for RAG consideration.  Time did not allow for comment
on the other two, but the CHP agencies involved stated that their comments
would be available by June 1, 1974.  There appears to be no problem with
aspect of the request.

E0/5/20/74


GREATER DELAWARE VALLEY
Temple Unit

Regional Medical Program

Coordinator:  Daniel Hall, M.D.

Staff:   Full Time Prof.                   0


      Part Time Prof.                   2


      Full Time Other                  0

Part Time Other                   1

Funds Requested:

Total  . . . . . . . . . . . . . . . . . . .

Continuation...,...,..... (

a New,..,.................. (

RM 00026

On duty since:   1972    _I

Proposed:       0

2            --

0

1

Period of Time Requested:

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975,)


.

RM 00026

.    GREATER DELAWARE VALLEY   Regional Pledical Program

       Jefferson Unit                                                       I

Coordinator:  Willard Krehl

On duty since: 11/73

Staff : Full Time Prof.

0

Proposed :      0

Part Time Prof.                  3


Full Time Other                   1


Part Time Other                   0
              Total           4

Funds Requested:

Total  .,*.,*.*.*....**...

Continuation............. (

   New...................... (
*

3

i

Period of Time Requested:

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


RM CC026

GREATER DELAWARE VALLEY
               Regional Medical Program             I

Univ. of Penn. Unit

.

Coordinator: John M-n.

Staff:  Full Time Prof.                   0

Part Time Prof.                  2

Full Time Other                  1

Part Time Other                  1

Funds Requested:

Total . . . . . . . . . . . . . . . . . . .

Continuation...,....,.... (

Period of Time Requested:

Activities Proposed:

             approv.
On duty since: 1967

Proposed:      0


           2

        i

i
I

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


0                                            RM 00026

GREATER DELAWARE VALLEY   Regional Medical Program

Medical College of Pa. Unit '

Coordinator:   Gerald Es--

Staff:   Full Time Prof.

0      Proposed: 0

Part Time Prof.                 2


Full Time Other                2


Part Time Other                0

Funds Requested:

Total ,..................

. Continuation,..,......... (

0 -New...................... (

           I    approx.
On duty since: 1g68

2

2

Period of Time Requested:

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


         .
   I
e

m 000Qfj

GREATER DRLAWARR VALLEY  Regional Medical Program                 I

Hahneman Unit

Coordinator: Bean Roberts. M.D.*                 On duty since:   1967

Staff:   Full Time Prof.                 0

Proposed:      0             -

Part Time Prof.                 2

Full Time Other

1

Part Time Other

0

Funds Requested:

Total ,,....l...,l..l....

Continuation..,.....,..... (

* -New................l...... (

2
i               -

Period of Time Requested:

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)

*On leave of absence, Bets as Coordinator GDVRMP
            .


,+
HAY   91974 _

-I II_ ..__- .-

GR DEL VAL.

PRUG YR 05

        COMPONENTS BY REGION
         06/74 COUNCIL

STERN- -.     COMP
           --. NO -

  ._
             cc00

             coo1
-I-- .I_--- -. c003"
            .~..
            coo4

-.
           CF05

. ---   -_  -   I .._       .-
             029

             030
_-    .-
             031
--   .   -_.-  03;.
__ -.
            036


             039
                   ~
            043
        044.


             045

- ---__-__ ._ 046.

             047


             048
---_.-__.--_ __.__ 049 -'

             051


            052
        053.


             056

_..

COMPONENT TITLE

PRCGRAH STAFf

HAHNEMANN BASE0 PROGRAM STAFF
-HE0 CDL1 BASED PROGRAM STAFF                  .

TEMPLE BASED PROGRAM STAFF

UNIV OF PENN EASED PROGRAM STAFF

CONT EDUC CA NURSG     .

PSDIATRIC TUMOR REGISTRY

REG COUNCIL CDNT EOUC
COMMUNITY HOSPITAL ME0 EDUC WORKSHOP

COYMUNXTY URGANXZ EMS SO N J

COMMUNITY HYPT CONTROL

                           -
COMMUNITY HLTH EDUC CTR

DIAG AND EVAL CHILDREN WITH HANDICAPS

LEHXGH VALLEY AREA HLTH CONSORTIUM

WEST YETRO CONSCJRTIUM

CONT EDUC KIDNEY DIS

QL'AL ASSESS PMEIJLATORY CARE
                                             .,
COMMUNITY SERV UNIT
IMPRDV-ADVISORY BOARD SKILLS

REG KIDNEY
SEG-R-ADIATIDN ISODOSE MEASUREMENT

FAYILY HLTH CARE ASSISTANT

._



DIRECT     INDIRECT
REQUEST     REQUEST

801.17~     294~448

45r53t      25,136

64*066    31,677 -

439296      219999

63,743      37,266
7,5;4          842

12r020       2,941

44r327      21,482

539532      13,104

44,283        0

1761336      22,243

68,709      14,742

28~492       3t524

6Pt800       26r628

50r000       6r750

26,348       15*150

103;9&3       15~262

79,487      36.705

32,464      139718

1279698      66,677

559840      18r85C

37,225            0

OSH-PWBOlO-23.

.

TOTAL
REQUEST

1,095,623

  70,667
                
  95,743
65r295

121r009

8~356

149961

65,809

669636

469283

198,579

83,451

32~016

899428

569750

41,498

139~250

116~192

469182

194,375

749690

37~225


          0                                                              .

MAY 15.1974                                  REOUESTED FUNDS LISTING                        OSM-PwBOlO-23 1
                                        COMPONENTS BY REGION
                                          06174 COUNCIL                                                             .
                                                                           

,R DEL VAL

PROG YR 05

ERN          COMP                COMPONENT TITLE
- -   _ --.. _-   NO . _ _ __ I__ -   _..

058    EXPANSION HOME HLTH THERAPY SERV

059    HYPT SCREENINWPT EDUC

L CONPONENTS     24                           REGION TOTALS

.                            .-
             

                    DIRECT     INDIRECT      TOTAL
_.           - -        REQUEST     REQUEST     -REQUEST _..I. . I

   34r67tj          0      34~678

    22,419      11,993      349412

                                         *

2r107r951

701?157   2rB09t108

-- .._..   _..      -- - _     ._





                                                                           .._

-.



.-

*









,
I

JUVIP .   Hawaii       -WC_

lu4 000 01

Jkqucst: $ls-s7,7og
      
Comn!l.ttcc Iiecommc:~dat -I on:   $1,100,000                        .$

0vcral.l assessment by individual. revicwcrs:   Average

Critique:

On April 1, 1974, Dr. Satoru Izutsu was appointed as the new
Coordinator of the Hawaii RMP. Since that time, many positive
changes are occurring in the direction of the program.  The staff
of the program is stable,having remained basically the same
during phase-out.  The Regional Advisory Group is being oriented
to its role and responsibilities to the program.

The reviewers, one of whom had been on the January 1974 site visit
were much encouraged by the f.orward direction the program now
seems to have.  This particular application, however, reflects
activities developed prior to the changes in leadership.   The
Committee anticipates the "new flavor" in the July application.

The Committee recommends approval of the application at a reduced
level of $l,lOO,OOO with the condition that the reduction be       '
equitably applied to the Pacific Basin and to the Hawaii portion
of the program.  Thus, the proposed figures are $889,602 for Hawai
and $305,107 for the Pacific Basin.

3ULY/AUGUST REVIEW

i    Estimated request as of- May 1974:' $;6&~,000
                                                 _

                                     .
WOB 6/6/74


.

STAFF Sl!MMARY FOR MAY 1 KEVIEW

REGIONAL MEDICAL PROGRAM OF HAWAII, AMERICAN SAMOA, GUAM AND THE TRUST

TERRITORY OF THE PACIFIC ISLANDS - RMOOOOl

The Research Corporation of the University of Hawaii, Honolulu

COORDINATOR :  Se toru Izutsu, Ph.D.                Since - May 1, 1974

STAFF: (FTE) Total - 15.75              Proposed :  19.25

Brofe8sional 10.75
Other        5.00

Professional 13.25
Other        6.00

FUNDS REQUESTED:   Total (D.C. & i.d.c.)

$1,567,709

Program Staff Administration - Hawaii       541,315
Projects Hawaii (10) 7 new ones          568,287
Total Hawaii Program                          1,109,602
Pacific Basin Administration            110,225
Pacific Basin Projects (10)             347,882
Total Basin Program                         458;107-

GRAND TOTAL RMPH             1,567,709

CHP COMMENTS:

Hawaii has no CHP (b) agencies.  The comments submitted by the CHP (a)
agency were not only considered by the RAG, but influenced the final
decision on a number of projects.  The CHP agencies for the Trust Terri-
tory, Guyam and American Samoa were involved in the development of the
proposal8 from the Pacific Basin.

ITEMS FOR REVIEWERS ATTENTION:

.  Past history and change8 occurring as a result of new coordinator:

.  Staff, RAG, CHP, Hawaii Medical Society, University of
Hawaii Schools of Medicine and Public Health.

.  Continuing problem8 between St. Francis and Kuakini Hospitals over
Renal Disease Programs.  (Project8 1147, Dialysis and Transplant Center
  - St. Francis - page 81 and #56 Kidney Dialysis Training and Education -
  Kuakini - page 94).  RAG will not fund until hospital8 have unified
plan or justify separate programs,

.  Project 842 - Health Screening for Elderly - P&G must rereview prior
to funding,

.  Project #68 - Cervical Cancer Detection, Trust Territory.  NCI has

similar request from T.T. DRMP and NC1 staff working with RMPH so
that WH will assist T.T. in further developing NC1 proposal.

, Need to "earmark" PSCifiC Basin Fund8


      a
L    Page 2
    HAWAII - staff suaaaery

e   CONTINUATION ACTIVITIES :

Of the 10 Hawaij projects only three are continuations.  0f the 10 Pacifjc
Basin Projects all are "new", in terms of location. Health Assistant
Training, Otolog& and Cervical Cancer projects have been conducted success-
fully in other districts of the Trust Terri.tory.

DRMP /DOD
WOB - 5/m/74


        5.1974
0.

01 HAWAII    PROC YR G6

YESTERN        COMP
_. -.. _-.   ._.      NO

     
              cuno
_~
             CC01
I. ,-_ _._--  ._-. -- .-.-
         coo3-.

               con5
      _.
             COO6
_I _._I_-. - - _. _.
               005

042
045 '

- _ -          ._
              047


               048


                049

_ _   - .









- _ _ _  _









_

052

056

062e

063
   .-
064

CC5

COMPONENT TITLE

PROGRAM STAFF

PACIFIC 6ASIN AOMIN

                                     .   
FACIL PLAN RES C ANAL

.

PROJ DEVELOP MONITOR C EVAL

FUTURE PRDG PLAN

STRENGTHEN DUAL ASSUR EFFORTS

HLTH SCREENING ELDERLY
IMPROVE HDSP HNPHR USE & RESTRAIN COSTS '

REG RENAL DIAL & TRANSPLANT CTR



HABAII CTY HLTH SERV EOUC

CLINICAL ENGINEERING SERV & TRNG CTR
ORGAN PKdCURE SUPPUYT TRANSPLANT ACTIV `.

KIDNEY DIAL TKNG & EDUC
f+AttI CTY HLTH S.ERV C' EDUC ACTIV

CDORP NURSG EDUC PRDG

OT@RliINQARYNGPLDGY TRNG

COMPUTERTZED WLTH INFP SYS FEAS STUDY

P T TRNG

IMPRCIVE ICU

SPECCH r, HEARING

NUTNITIDN EOUC
HLTH INFO SYS



DIRECT
REQUEST

1921183

105?128

1291765

90,375

99,044

47r890

73,193

84,550

b3r204

74,222

57,192

59,556

44rlll

11~674

7r836

37176Q

81975

311500

3tat508

33,440

13,240

13r394

  









  ;









-.

TNDXRECT
REPUEST

81113

5r097

79355

7r288

7,192

8,716

4~462

    0

22,678

41223


    0


    0

4t411

    a

  589

    a

    0

    0

    0


    0


    a


    0

OS     010-23
c P-

TOTAL
REQUEST

2013~296

1101225

137r120

97,663 *

106,236

56~606

77r655
               t .,
841550

65*1182

?8*445

57rl92

59,556

48~522

111674

a*205

17t749

BtWri

3l$SOD
3br508

33r440

13r240

13,394


          . -


.: a I1974

COMPONENTS BY REGION
  M/74 COUNCIL

          -           .

`1 HAWAII          PROG YR 06

ItSTERN           COMP                 COMPONENT TITLE
.-__ ._ -  _.. .    NO -

         066 - OTDLOGY AND CLEFT LIP AND PALATE
        067 HLTH ASkJST TRNG
-_.-.-__.- .-_. -_. - --__. _
              068  CERV `CA DETECT -PONAiE E HARIANAS
                                                 I '

D. OF COMPONENTS     25

__,-. _.-. -__ ._ .__._ .., _ _. __ __        _   


          -.,                       _

-.   . _- .___ - ._..^   .   .-. -_ __ I   ._..   _.

I -_ ._-----.. _ --  -.. . -- - -. - - .-   _..-   - _... -_ .- ~.  -

_.
              DIRECT     INDIRECT
             REQUEST     REQUEST

      31,237            0

      124,000       3,828
.
       34rooo         ' 0

REGION TOTALS       `1.483.98f      839722


   .* .                  .._ _.

i

0      -


OSM-WBOlO-23

Lq- ?.- '

TOTAL
REQUEST

31,237

  1279 828
. . -
  34rooo

lr56ft709

---I_-.-- -.--- - _ _. .-..._,.-._.    -     ___ __..__. ,...^_. __ _,,                        I . _   -_ . _

I

__ ,_-_ ..- .-_  _.. -.- . - __.. -. ___       


RBCIONAL MEDICAL
         TRUST TERRIT(~!IY OF '

Current (l/74-6/74) and Propos

NO.

Component

100

303
304
305
306

Hawaii Program Admin. Staff
Facilities Planning Research & Analysis
Strengthening Area Quality Assurance     .
Project Develop., Monitoring & Evaluation
Future Program Planning
(Total IIawaii Progra: Staff)

28     Health Information Network of the Pacific
30     Waianae Coast Comprehensive Eealth Center
42     Health Screening for the Elderly         .'
45
47   ,_ Hospital Manpower
   _ Dialysis and Transplant Center
      (funded l/73 - 12/73 $lO,OOO)(St. Francis)

48    Hawaii 'County Health Services/Ed.
49     .Plenning for Comunity Based Clinical Eng.
SO     Quality Assurance Trng. Seminars
:3    * Organ Procurement in SlIpport of Transplant
      Hypertension Detection & Treatment
56     Dialysis Training & Education (Ruakini)
57    Maui County, Health Services Educ. Activities
58     Coordination of Nilrsjng Educ. Programs

                Total Iiawaii Projects

     Total State of Hawaii Program

.    Total Pecific Basin Program

     Available Unbudgeted RXPH Funds

                   CRANDTCTALRXPH

Funded (6moa.)          Proposed (12 mos.)
l/74-6/74              7/74 -- 6175

147,846                 200,296
40,946                137,120
32,143                    -Q-
-O-                 97,663
-O-                106,236

(220,935)

(541,315)

16,840
58,665

   -O-
   -o-
  77,655
*   84,550
  85,882 -
       1

-o-
1 -o-   I

-O-   I

14,642
4,490
7,500
-o-
4,500
,- 0 -
-o-

-O-     I

(106,637)

327,572
  
108,518

169,756

605.846

.



               .   .

78,445
57,192
56,606
59,556
-o-
48,522
11,674
8,205 *

(ShS,iS?)

* 1,109,602

458,107

1,567,709

.

Paw 1
c      .

Remarks

RAG must review again `prior to funding

847 & 56 must jointly prove to RAG need
for 2 programs or present unified plan
before fundi'ng.

Funded W/73-12173 $35,000 -

See P47 above

5/u/74
RLR /wOB/k!!


.
P I

.

_.
-3

         .


. .
  .

*       . .

.      .

,



I LLINO I. S REGI GNAT., MEDI CAL 1'IIOGRA.M
RM OOOGl

fiequcst:
$2,816,935
Conmxittce licconmmclldati.on: $2,816,935
                  --I__
Overall. Asscssmc_t by Individual lievi.ewers : Average/Superi.or

critique :
---
Members of the Rcv%ew Commi.ttce agreed that the leadership of the IN/i'
is strong and the program has remained i.n good order inspitc of the
phase-out threats.  There was a discussion of a possible leadership
lag when, on July I.st , the current coordinator wi.11. devote 25%
of his time to the Illinois I&P.  The Board has established a search
committee, It was agreed that with the obvious strength of the Creditor
team, coupled wi.th the short time-frame, that the decision to continue
the coordinator on a part-time basis was a wise one, To bolster this,
the region has been successful in re-emp1oyin.g many of its former staff
members who had accepted other employment at phase-out.   The RAG has
remained in tact and are the decision-makers.  The region has demonstrated
a unique ability to initiate programs which have continued under
other than I&VI' dolla.rs.  Illinois has had a history of joining forces
with the QP agencies in their objective type pl.a,nning efforts.  The
reviewers agreed that the program proposed may begin to solve some of
the urobl.ems of the Health Care Delivery Systems in a very complicated

ared of the country.

,JULY/AlJGUST IUW'IEW

Estimated Request as of May 1974: $l,OOO,OOO

DRMP/Ix)D
SCOB/ 6-6-74


f, -4                       MAY REVIEW STAFF SUMMARY

Prepared by:  Lorraine Kyttle

RM 00061

ILLINOIS REGIONAL MEDICAL PROGRAM
122 South Michigan Avenue
Suite 939
Chicago, Illinois 60603

Morton C. Creditor, M.D.,Coordinator

CURRENT STAFF

Full-time Professionals -
Part-time Professionals -
Full-time Support Staff -
Part-time Support Staff - _

11
0
7

       0
(total) 18

On Duty Since: June 1970

PROPOSED STAFF

Full-time Professionals - 14
Part-time Professionals - 0
Full-time Support Staff - 10
Part-time Support Staff - 0

(total) 24

FUNDS REQUESTED:  (Target Figure $3,814,015)

Total Costs - $2,816,935

Program Staff - $656,833
Continuation  - $1,155,128 (7 activities)
New       - $1,004,974 (6 activities)

ACTIVITIES PROPOSED:

Continuations - Two of the "continuation" activities (18 and 24)

            are traditional continuations.  They represent major
concept thrustsfor the program in the fields of hypertension and the
problem oriented medical record, and activities aligned to these
thrusts have been sponsored by IRMP since 1972.  The remaining continuations
are activities funded from the October 1973 or January 1974 awards.

New - The "new" activities (beginning with 135) continue the conceptual
     thrusts in several areas.  CAM health trust is the result of
an effort to demonstrate the more efficient delivery of existing
health services.  Fostering the design of new or refashioned health care
delivery systems has been one of IRMP's objectives. The state-
wide hypertension control program is an activity growing out of
2 years' preparatory activities.  Having demonstrated the viability
of the role of the computer in treatment of some chronic hypertensives,
and with data concerning the epidemic proportions of hypertension
in the State,  IRMP had developed a conceptual attack on hypertension
beginning with local "bs" and culminating in a state legislative package.
This is the typical IRMP approach -- to precede a major statewide effort
with political subdivision entires throughout the State.  Problem-oriented
medical record activity was handled successfully in this fashion.   Renal
disease activities were less staisfactory. Dr. Creditor is listed as
the Project Director, but this is an interim arrangement.


Page 2 - Staff Summary
Illinois RMP

CHP COMMENTS:

All activities were submitted to appropriate CHP agencies and the
comments are attached.

ITEMS FOR REVIEWERS'ATTENTION:

As of July 1, 1974, Dr. Creditor will no longer devote 100%
of his time to the directorship of IRMP.  He will be joining
the University of Illinois at Urbana and will devote 25% of his time
to IRMP leadership.  The Board of Trustees of IRMP, Inc. have discussed
arrangements with Dean Bloomfield at Urbana and have concluded that this
is the best of immediate arrangements.  Dr. Bloomfield is a member of
the RAG, is deeply committed to the program and assures the Board
of IRlQ that such arrangements will be honored at least until
December 1974.

At one point following phase-out orders, IRMP staff was reduced to
four professionals and two support staff. Its current complement of
18 professionals is almost entirely composed of former IRMP staffers
who left other employments to return to RMP.  It is a competent
group, with experience in working together under stress.

DRMP/DOD
SCOB/5-17-74


m


MAY/.JIJM 1974 Rl'VIIll\i

Request*: $1,221.,159
Cormni ttcc Recommendation :  $1,121,159
                ---
Forall Assessment by Individual. Reviewers :
               Average/Below Average
              -

:
Critique

One of the major CO~KX~~S of the reviewers was the apparent inabi.lity
of tire region to wri.te a proposal - - to tell their story (at least the
current document) . The program staff was considered satisfactory- -
"Everyone of the current staff have been in RMP for over four years and
they have experience ."  The RAG was considered to be in order with
appropriate back-up commit tees .  During January 1974, the region
poll.ed its RAG, committee members  an d other health i.nterested groups
to re-evaluate the IlWP objectives and priorities. Based on this,
the region plans to move ahead utilizing a series of contracts to
accomplish some of these objectives .  The Indiana R3# envisions an
umbrella approach of improving the quality of medical care in the re-
maining limited time-frame.  The region is extending its sub-regional
de&.opmcnt by working closely with'existing (b) agencies. In
arriving at the reduced funding level, the committc?e believed that
the support of the contin.uation of the EMS activity would be low
priority or at least open to question - - based on the ifl.formation presented.

Estimated Request as of May 1974: $400,000

DRMP/DC)D
SCOB/6-6-74


MAY REVIEW STAFF SUMMARY      l \

INDIANA REGIONAL MEDICAL PROGRAM
1300 West Michigan Street
Indianapolis, Indiana 46202

Steven Beering, M.D., Coordinator
George Lemnson, A.B. Executive Director

Current Staff:

5 Full-time Professionals
1 Part-time Professional
3 Full-time Supportive

FUNDS REQUESTED:

Total Costs  - $1,221,159
Program Staff-  ($265,775)
Contracts Supported From

      Funds-  ($616,760)
Continuations-  ($338,624)

Prepared by:   Joe Jewel1
Grant #: RM 00043

On duty part-time since 5172
On duty full-time as Exec.
Director since 11173

Proposed Staff:

10 Full-time Professionals
2 Part-time Professionals
6 Supportive

Target Figure: 1.4m
Estimated July Request: $400,000

Period of Time Requested:  All Program Staff and Operational activities
                 are scheduled to terminate 6/30/75.

ACTIVITIES PROPOSED:

See Printout

ITEMS FOR REVIEWERS ATTENTION:

EMS Project:  Project f/32 is a request for the continuation of EMS activities
        in region 7 (6 counties in west central Indiana).   The
total request of $95,000 is for equipment.  During 1974, the state legislature
passed the Indiana EMS Act with $75,000 to be initially provided for
administrative purposes for a new EMS Commission.  The funds requested from
IRMP are to be used to establish a demonstration model for the' State.

The region has requested $616,760 to support contract activities as a part
of the program staff component.  The area of proposed activities are
listed on the last page of the application and are described on the program

form 15 (page 33). The broad areas are:

1. Emergency Medical Services System Development
2. Family Practice Program Development

3. Integration of Comprehensive Health Planning and FRMP Activities
4. Hospital Accessibility


4      B
Page 2
Indiana RMP Summary

The IRMP review process has been approved as has its management
and administration processes.

CHP:  This is an. application for continuation of presently funded
   program staff and project activities.  The region did not seek formal
review and comment by the Comprehensive Health Planning bodies.  However,
CHP's throughout the state, including the 314 (a) agency and all
areawide agencies have participated fully in the reassessment of priorities
on which the application is based.  Further, they have participated in
formal discussions with the IRMP Program Staff of the concepts that are
embodied in this application,The CHP (a) Director is a member of
the RAG.

DRMPjDOD
SCOB/5-16-74


INDXANA _ .  PROG YR 06 *

ITH CEMTRbL.  tom. -
_.__ __- .._ ----.  -.-. NO ._.. _ .-.- -

coo0  PROGRAM STAFF

_' _.. *

             024  -RENAL AL,LOGRAFT
-.-. _-- .---.      _.- --
            032  EMS`- REGION- VIT
                  ---
            035    HYPT
    __... ~_..-- _
            037   SPECIALIZED HED
-_. ~_-----I .-.- -    .-.... -
            038   TEL-I&

-.

SERV '

     039 \   PERINATAL AND INFANT

COMPONENT -TITLE

_- ^_-_- . -. -       __ _ _ ._   _ .-. -   --

OF CCWONENTS _.._ 7 - _ . .    _.. ..__

REGION TOTALS

.

.





    ..- _.      ._-... --.


               _

  DIRECT
-.  REQUEST

816,535

  7~446

  95,000

141t822

2fdiOO

4lt170

23~766

.- 66rOOO-`-  882,535
-1,320      8,766
  _. .-    _ _ ^.. _.
      0      95rOOO
   a. 141t822


      0      27*500

.-

0

41,770

0    23,766

1.153r839     6t.320 .le221~159 -

.


                0     `,

INDIRECT --   TOTAL             s
REQUEST     REQUEST .-

_  _  _ - -    _--     ._


   _

._  .           I _ _. .- ^ .



Committee Recommendation: $2,000.000
Overall assessment by individual reviewers: -am
          .          .

Critique:

Concerns were expressed by the Committee regarding the failure of the region
to add more minority members to staff. The Program's efforts in this
direction were thwarted by the planned phase-out in February 1973. The IRMP
insists that the minority effort continues.

Support for reductions in the amount requested is based on past experience
with the region's habitual "inflated" fund proposals. The Program has
demonstrated its resilience in the past and will continue to react positively
with a restructured program based on the funds awarded. This positive ability
to react has been one of the Region's outstanding talents.

Project #63 - Health Information .Assistance to Regional State Legislatures
($111,894) raised concern regarding its increased budget. Past funding for
6 months was $19,349:                                                                I

Estimated request as of May 1974:   $' -900,000 - 500,000


STAFF SUMMARY FOR MAY REVIEW

INTERMOUNTAIN REGIONAL MEDICAL PROGRAM:    RM 00015

COORDINATOR:  Ward B. Studt, M.D. - since February 1973

STAFF:(FTE) Total - 18.87 (19 persons)

Adaitional proposed: 3

Professional:  8.87 (9 persons)               Professional: 2
Clerical:     10                        Clerical:     1

FUNDS REQUESTED:   Total (D.C. & I.D.C.)    $3,849,425

Program Staff                     667,153
Projects: (49) total               3,182,272
Continuation (11)                 948,167
New (38)                     2,234,105

CHP COMMENTS:

Received from "A" agencies, (Nevada, Idaho, Montana, Wyoming, Colorado, Utah)
and "B" agencies (Colorado, Montana, Utah).  Agency directors attended
4/15/74 RAG meeting and responded to projects impacting their areas. RAG
members responded, by deleting 2 and adding 1 project.

CONCERNS:

1.  EMS Activities

#40 -

  #89 -

2.  Renal

  #96 -

Emergency Medical System, requests funding ($78,550) for third
and final year.

Utah Aero Ambulance Assistance, extension of #40, requests $3,000.

Activities

Kidney Disease Prevention, Rock Springs, new - requests $5,600.

3.  Funding Request 50% above 07 award

#62 - Health Information Assistance to Regional State Legislatures -
  39,349 (6 months) - requests $111,894

Target Funding Amount (140% of annualized level) = $3,500,000

Application request $3,849,425 which is $349,425 above target amount.
Plan to request an additional $400-500,000 on July 1, 1974.


Mid-Continent Operations
Staff Analysis: Mary E. Murphy

Intermountain RMP: RM 00015

The Intermountain Regional Medical Program application requests funding
from July 1, 1974 through June 30, 1975 for Program Staff, 11 continuation
activities and 38 new activities.

Application Request for $3,849,425 includes:

PRO@AM STAFF-

f:$;blTCj-S
Continuation

$667,153

#33 -
#34 -
#35 -
#40 "
#118 -
#60 -
#61 -
#62 -
#69 -
#75 -
#86 -

New

#78 -
#79 -
#81 -
#82 -
883 -
#84 -
kda5 -
k'87 ,-
#b8 -
xi89 -
#90 -
#91 -
#93 -
#94 -
#95 -
#96 -
#97 -
#99 -
#loo-
#102-
#104-

Health Systems Quality Assurance
Nurse Practitioner
Infectious Disease Control Program
Emergency Medical Systems
Intermountain Regional Platelet Typing
Community Organization
Health Manpower Intelligence
Health Info. Assistance to State Legislatures
Radiology Quality Assurance Standards
Hypertension Control - (Reservation Indians)
Modeling the Utah Health Care System

Sub-total

Hospital Study - Clark Co, Nevada
Idaho CHP "A" Assistance (SICHR)
Utah CHP "A" Assistance
Shared Service Study - Montrose, Colorado
Montana CHP "A" Assistance
Colorado CHP Assistance - Western Colorado
Nevada CHP "A" Assistance
Rural Hosp. Management Consulting Service
Small Hosp. Management Engineering
Utah Aero Ambulance Assistance
Multi-Disciplinary Allied Health Training
Regional Pediatric Service Study
Regional Self Help Medical Care Training
Indian Clinic - Henela (Montana)
Urban Indian Clinic - Salt Lake
Kidney Disease Prevention - Rock Springs
Dental Health Training - Helena
Medical Consultation for Rural Communities
Migrant Health Center Development
Urban Poor Health Clinic
Rural Medical Technology System
Rural Quality Assurance
Rural Medical Practice Management

-   #105- I
    #106- i

#707- Home Health Care - Idaho
Bill- Indian Health Delivery System, Montana

100,000
70,000
123,795
98,023
21,240
126,000
90,455
111,894
74,827
47,433

7,100
!mJn

47,433
85,000
100,000
6,500
49,750
50,000
24,000
120,000
24,412
3,000
98,000
88,900
100,000
15,000
100,000
5,600
20,000
40,000
20,000
12,000
115,900
126,900
114,900
23,940
40,000


Intermountain Staff analysis - page 2

#117 -
#119-
#124-
$5126 -
#127 -
#128 -
#129 -
#130 -
#l)l -
#132 -
#133 -
#134 -
#135 -

Multi-Hospital Inservice Training, Idaho           26,310
Master Health Plan for Univ. of Utah Hlth. Science Ctr. 86,100
Physician Comm. with the Deaf               105,600
Indian Dental Health Screening                 59,652
Congenital Heart Study - No. Cheyenne            15,000
Lung Disease Patient Resource G&ii&              4,500
Rural Primary Care Demo. - Wyoming              55,760
Quality Assurance and Utilization System          100,000
Education for Action                       70,575
Regional Health Planning Assistance             63,901
Health Planning Communication Project            58,093
Technical Assistance for Health Planners          100,464

Multi-State Health Planning Liaison Project         96,908
                             Total   3,849,425

The Intermountain Regional Medical Program's thrust has been to improve
the availability and accessibility of full spectrum primary health care
to all persons of the Intermountain region. The Program presently places
emphasis on these areas and plans to: 1) facilitate the transition to
the general kind of health resource planning mechanisms and efforts
envisioned by the pending legislative proposals; 2) increase the
availability of and improve the access of primary care services for
medically underserved populations and areas; 3) lead to greater coordi-
nation and/or sharing on geographically integrated bases of expanded
secondary and tertiary patient care resources and services.

The requested application is approximately $350,000 above the target
figure (140% annualized level) of $3,500,000. The DRMP has stated that
it plans to submit a July 1, 1974 application requesting an additional
$400~500,000.

An arthritis application was submitted for review for the requested
amount of $385,463.
body of reviewers.  The proposal was to be critiqued by an assigned

ANALYSIS OF THE INTERMOUNTAIN REGIONAL MEDICAL PROGRAM

The IRMP is in its second year of triennium. Present funding (l/1/74-
6/30/74) is in the amount of $1,118,238. Project actiiities number
22 at a cost of $564,562.

Dr. Ward B. Studt has served as Executive Director of the Program since
February 1973.  He followed Mr. Richard Haglund who served in an acting
capacity for almost one year.  Mr. Haglund ran a "tight ship," had a
very reserved personality and was an excellent manager.  Differences
arose with the grantee, the University of Utah Medical Center, due to
conflict of personality (Haglund vs. university officials). These
differences precipitated themselves in the grantee/IRMP relationships,
procedural interpretations, etc.  With the appointment of Dr. Studt.     .
the grantee relationship problems disappeared. Dr. Studt is a
personality quite opposite to Mr. Haglund. He is openly and
enthusiastically agressive, and moves in all directions.  It appears
that a stronger managerial quality would be beneficial. Dr. Studt
is a "driver" and expects an enthusiastic response from


Intermountain Staff analysis - page 3

staff.  Staff's reaction to him is "mixed." Several staff members
have stated that they feel a lack of assistance and understanding
when problems are discussed with Dr. Studt.

The Regional Advisory Group with a body of 37 members, composed of
the Coordinators of Mountain States and C/W RMPs, as well as CHP
directors (2 'A', 1 'B' agency) has been active during the past year.
A new chairman, Mr. Kenneth Knapp, was appointed, He has been meeting
with select IRMP staff and RAG members on a weekly basis,  Minority
representation on the RAG continues to be carefully monitored and
efforts have been expended to secure minority RAG Members.

The IRMP staff is a competent body of persons totaling 19 persons or
18.87 FTE (prof-8.87, clerical-lo).  The staff is supported by project
staff of 27 persons or 24.87 FTE (Prof.-19087, clerical-5). Many project-
staff are in reality Program staff, serving a dual function under the
Matrix Organization system of management. If assigned to a project as
director, an employee is carried on the project staff roster and payroll.

    Staff formerly occupied three separate office areas on the University
    medical campus.  The separation of staff members, as well as the high
    indirect costs rates (39%),encouraged IRMP to relocate at Research
   Park,which adjoins the University of Utah,in April 1974. The new
    facility has provided a more adequate working area and is believed to
e  have improved morale and production.  Indirect cost rates are presently
     at 28.7%.

A non-profit corporation, known as the Health Development and Services
CorpOration (HDSC) has been formed within the IRMP structure. It is
viewed as a project which is expected to become self sustaining in
July 1974.  It is the concern of Mid-Continent Operations' staff that
the separation from IRMP will be a complete one with no further sharing of
Program or Project Staff.  Assurance was given that Dr. Studt will not leave
IRMP to direct the HDSC at this time. Dr. Ray Beck&t and Ray Miller,
Project Staff, and Mr. Lynn Davis, Program Staff,plan to go with HDSC.

IRMP has shared an excellent relationship with funded CHP 'A' and 'B'
agencies within its region.  All of the agency directors were invited
to attend the April 15, 1974 RAG meeting.  In attendance were 9 directors.
The representatives in attendance were given ample opportunity to respond
to projects impacting their areas. RAG responded affirmatively. As a
result, two proposals were deleted and one proposal was added in response
to CHP input.  Absentee Idaho and Wyoming CHP State Directors responded
by letter.  IRMP is to supply action taken on the written negative comments
received from CHP.

On all activities to be conducted in areas which overlap with Mountain
States and C/W RMPs, written assurance will be submitted that projects
have been reviewed and approved by the three coordinators and their respective
RAG chairmen.

The IRMP is considered a good program but it is felt that the region
is overfunded.



0
   HAY/JUNE 1974 Rl':VTEW

                                          

     Request:  $?,061,349 '

RM 00027

Committee Recommendation:   $1,061,349

Overall assessment by individual reviewers: Above averase to Superior

          .

   Critique:                                                         '.
I

The Review Committee considered the Iowa RMP continuation grant applica-
tion request of $1,061,349 and recommended approval as requested.
Reviewers continued to be impressed with the imaginative Coordinator,
strong Regional Advisory Group, good program staff, and a well administered
and managed Program.

   On May 28, 1974, DRMP received favorable letters of support from the
    Health Planning Council of the Midlands regarding project #'s 55 -
      Homemaker - Home Health Aide Training and project #56 - Family Nurse
     Practitioner for Use in i?iZil Iowa.
                                       --
1

I

JULY/AUGUST REVIETJ

Estimated request as of May 1974:  $200,000

MC0 6/4/74


    7
*I t            STAFF SUMMARY FOR MAY REVIEW

0    IOWA REGIONAL MEDICAL PROGRAM:   RM 00027

COORDINATOR: Mr. Charles Caldwell - since October 1972

STAFF:  (FTE) Total - 18.8            Additdonal proposed: 2
Professional: (FTE) 14.8               Professional: 2
Other (FTE)      4

FUNDS REQUESTED:   Total (D.C. & I.D.C.) $1,061,249

Program Staff,                  622,234
Projects (11) Total               439,115
Continuation (4)                172,898
New (7)                     266,L'l I

Target Funding Amount:  $1,285,5X

CHP COMMENTS:

As of May 16, 1974, only the Tenco Health Planning Agency had responded
to IRMP eontinuati'on'application~for review and comment.

    Dn May 20, 1974, DRMP received a letter from the IRMP contatning infor-
e   mation on the following five CHP agencies. The Northeast Iowa Health
    Planning Council recommended that two of three projects be approved.
      Project #60 - A Planning Study of Primary Medical Services in Iowa was
     recommended for disapproval.

The Health Planning Council of Central Iowa had favorable comments.

The Siouxland Health Planning Council raised tw questions concerning
project numbers 55 and 56.
The Health Planning Council of the Midlands and the Health Planning
Council of North Central Iowa have delayed the review of the IRMP activities.

The Iowa RMP has not yet responded to the negative comments or questions
due to the short time frame.


: 4 91974     _ _


   -.. ..-    _ _ _   ._- ._..._ .-.

!7 ,IOWA      PROG YR 05 .'

REQUEST& FUNDS LISTING
COHPONENTS BY REGION
   06174 COUNCIL -

110 CONTINENi COMP .-      COMPONENT TITLE _- -           DIRECT
          _. . _ NO                                                           REQUEST
     _.... _--         _.                      

.

             too0   PROGRAM STAFF
_ _  _ __ - __  . _
.              038   MODEL RkG PRIM CARE
---.- ----I- -I- .  ..-.  --.-..
              040   SIUUXLhND AREA ilLTH EDUC. .. "
._- .-._ -. -.. _
              041    RENAL PT SOC SERV         1 .

.


                

            044   YODEL REG EMS CMNC SYSTEM
                                                             -.
.__. --.- -__-- ._.-. 050~   FAMILY PRACT COMMUNITY EDUC FILM

      _ 0%'  UNIMRH RECORD SYS QUAL CARE IMP'AOV
__. -  _~. _. .  052  Ht?SP COST STUDY PROSPECTIVE REIMBURSE      .

11,065            0    11;065
                                      -
4,430           0       49430              .

-I-.. .._-. .- -_.-.. _. . 054 -. -HCDEL .PERINATAL CARE CTR .AND EDUC
        05s - .HOMEiAKER-HDNE HLTH AIDE TRCJG
        -056    FhM NURSE PRACT RURAL

._             -
            100I000

.-- ____.   -_ .___. --..  . _                       _    _ _
              060   CRIH CARE PLAN - `-    .-

IO OF CEttjPONENTS    12                            REGION TOTALS         84lr276

_   _ _ -     _ _- __ _ . -             -

                            _ _.


    _                `

_..__ ._  __ ___-_ _._ -_  - - - . - - -  . .____. ._ -...- .- .-.-. .   _ .: __

                            _ .

--- __ .__.. __ _.--.. .- .--.- I --. -- - .-. -- --- -        -._. .

.

INDIRECT .-   TOTAL
REQUEST     REQUEST -

443rll.O     179~124   622~234 --

38~293    14,659.     52r952
33,213 .-      .
        . O- -- -. 339213

                                     ._ _ _..  _._
12r172 - 0 -  12,172 ..

74~561.           0      74~561

                                  . _- __ -.-
91871       0.   9~871

22,044

68 r302

              24r215

.

101517      110?51?

  5*349      279393

      0      689302
          .-             --     _
101424      349639

220,073    1.0619349

_. _.      ..-.             ,

..___ -...-

                                                           -
                                       _.




ml-iIT     .- . ..-. .-

RM 000%

-_ -,- .
   Rl?.Cp~Si :   . $1,733,380

          .,
    Committee Recommendation:     $1,633,380
   

Overall assessment by kdividual reviewers:   Above Average - Average

          * *
I.
I.



Critique:
Critique:
The.Review Committee felt that the recommended amount would allow the Program
The.Review Committee felt that the recommended amount would allow the Program
suffic'jent financial latitude and require them to take a more careful look
suffic'jent financial latitude and require them to take a more careful look
at the overambitious project #91, Regionalization of Perinatal Care ($325,808).
at the overambitious project #91, Regionalization of Perinatal Care ($325,808).

The Committee felt that the Kansas RMP has received good leadership from
Dr. Robert Brown.  He has received support from a talented staff which has
been -reduced considerably in size since the planned phase-out (February 1973).
Concern was expressed regarding the absence on the staff of minority       -'
representation.  With the phase-out, an outstanding black professional staff
member found other employment.  The staff is well populated with female
professionals.

Another concern centered on the lack of documentation regarding the
anticipated funding for the continuation of new activities beyond June 30, 197?.

Project #91, Regionalization of Perinatal Care ($325,808) was a very
ambitious Project and reviewers felt that some issues were not adequately
(addressed.' Dr. Brown is enthusiastic regarding the future of the project
and the prospects for continued funding of it.

JULY/AUGUST REVIE1q

Estimated request as of- May 1974:'

$300,000

MC0 6/4/74


      .
c'              STAFF SUMMARY FOR MAY REVIEW

KANSAS REGIONAL MEDICAL PROGRAM: RMP #02

Prepared by: M.E. Murphy

COORDINATOR: Robert W. Brown, M.D. - Since 1966.

STAFF: (FTE) Total - 11

Professional: 9
Clerical:     2

Note:  2 additional staff positions (1 Prof., 1 clerical) carried.Assigned
    to project #51 (Wichita HS/EA)
Requested PoSitions: 7 (5 Prof., 2 cierical)
FUNDS REQUESTED:

Total (D.C.+I,D.C.): $1,733,380
Program Staff     623,632
Projects:       1,109,748
Continuation (11)  679,244
New (4)        430,504

CHP COMMENTS: Received from 'A' & appropriate 'B' agencies & included in
       application.  Comments reviewed and responded to by RAC.

CONCERNS:

._,I

1) Project #70A:  EMS Training Programs; extension of #70 was initiated
         from Program Staff funds and is a continuation of the
          activity.                06 Award
2) Project #51:  Community Health Educ.(Wichita) 7-1   07 R,eqUeSt

                          $24,840   $117,976

3) Project #52:  HS/EA-Capital Region         20,000    112,327

Target Funding Amount (140% annualized amt.) = $2,170,000

Application request ($1,733,380) $436,620 less than target figure.
Anticipated July 1, 1974 request of $300,000 will remain $136,620 below
target. Estimate 8 additional new contract activi+inc fnr .IIIJU 1
submission.


  Mid-Continent Operations
Staff Analysis: Mary E. Murphy

Kansas RMP: #02

The Kansas Regional Medical Program application requests funding from
July 1, 1974 through June 30, 1975 for Program Staff, 11 ongoing and
4, new activities.

Applicati'on Request for $1,733,380 includes:

COO0 Program Staff

$623,632

Continuation P$ojects

#46 Health Services Training-Marymount         46,480
#51 Comnunity Health Educ.-Wichita           117,916
$$2 HS/EA- Capital Region               112,327
#53 HS/EA- Northwest Region               94,667
#61 Dental Assistant Program               50,000
#66 Juvenile Diabetes Project              59,743
#72 Rural Health Service Delivery           11,000
#74 Pharmacy Education                   25,000
#77 Indian Health Service                 55,000
@31 Hypertension Screening                97,051
#70pEMS Training Programs                10,000

'._

P86 Quality Assurance of Ambulatory Diabetic Care  28,500
#89 Primary Health Care in Rural Area         26,288
#90 Berkeley Health Education              49,908
#91 Regionalization of Perinatal Care         325,808

The Kansas RMP has regrouped previous goals and objectives to conform more
closely to the Public Accountability Reporting categories.
Projects are grouped as:

f, Health Care Delivery
  A. Primary Medical Care
    1.  Professional performance - improving existing skills
   2. Professional performance - new skills
  B. Primary Medical Care - increasing the availability of and
   improving access to services
C. Regionalization of Secondary & Tertiary Care

II. More Effective Use of Health Manpower;Greater coordination on a
  geographically integrated basis, to improve the produotion, skills,
  utilization and distribution of health manpower.

III. Quality of Medical Care Assurance

IV. Disease Control

   Program direction has shifted from the early priorities which
emphasized the "information gap," to those project activities which are
more directly concerned with expansion of new services, regionwide


                            -2-
e   projects for categorical diseases, quality assurance, subregional
    development of manpower, education programs and public education.

  The KRMP expects to submit a July 1, 1974 application requesting
approximately $300,000.  Eleven projects are in the review stages and
it is anticipated that additional projects will be completed.

An Arthritis application was submitted for review and requests

$390,013. The proposal is to be critiqued by an
reviewers.

Sumnary of the Kansas Regional Medical Program

assigned body of

  The KRMP is in the third year of its triennium. Present funding
(l/1/74 - 6/30/74) is in the amount of $856,786. Project activities
number 15 at a cost of $557,667.  Program staff numbers 11 full time,
consisting of 9 professionals and 2 clerical members.  Pre-phaseout
staff numbered 46 full time employees (23professiona1, 23clerical).
The present staff appears most competent.

  The Program Director, Dr. Robert Brown, has served as coordinator
since the start of the KRMP in 1966.  He is now serving in a full-time
capacity.  Dr. Brown has provided strong leadership for the Program.

      The Regional Advisory Council of the KRMP has remained most active
    in the past year, having met six times, as opposed to the four meetings
    required per Council By-Laws.
\--0'

  The RAG'relationships with the grantee, the University of Kansas
Medical Center, remain excellent.

  The State of Kansas Coordinating Council for Health Planning endorsed
the KRMP application for the funding period July 1, 1974 through June 30, 1975.
Approval was given for the continuation of thirteen projects, all of which
had previously been favorably reviewed by the CHP agencies.  In addition,
approval was given for four new projects, Quality Assurance of Diabetic
Care, Primary Health Care Project for Desoto, Kansas, and the Berkeley
Health Education Project in Wichita, Another project, the Regionalization
of Perinatal Care, has been favorably reviewed by the CHP "B" agency in
Wichita and is currently under review by the 'B' agency in the Greater
Metropolitan Kansas City area.  Dr. Brown expressed much enthusiasm regarding
the Perinatal Care project which he felt has excellent potential.

The application request appears acceptable for funding.


  M      1974
..-* _   .

2 KA!!SAS        PRDG YR 07

REQUESTE $I WW LISTING       
COMPUNE  S 6Y REGION
   06174 COiJNCXt -

ru CONTX~JENT   CO+p -- -' -    .CO!4PbNENT TITLE                       DIRECT
. ..^  .--- ..-.-._ _-.  NO   ._ -. .     . . -_ _..                         .-.      _ REQUEST

coo0  PROGRAM STAFF ..       .'                         492,Sti

       
              046    HLTH SEW TRNG                       41,500
                                                .
----.--.. _- .__._- _,.     ..- ._..
              051   CCN?IUNITY HLTH ED "   .    _              _ .        -.  109,529 -

_... - -... ._ _ .~_. C52 --- l-!L~ti SERV ACT+CAPITAL REG

              053    HLTH SERV ACTIV NW REG


. ..- _- -_-. _ 061 `-  D&l ASSIST              

06a   itLT!i #TN ED JUVENiiE OIAB -

            072 - RURAL HLTH SERV DEL MODEL .-
-.- ___ _._ __--.. _. __.   _. .-_                           _.... -
            074   PHhRM .E&c' - -.-. -

-. -.
         077   `IVZIAN HLTH SERi  - .

_   . -   
              82r300

at341

50,006

           59,743
        111000
       18r659 ..
       50,000

87,000

131r098

4~980

8,447

309021

13,326

     0


     0

    0

69341

srooo

lOr051

           021    HYPT SCREENING
--_ -... -- ---- .--.-    .-. -- _ _ ,. .__ _, _. _ I   _        _. _- I   . .__ __ _.            .
          07oA    EMS TRNG                          10,000 -.          0
                                                              -.     
         086  &AL -ASSUR. AMBULATOR+ DIAB CARE                       21r900 '   6,600

          '089   PRft4 HLTH CARE iURAt AREA DE SOTO              26r288        0

.  .6
        0%   o-23?

__        .               .I

INDIRECT
REQUEST



  _. _ _-.. _.__. -_ __ 090                      _..__.                  ^_ _
                  SERKELkY HLTH EDUC                      47~568    2~340
                                                    '
                   _.
              091   RiGIONALIZATION PERII'iATAL-CARE STATEWIDE              2881893      36,915
                                                                                     .

OF.C%??l?NENTS- 16- _ - ^     _ _..-_    _ .    ._   REGIGN TOTALS   .    1.478.255     255,125

_. --.. -

   TOTAL
REQUEST

6239632 --

46,480

Ill*976

1121327 --

   949667
_.   50tooo

  59,743
llrOO0 ,
.- 25*000 -.--

55rooo

971051
GO00 ._ _   - . ..-



28r500

26t288
_ -~9r906 - -.- - ~- -
325,808

~ 1,?33,380




LAKES AMA


RMP Lakes Area

ml 00013

bNY/mNE 1974 REVIEW

Request: $2,072,000
Committee Recommendation: $l,OOO,OOO

Overall assessment by individual reviewers: Below average - average

Critique: This application requesting two-year funding for five of the
13 projects was discussed in considerable detail by Panel B, The
Regional Advisory Croup and review process was considered democratic,
elaborate and complex.

It was noted that the current staff is quite large (45 total, 20
professional) but apparently lacking in some needed areas of competence
since funds for six additional professional positions are requested.
Staff leadership seemed superior.  The reviewers were concerned that
staff-directed projects overshadowed activities sponsored by other
agencies, a ratio of five to one in terms of.funds.

Based on the review and comments, the CHP-RMP relationships appear
healthy and continuous, although the two groups did not agree on all
the pro j ects ,  The RMP's ability to attract other sources of support
is quite good. Of particular concern was the request for two years
additional funding for two projects that have been funded by the RMP
for a number of years --the Telephone Lecture Network and the Tumor
Registry.  The Committee's recommendation was to approve the applica-
tion at the reduced level of $1 million; this level represents about
$400,000 less than the current annualized figure. The Committee felt
the .R&P needed a strong message about the practice of continuing to
support projects beyond three years.

,JULY,`AUCUST RJ5VIEX'

Estimated request as of May 1974: $520,453


LAKES AREA  Regional Medical Program

Coordinator:  John R.F. Ingall, M.D.

Staff:  Full Time Prof.                18

     Part Time Prof.                  2

     Full Time Other                24

     Part Time Other                  1
                  Total         45

Funds Requested:

Total  *.*..**..*****.*I*.   2,283,635

Continuation .,.,..***....  ( 662,778 )

New
   o ???????????o?????????  ( 343,755 )

RM 00013

On duty since:1966

Proposed:      6

0

2

1

9

Period of Time Requested: The period of time requested in this application is
for FY 1975; however, a number of projects are perceived as being supported
through FY 1976.       'I                            M

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


,      ,

~00013
    Lakes Area

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.       I

HMO project: NONE

EM project: EMS project is being carried over and they hope to acqutre
funding from the EMSS program at the donclusion of F'Y 1975. As of the $pring
of 1973, this activity was making significant progress in meeting its  tated
objective.

PSRO: The application makes no reference to such an activity.

Kidney:  No activity in this area.                   .

CHP comments: Received from Western N.Y. CHP, but not from the Western
Pennsylvania CHP.  The W. Pa. CHP had more than adequate time to respond,
i.e., 45 days, and failed to do SO.

The LARMP did react to the CHP comments provided by the Western N.Y. CHP and
this reaction is reflected in the current application.

E0/5/20/74


-... _                      _            . .     t

LAKES AREA ___   PROG YR .-06 _.

ERN

COMP
-.-..m --- .-


   COMPONENT iITLE
. - . _ - -...1.. .- -      - -

-.
  coo0   PROGRAU STAFF
cors  RURAL- LA; IMPRbV `.                

   - _._ -_ --
CblI         ._.
    RURAL EXTERN

-^--. -.-. ___ __.. _ COlJ TWO CNTY NUTRITION               .

- -- ._ -..-._ -.._
          001   TELEPHONE LECTURE NETWORK             

--we-- -.. -.- ^     _._.
           010   TvHoR SERV REGiSTR? .- - `-
~.-.- -.--_. _ 025-                             .. __ __..
         ALLEGANY HOBL HLTH, UNIf
      028 --- EWSS                                  -

---- -.---- __-    ---. _.
          029   LAKE A H E C                            -  - .^ ._


-.--... - .~____ _
       032  REG HYPT
- .._- --_. .__..._ 034. - PREPARATION NURS PRACT
-.--.-- .-.-.._ _ _.-_.- --.  _ _
           035  HLTH RELATED FACIiITY iTA& TRNG ..      -- - . -

-..---- .-_ --
          036  AU&LAThRY CARE SERV PLAh
      -037 -- HOVSEHOLii SURkY ELDERLY. -
2-w-...-. -_---.- - _.^__ - .-_.___ __.- ..____._ _ _ ___   ._._                       . . .  . .

JXHT!NENTS   -14. - .- -_ _       ._    _   _ _ REGION TOTALS

-I_- - - -----... __- ------.- r_ . __. . _._ _  - ..-- .- - .- _    ._.-_, -_ ,_
                 .
--    -.- -.-- . . . . _ _.  .___                       .._.-                 .

                   .                            . _.     :

-I,---- .---. --- --. - .-- ----  . - _ _      ..-. - - . .    -_ -       .-.. . _

. . - - --. .--   ___ - -_.-.   _ _                                   

.

      DIRECT   INDIRECT ~.    TOTAL
  R EQUE ST     REQUEST    REQUEST __

777,110            0     7n.110
62,800.        __.    -    `.
               0      621800
40tooo -                     C
                0     40,000    c

  _
    30,870

0

30ts70 ;

`154.400        0.'  154r400  c"

.  ,- 2OOt700 '   ..^- .._     -_  _         --
                     0     Zoo.700  c-

  17,000                 -
                   0    -27,000      ---  -

217tOOO      -0   ~217,000              I

.L.                .- _.
265rOOo -. 0  - .
                 265,060   .._ .-- .-_. _ _

140t000

38,320

5t200

     0
  ;        140,000
._...
     0      38t320
. .._-._   _  . _. _. .^         . -_ __.
     0       St200

88t800 ..- 0 .- -.- 88t800

  25,000      0 - 2stooo - -.
              .   ,.._. ._ . ^.. -_                     

2t072t200     . ..o - 2t072t200     -     . ._

_.        .    

.__ ._..         .    -...- ..--_    .-_-. .._. _ _ _ _ _ __ _

                        


--.---.- .- .- _ _ ._ _ -__ _ _.__


a


J.u LL    WV." . - . -..v
    --

e  MAY/.JUi\' 1.974 RI:VIEI*I

RM 000 33

Request:  $985,212 '


Committee Rccommcnclation:      $985,212

Overall. assessment by individual reviewers:
          .

BELOW AVERAGE

Critique:

Review Commi'ttee considered the Louisiana RMP continuation grant
application request of $985,212.  Reviewers noted that Dr. Sabatier,
Coordinator has increased his time and effort to 50X, Program
leadership and Program Staff were rated satisfactory, The Programs
past performance and accomplishments have been spotty, However, the
present application includes some outreach programs in some of the
rural areas and they have begun some patient care program activities.
Efforts are being made at bringing services to people who are denied
services at the present time.

Reviewers believed that the conditions the New Orleans Area Health
Planning Council - CHP (b) agency imposed or tried to impose on the
Louisiana RMP were totally unrealistic in demanding that they come
and present their proposals for review.

The Program has good relationships with the grantee, Historica.lly, the
The Program has good relationships with the grantee, Historica.lly, the
financial management has been excellent and the Program has kept indirect
financial management has been excellent and the Program has kept indirect
cost rates at a low level.
cost rates at a low level.

JULY/AUGUST REVIEW

Estimated request as of May 1974:  $250,000                                   .


                                                     .'

.

MC0 6/4/74


STAFF SUMMARY FOR MAY REVIEW

LOUISIANA REGIONAL MEDICAL PROGRAM:    RM 00033

COORDINATOR: Joseph S. Sabatier, M.D. - since 1967

STAFF:(FTE) Total - 8.6

Additional proposed: 1.25
Professional: .25
Full-time - .25
Other:       1

Professional: 7.6
Other:       1

FUNDS REQUESTED:   Total (D.C. & I.D.C.)   $985,212

Program Staff
Staff Components
Total Pro ram Staff & Components
  4
Projects  15) total
Continuation (6)
New (9)

242,632
12,890
255,432
729,780
324,732
405,048

CHP COMMENTS:

April 29, 1974 letter from David M. Smith, Chairman, Louisiana RAG to
Dr. Pahl addresses two situations which involved the New Orleans Area
Health Planning Council and the Northwest AHPG. For example, the New
Orleans Area Health Planning-Council sought to conduct more than a
"need assessment," notified project proposers the Friday evening before
the CHP Monday meeting that they must be present to "defend" their proposal
or the proposal would not be approved.

The Northwest Louisiana AHPC, took exception to the fact that they were
not sent the entire projects with a line budget and that a member of the
Louisiana RMP Regional Advisory Group did not attend their meeting.  It was
impossible for LRMP to have responded to their requests when the Northwest
AHPC did not ask LRMP for additional data nor for a RAG member to attend
their meeting prior to its occurrence.  The RAG is taking affirmative action
to clarify these matters with the concerned agencies. Extensive CHP
comments are included in pages 79-102.

ITEMS FOR ATTENTION:

1)

2)

3)  Four proposals amounting to $390,013 have been submitted for Arthritis.

During the DRMP phase-out period (February-June 1973), the Program
Staff was drastically reduced to a part-time Director and a business
manager.  In attempting to respond to DRMP telegrams and letters for
the rebuilding and strengthening RMPs nationally, Joseph A. Sabatier, M.D.,
Director, has re-employed his Deputy Director and two Associates for
Program Planning and Development. Dr. Sabatier has increased his
time and effort from 25% to 50%.

The Louisiana RMP's continuation request of $985,212 is lower than
the 140% target funding amount of $1,241,212. JuJy 1 request - $ZW,OOO.


                                 f
     -. -.

*I974  -:- _'

33 LOUISIANA ..,-  P.RO6 YU -04       __

MD Cbl'JllNENT CDHP
.-I.- .._. -_. I .__~ _   ND ._     __

-- .-- ..- _.-__ _ . COO0  PROGRAH STAFF
------. .L _..-_ ~.

COt4PONENT TITLE -.    -

             coo1   UED ED t PHY UTILIZATION
--,.--_ ..--.- -.-..- -- - . - - -                                     - _

coo9

         027
-- _"  __. -_  .___  _ ose

.042

               043
- -  -.. - -   044 '
_-. --..-. ._ ..-__. _.._ _ :
        047.' -.

049

   -...  G50
--- . - - . -_ - _-. _ -.  __
             OS1

.-  - .~_~... . . . _  _~ 052.
- _ _. _ _   .
             053

- '-... -. ..-_ -._. -__. _ 0s; -.

              055
        656

-.- . .---- _- .__ .__ ___
             097

i0. OF COMPCN ENTS _ :8


e--.--e -.-- ---. -__ ..I ____._

NON EMERG HE0 TRANS STUOY   .
T&G EHS PERS

OUTREACH NUTRITIONAL COUNSEL DIABETICS
`E M i HICki RISK NEONATES & ILL INFANTS
GUAL ASSUR IN MEDICAID PED CARE.      .. '


                                        '

PT FOLLOW UP HYPT SCRNG
C&T CONTAIN CRITERIA .HOSP.HLTH FACIL   -

-FAMILY NURS PIL3T PROJ     .
ASSESS CIUAL ME0 CARE CONSULT SERV
`ACADIANA DEN SERV 8 ED ~    - .

DEMO-.PRIM DENT SERV HDaL DENT BUS      

rmT HYPT THRU hluRs DUTREACH

. .

_


      .









^. .___












._. .









      





    . _

DEMO `FRIH CARE MID WA'Y ASSESS CTR         . - _-

DEMO- ACCESiIBLE PRI!4 CARE INDIGENT
ROLE FAiHLTH NURS PUB HLTH SETTING
.D&O- PEO NURS ASSOC IN'PRiV- CARE PRAC

-. .-. _. __- _                       a .

_ .     -. .-     _ _   _    REGION TOTALS

-_-. -- ___ .-       .- -.. - _ .-_           

DIRECT    INOIRECT'     TOTAL
REQUEST     .REOUEST    REQUEST .

2421632

4T800

8,000

lOlr270

16t130

6ltX45

bOr000

421740

17,400

32t90.0

34,000

40,606

24t881

451226

84t015

63t974

lbt250

38,800

94Ot769

        0.

        0
     0 -
     0.:
     0.

    2Oto4-r

        0

   0
  0

:      0

0 -.
.- _
0

0

0

17~328

    0

    0

Tt068

4w3

- . .

,

2429632

49800

        --   -- - ---- I
8tOOO

i0?,270

16t130
81t192           _.

                  .
6OtOOO          I

42t740

--
17,400

32t900

34t 000

40t606

24t881

451226
lOlt343

63t974

16t250

45t868

985t212



Crj tfrl~ic?:  Panel B reviewers concurred that the Maine application was out-
standing among those reviewed during this cycle.  There was no question as
to the strength of leadership, competence of staff or dedication and leader-

ship provided by the RAG.

It was noted that MRMP had gone to considerable expense and
beginning years of the program to develop a sound data base
care delivery systems needs could be accurately identifi.ed,
objectives and priorities established.

effort in the
from which health
and program goals,

MdMP,has had excellent success in attractiag and utilizing non--WI? funds in
support of its program and has been one of the few in the country to receive
an appropriation from the state legislature to continue i.ts operations after
receiving phase-out notification from DRMP.  In addition to state funds,
MRMP has also received support from the VA (joint funding) and,from private
foundations.                                                                          I

Relationships with CHP were considered to be good although there was some
question as to the stage of development of CHPs, in Maine.

This region was considered to be superior in all aspects and Committee noted
that no application is expected.from Maine in the July-August cycle.

JUI,Y/AUGlJST REVIJllJ
         I__-

Estimated request

as of May 3.974':'    -o-                 -


      t
*                                             RM 00054

MAINE

Regional Medical Program

Coordinator:  Manu Chatterjee, M.D.

Staff:   Full Time Prof.                 11

      Part Time Prof.

Full Time Other

6

Part Time Other                  0
           Total           17

Funds Requested:

Total  ,*..,..............   2,020,875

Continuation ..*..*a*...*.

Ijew .,,.....~..~,,........

e Period of Time Requested:

( 227,940 ) 3 projects

(1,156,071 116 projects

approx.

On duty since: ~67

July 1974 through June 1975

Proposed : 13

1'

231

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities.which extend beyond June 30, 1975.)


.

List
over

moo054

Maine

any continuation project or staff activity for which substantial increase
annualized current funding is requested.               !

HMO project:   NONE

EMS project:  Continuation without sidnificant increase

PSRO:  No problem indicated, proposal is for development.

Kidney :                                                  .
       NONE

CHP comments:   Comments support the rqquest

E0/5/20/74


-.        - --.   -   _ _

   MAY 0 4 -.

MAINE      * P ROG YR .06

REOUESTED F 8 ISTING
    COMPONENT     EGfDN
     06/74 COUNCIL

ERN        cow               COMPONENT TITLE
Me-.- -.-_ I __- -___ _. NO __..- ._- -. _      ._ ___. _. _ _ .__ .._ _ _ _.__. .

                                                .
- .~ _-_      __~                      -.
          coo0  PROGRAM STiFF

-   -.   -_. _ - ._
.       0268 - EwS COnT 8

----. -- --__. __  - __..._..
           0293  FAMILY `iRACT1Ci R&lDEtiCY . --.
-- - - _.... --.__ 03&C SCHOOi PREV HLTH             I
       O&A &AL COWWNITY HLTti CTRS
-_l_l --- ---.. -.   _
           067A   MODEL OUT PT CARE DEL SYS
---..-.- -_. -_ 06RA .t COST ANAL HFO CARE

           Ot9A  DESIGN STATEwIDE MED TELE CMNC
---.-- ..--.. -.-:...   ._.
           070A  BLUE HILL STONINGTON EVAL

DSN-P 8 23 I


                :

                *

DIRECT     INDIRECT      TOTAL
REOUEST REQUEST     REQUEST -. _

6361664

53,044

-- .__.   .
                  909246

849650

1801992

.      -.       
                   54,200

50*000

SYS       55,200

. _.
           69,737

          O71A   HYPT CONTROL RURAL MAINE                            85 *500

           072A  EXPERTHENT RURAL DENT HLTH                          28,200
-__ -.---.--..
      .073A -                                   
         HLTH CARE DEL SUPPORT BANGOR AREA        .      .
                                                            61~765

           0748   FAHXLY HE0 COMMUNITY                                 .67r7BO
. -
      .      0759   EDUC RESOURCE DEVELOP E MAINE                         102r500
-._.---__- .
         0763  MULTiDISCIpLINARY PRECEPTORSHIPS                     51,300

_ _
          077c  NURSG t ALLIED HLTH                      
                                                                80 too0

-

     07BC - ~OGULAR INSTRUCTIONAL srs EMPLOYEE TRNG                  511709
-._ __. .--. _. _
     079c EXPERIMENT SLOW SCAN TV CHNC -. `.'                     26~588

        OBOD  `P.ROF STANDARDS REV                               130 t600
     oa1D  QUAL ASSUR PHYS EDUC                             60 to00
                                       __ .._

COMPONENTS     20                          ' REGION TOTALS        2*020,875

a   -6361864
0 .- -. 53t044

_ _
     0    90t246 -

     0    841650 -

0     180,992

. .     __.

0

54t260~ -. .

0.     50tooo

0 . 55t200

0 69t737

0      85t500

0      28t200

_.  o-.

61t765 -

0    67t-780

0      102t500
0 51t300
0     BOtOOO

0      511709

0    26t588
0 -   130t600

0    60tOOO

0    2t020t875


a


RMP Maryland           --

RM 00044

Request: $762,663

Committee Recommendation: -O-

Overall assessment by individual reviewers: Poor

Critique:  This application was
its initial deliberation and on
recommendat ions were reviewed.

discussed at length by Panel B, both in
the final day when all the Panel's
The reviewer had served on the site

visit team several years ago when concerns about staff capability,
RAG functioning, grantee over-influence, concentration of program
effort in the Baltimore area, and emphasis on data collection were
noted as problems. These problems for the most part seem to persist
except that activities are noti being proposed for areas outside metro-
politan Baltimore.

The Maryland RM? does not appear to be a vital force in Maryland; there
is no progrxmmatic focus and the funds seem to be supporting a series
of separate activities.  The Committee concluded that the Maryland RM?
did not appear to be a vital regional medical program in the traditional
sense nor a useful vehicle for transition for the future. The Committee
recommended this RMP be phased out.  No funding recommendation was made
but the Committee assumes that any needed funds for an orderly transi-

tion would be made available.

JULY/AUGUST REVIEW

Estimated request as of May 1974:

$400,000


MARYLAND

Refzional Medical Program

Coordinator:  Edward Davens, M.D.



Staff:   Full Time Prof.                4

      Full Time Other               1.50

Total          5.50

Funds Requested:

Total  **...,.....,.*.....    762,663

Continuation
             .,..,,.....*.   ( 216,445

e New
         .~~,.~.,.,..,~....~...   ( 129,394

Nprojects);

1

Period of Time Requested: Nome beyond June 1975 .

RM ooou

On duty Since: July-

Proposed:     7

3

Activities Proposed:

9

416,824 Program Staff

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1375.)


I      "                               RML
                                      Maryland

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.
       *

KM0 project:   NONE

EMS project:   NONE

PSRO: Project 51 though not a proposal to establish a PSRO, deals with matters
of concern to PSRO interests.  It would demonstrate feasibility of performing
quality assessment claims review consistent with requirements of JCAH and PSRO
using a centrally managed uniform reporting and review process.

Kidney: NONE                                            a

CHP comments:  Review and comment letters enclosed in application.  No adverse
comments.  Reaction varies from moderate to enthusiastic support,

*Project 56 "Data System for Manpower Planning & Criteria Determination for
Process Review in Hospital OPDs" - The amount requested would represent an
approximate  doubling of the annualized figure.. The project would establish
an encounter data system aimed at "planning the more effective application of
community-based manpower and designing crit&ria and standards relevant to
PSRO legislation."

E0/5/20/74


.
                 . _   .~              -

MhY 0`
       4 .- _ _ _.

MARYLANO

.`PROG YR 05

ERN -.    coup               COMPONENT
- ._.. -- ._... r.-__  _  NO...- ._              _.

.

REQUESTED F d TSTING
   COMPONENTS     EGION
     06174 COUNCIL

TITLE



coo0   TOTAL PROGRAM STAFF

           051    OEHONSTRAtION OF A MODEL HOSPITAL QUALITY ASSURANC
.------..--.- -. _.- _.. -
          055  THE HEALTH PLAN FOR MARYLAND `,                

.    
          056   DATA SYSTEM FOR MNl'WR PLM'NG & CRITERIA DETERM.'

057   GERIATRIC NURSE PRACTITIONERS IN NURSING HOnES
058   MODEL PRIORITY RANKING METHODOLOGY

                     
                  \

: XOHPGNENTS . 6           : -           ._        REGION TOTALS

-_ _. _ - - _- _ :._.        _

-__ -.      .    _ _ ._ -. ..-    .-.. _..    . __. _ _

          
                    I
-...-- - .-.- ._ --_ -_   .- - .___ _

OIRECT
REQUEST

3369467

l37,OOO

25,000

57,569
`51,543
529851 '

660,430

_   . . -

            OSM-PU 63

                              t
. -                           _.

                                    1
INOIRECT .-    TOTAL
REQUEST    _ REQUEST `.. _

80,357     416,824
  6     137,000

-.
0    -25,000

21~876 .-  79,445 -

    0      519543

    0      52~851

1QZr233     762,663



MAY / ,JIJNII 1974 IKVIl~\;'
--       -I
Kequest: $3,385,158
--

Connnittcc kxonuncndation: $2,600,000

Overal 1 Assessment by ! ndividual I?cvi.ewcrs :
-me__. F--.-..- Above Average
                         _I_..

Cr.i tiquc: :
. ..---
*Ws region's proposal was rcvicwed in depth by two reviewrs, both of
r&xn haj f0rmcrl.y site visited the program. This .region was considered
to have cxpericnccd, strong `I eadership, conrpctent staff, experienced strong
JIG, exccll.cnt (I 1P rel ationships , and the ability to gcnerate health data
that rcfkcts the heal.th care needs of the region. `1lri.s data was used
in estnbl.ish:i.ng the goals, objcctivcs and prioriti.es of this region.
Rcvicrwrs commended. the region on i.ts past pcrfor-mance in bringing <an
enormous num'ber of dollars from other sources into the region.

Crjt:j.cism was levelled at a project dcsi.gm.ed to .bqFove death
certificate data and another that had escrowed fw:.ds and aimed at the
deve1.opment of communj. ty health nmpower conm~i ttc~ .  Further criticism
was :leveled at escrowed funds being set aside for the development of
an umbrella trusteeship 0.C regional halt% service agencies.  Reviewers
did not feel that these last two activitj.cs were sufficiently developed
at this point in time to allow proper review.  The above criticisms
were taken into consideratiorl in arriving at their recommendation,

JULY /AUGUST I?l3IE14

Estimated I&quest as of May 1974:  $1 ,280,OOO

DRM?/6-6-74
SCOB/IXID


v      t              MAY REVIEW STAFF SUMMARY

MEMPHIS REGIONAL MEDICAL PROGRAM
1300 Medical Center Towers
969 Madison Avenue
Memphis, Tennessee 38104

Prepared by: Lorraine Kyttle
Grant i/z RM 00051

James W. Culbertson, M.D., Coordinator       On Duty Since:  Beginning of I'rogrnl

CURRENT STAFF                    PROPOSED STAFF

Full-time Professionals - 15
Part-time Professionals - 0
Full-time Support Staff - 9
Part-time Support Staff - 0
           (Total) - 24

Full-time Professionals -  20
Part-time Professionals - 0
Full-time Support Staff - 10
Part-time Support Staff - 0
           .(Total) - 30

FUNDS REQUESTED: (target figure $2,341,400)

Total Cost - $3,385,158

Program Staff - $697,290
Continuation  - $1,633,831 (28 activities)
New       - $1,054,037 (9 activities)

0   CONTINUATION ACTIVITIES:

This request will complete a period of funding approximating three years
for five of the continuations and a period of approximately 2 l/2 years
for nine others.  This request will round out funding periods of from
1 l/2 to 2 l/2 years for the remaining 14 activities. Memphis has a
history of doing an excellent job of revolving the begin and end dates of
its activities so that new components can be initiated in response to
RAG meetings.  The overall termination date of June, 1975 does
violence to this good planning.

NEW ACTIVITIES:

Not shown in this application (because it is not seeking funds) is
the $40,000 N.W. Tennessee CHP Council activity being initiated from
existing developmental funds following approval of the proposal at the
April 1974 RAC meeting.  This application seeks $300,000 in escrowed
dollars with a high priority being placed on activities in all suitable
health service agencies looking toward the development and establishment
of regional health service agencies in response to pending legislation.
Memphis has a history of facilitating the establishment (through funding
as well as person power assistance) most of the "b's" in west Tennessee,
eastern Arkansas, Bootheel Missouri, northern Mississippi and southwest
Kentucky.  Also escrowed in this application is a $500,000 thrust for the
development of community health manpower committees for the purpose of
translating local health care delivery needs into health manpower and
educational needs.  Ten local consortia will be developed.  The sites have


1  Paga 2
Memphis Tennessee RMP Summary

been preliminarily selected for six of the 10 and they represent excellent
deployment across the region.  The eastern Arkansas group is already in
budget negotiations and the west Tennessee group is approaching
that level of development.

CHP COMMENTS:

All proposals were submitted to appropriate state and areawide CHP agencies.
Replies were received on most of them.  As replies are received on the
remaining proposals, they will be forwarded.  Not included in this
application is a Bootheel Missouri physicians assistant proposal for
a rural setting.  This proposal was unfavorably reviewed by the "b"
and the RAC deferred action on it pending negotiations between the local
proposer and the local "b".

ITEMS FOR REVIEWERS ATTENTION:

The Executive Committees of the Memphis RMP, the Memphis CHP 'lb", and
the local experimental health systems corporation (HSM, Inc.) are develop
the organizational framework for consolidation of an umbrella trusteeship
organization for purposes of responding locally to pending national legis

ing

lation.

DRMP/DOD
SCOB/5-17-74


    c1      1974


. ._ il- .-- -- --.-
     _

1 MEMPHTS .._.     PRUG YR 06

3UTH CENTRAL     COMP
  -  .--- --.. _ .__  NO

CO@0

coo1

- -. _  _   

COOP

CO55


coo4
--cooe

co39

co10


CO11

6312


co13

CO14


DO30


02 1
023'.-


033


0114'3
  -

032


040


047
04c


549.

.

PROG STAFF

COMPONENT TITLE



IDENTIFICATION INACTIVE NURS

IDENTIFiCATION HYP INC PREV AND RES

INVENTORIES H E W RESOURCES

NO MISS KIDNEY FDN

ANAL HYPT

S,E REG MED PROG

PlfB ACCOIJNTAEIL GROUP

PROFILE >MINDRITY HLTH NEEDS URRAN

EX?A;r RE; HLTH PROFILE

TRENDS  REG VITAL STAT
HLTH SERV EDUC ACTIV     - _ __

f5vEutPME~T9t COMPO~~ENT -

HIGH ?ISK INFANT

REG RLOOD GANKING & TRANS

t:+PRD'/ (:,UAL ASSUR DEATH STAT

rias AUDIT E IXPR0V UTIL NURSG MNPWR
POST GRAD EDUC INTENSIVE CARE . --       _.


HYPT CNTRL

AUDIT Ci-NTEKSG POST GRAD EDUC
                              .. -

HOME HLTr! CARE C HLTH EDUC

CRITTENDEN cL1Nrc ~0~6 HLTH CARE

OIRECT
REQUEST

INDIRECT
REQUEST

608,212      899078

69626       lr165

6,826       19165

48,393       2r447

4,500            0

?*300'           0

39600            0

2r250            0

13,706       21621

25,865       31192

16,365       3t192

500,000            0

300r000           0

230,960      53,553

2399750      44,512

60,529      19~324

58;767      10,462
559073 .,       0

21,681

1,087

643470       31,354

1529368            0

24r490            0

                  *
TOTAL
REQUEST

697~290

.

77791

?*991

50,840

4t500
_ 7,300

3~600

2r250

16,327

29,057

19,557

500r000

300,000

284 t 513

284,262

79,853

69t229 '

551073

22t768

95,774

152~36% ,

249490


                    . _


     MA e. 974




. MEMPHIS         PRM; YR 06

IUTH CENTRAL     CDMP
            NO

          COMPONENT TITLE                       DIRECT
. - . _                     .._ _      ..- _.      REQUEST

050

EXPAN MID SO EYE BANK                               159560

COMMUNITY HOSP %ED AUDIT SYS                           17r912
--MULTIPHASIC SCREENING EVAL -      -- -                 71 r686

053    GIBSON CTY HLTH SERV t MNPWR UT11                       28.924

054

055

056

057

e5 4

@bCt

061

ARLINGTON HLTH SERV t MNPwR UTIL

"IED HELP

PlEIGH95RHOOD HLTH COUNSELORS EXP NURSG ROLE

\YALDPUSHA GRENADA LEFLORE CHRONIC OXS
                                    . .
flSIoN HOSP LEARNING CTR

HOSP EED ilTILIZ REV

DIET CSNSULT
f'r9UG & TOXICOLOGY INFO CTR .-- `. -'

    339227

     6rOOO

    469026

   105,195

' 259250

    37,116

    II.240
-.
    38,498

063.-

065

-1.     ---    .
            066

PRIM HLTH CkRE REG IX

HLTH :W?YR EPsUC

                      51~600

                      16~020
_ __- ._

STAFF c SUPPORT TV FUNoi PUB EDUC

-- .- . . .._  .
            499023

067

SHARE0 HO$P AND EXT CARE FACIL

CONS~J:~ER EDUC
. -          - _.. . .     _- ,_._ .._.

329219

18p350

068

REQUESTED 6  LISTING
CO~PONEN    Y REGION
    06/74 COUNCIL

OF CDMPCNENTS . _ 39                                 REGION TOTALS       3eO55.577     329~581    3,385 w 158

.        ._









INDIRECT       TOTAL
REQUEST     REQUEST

     0


     0

8t866

4p697

6r 105

     0


     0

79718

     0

6,897
;

     0

14t 171


     0

39733

11,962

     0

2,330

15,560

17~912

80~552

339621

39~332

6tOOO

461026

1129913

25r250

449013
119240

529669

51,600

19 9753
60,985 ..

32rtl.9

201680

osn a O-23



RJvJP Metro Washington, D.C.
Rbl 03D31         --___I

Request: $1,272,3135

Committee Recommendation: $l,lOO,OOO
Overall assessment by individual reviewers: Average - above average

Critique: This application requesting support for staff, eight ongoing
projects `and four new projects , appeared to the reviewers to be a
cohesive request in line with the objectives and needs of *the region.
The Regional Advisory Group appears to be an active body 1.11 contrast
to the situation several years ago; the revi.ew structure is well orga-
nized and the relationships of the RMP to the CHP agencies have %een
strengthened.  The activities, both proposed and ongoing, appear to
be directed at major needs for the population served, with a strong
emphasis on improving cli.nical services for non-emergencjr patients
and kidney di.seases.  The RJ@ has been effective in developing joint
funding for a number of the projects.
The Conutittee believes this region has improved. The Committee
recommends that the application be approved at a reduced level of
$1,100,000.

JULY/AlJGUST REVIEW

Estimated request as of May 1974: $450,000


RM 00031

e METRO WASHINGTON D.C.     Regional Medical Program

Coordinator: Vaughan Choate




Staff:   Full Time Prof.                  8

       Part Time Prof.                  0

       Full Time Other                  2

       Part Time Other                  0
                      Total          10

Funds Requested:

Total .,.....,,..,......I    1,272,385

On duty since:   1972

Proposed:       9

0


4             -

0
13

Continuation.............   ( 1,100,083) - 8 projects

New.....,,...............   ( 679,067) - 4 projects

*
  Period of Time Requested:

Thru June, 1974

Activities Proposed:

Refer to Management Information Systems (MJS) printout. (Also, note symbol C
will be placed next  to activities which extend beyond June 30, 1975.)

,


m 00031
  Metro Wash, D.C.

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.

HMO project:

NONE

EMS project: Previously planned, second phase for communication system.

PSRO:           NONE

Kidney:   No increase , phase-in of previously planned components.

cfip comments: Until within the last year,
this Region.                 CHP (b) agencies did not exist in
      The newly formed agencies participated in the development of

this application,  The MWRMP has also assured these agencies that should
comments be forthcoming, until June 1, 1974, they will be forwarded to the
National Advisory Council.

E0/5/20/74


_.                   _.. -  - _

    MAY

-                     _. _' -

DC METRO       PRUG YR 06 '

TERN

  COHP
NO --. _ _ _

COMPONENT TITLE                        DIRECT
_ _           _"        _    REQUEST

INDIRECT       TOTAL
REQUEST      REQUEST

coo0   PROGRAM STAFF                                      136,339      359963

CO09   REG EMS CHNC SYS                                    lOOtOOO            0

__ _.

REQUESTED       LISTING
    COHPONEN      REGION
      06f 74 COUNCIL

-__-.- - _.- _.__._ _ Colt--`-- NtiRsE NJDWIkE MATERNITY NURS ',  __ ..-       _. _ .
                                                                  57,260

            co12   HLTH CARE SENIOR CITIZENS CHRONIC LONG TERM ILL          1289300
                                                 I

             coi3   HYPT DETECT AND FOLLOW UP                       i29,540
-- --.-.- _
       co14 .- HYPT DETECT ANO FOLLOW UP        _   _ . .-          20rooo*

0377 ' CHRONIC OBSTRUCT PULM DIS                            44r471
049P  COMPRE K'IDNEY DIS CHTRL CENT TISSUE TYP FACIL             12,730

-----_-.-. 2 . 049C'-- . CC'MPRE.KICNEY DIS CNTRL COMMUNITY HOME DIAL CTR       .
                                                                    21,660

            04?f  C~HPRE KIDNEY DIS CNTRL KIDNEY TRANSPL                 21~850
        049G COMPRE KIDNEY 0Is CNTRL,OUT OF CTR HOME DIAL TRNC          259000
.---.-__ ._.._. _.
      . 055 PRIM -CARE FACIL-    ._-. _        -.                    . _
                                                               332rOOO

, .-- ..- .- ___. _
            056  .ASSIsT CHPS
-. - _. _ ~. - _- -    .^,
      o

132~000

?????*?????????????????? ?? ??????? ? ? ??? ?? ? ? ?? ?? ?   ???  ? ? REGIDN TOTALS .  _ . lr16lr150

.._

  111,235.  1.272.385 .~. .~       -

.

14,216

21,630

    0
  0.

209666

4t462

5,000

9~298


     0
  .O
.
    0

                     8
---I- - ----.-- --_ - ..i-. _.- _--.__ ._. ___.-.._ _ ._ . -   -   __.. - _ --    .       -. _ --. .

osn        23

                P

172,302

100,000
           _-.
71,476

1499930

129,540
20,000 ^ .-

65,137

176192

  26,660

   319248

   25,000

332,000

132pOOO



t.     -8


                  MAY STAFF REVIEW SUMMARY

MICHIGAN ASSOCIATION FOR REGIONAL
MEDICAL PROGRAMS
1111 Michigan Avenue
East Lansing, Michigan 48823

Prepared by:  Jeanne Parks
RM#      : 00053

William Graham-Welke, Ph.D., Coordinator

Since September 1973 hc
has been with MARMP as
Deputy Coordinator since
1969

Current Staff:              Proposed Staff:

8 Full-time Professionals            12 Full-time Professionals
0 Part-time Professionals             0 Part-time Professionals
5 Full-time Other                  9 Full-time Other
0 Part-time Other                  0 Part-time Other

Funds Requested :

Total Costs   - $3,777,341
Program Staff -    346,582
Continuation -  1,675,271
New         1,755,488

Target Figure     : $2,889,404
Estimated July Request:   800,000

Period of Time Requested:  All activities will terminate 6/30/75

Activities Proposed:  See MIS Printout (attached)

Cl IP Comment :

Page 46 of the application describes the regions procedures for involvement
of the CHP "b" agencies and the "A" agency in the review and comment
process.

All projects in the application were sent to the appropriate "b" agency
or council of the "b" agencies for review and comment and the entire
application was referred to the "A" Agency Health Advisory Council for
review and comment.  Due to time constraints, however, few of the projects
had received review and comment by the time the application was processed
through the RAG.  The Program Coordinator met with the "h" Council
following the RAG meeting and prior to the issuance of project contracts;
MARMP staff and the "b" agency staff will meet with the approved project
staff in an attempt to accommodate the "b" recommendations.

A and B agency comments will be forwarded to DRMP subseoLuent to this
submission.


     Page 2
0   Michigan RMP Summary

Items for the Reviewers Attention:

Project COO2 - EMS Planning and Coordination, is the continuation of a
pro
of 36,325.
$ ram staff activity which was funded l/1/74 - 6/30/74 for a total
     The current request of $750,000 represents quite a

substantial increase in funds.  Essentially it proposes to provide the
continuation of linkages and relationships between and among MARMP
and non-M/W@ programs.

COO3 - Michigan Hypertension Services Coordination Program
This is the continuation of a program staff activity which is currently
funded for a total of $22,677 through June 30, 1975. Current request of
$124,694 represents a substantial increase in funds.

Project #55 - Health Careers Resource Center for Southeast Michigcan, was
funded for $46,600 through December 1973. The region is now requesting
$88,200 to continue this activity through <June 1975.

Pro j ect #56 - Vocation Education Center
Funded through December 1973 for a total of $35,300. Current request,
$113,463.

KIDNEY:

Project #76 - Renal Disease Radio and Television Spot Announcements
This is a continuation Public education program.

Project #lo8 - Educational Program for Automated Peritoneal Dialysis
          in Renal Failure
New Kidney activity.  Is this a part of the Michigan State Renal Plan?

DRMP/DoD
5/20/74


   M
. a 1974




3 MIC!iXGAN

XJTH C ENTRAi

.









-..

: _. -- I    ' -

. PRDG YR 06 +

COUP
NO

- .- -.    _--.-_ .'



coca

col?2
COO3


055


056


061

062 '


073

076


of30


031


C83

089

095


091

092


093


094


095


096
_
397


c31-

, NEIGH~C~KJO~ PH.&Z-l HYPT `CONTROL
DEMO HYPT CONTROL DETROIT DEPT PUB WORKS      .' .


, HYPT DETECT & CONTROL
IMPROV PT CARE THROUGH .SHARED SERV CONT EOUC

24 HOUP STATEWIrJE EHER ORUG ANAL FEAS                   81 t750
VENAL DIS RADIO s TV SPOT ANNOUNCE            - _.
                                                40 r674

.OEV SUPPORT SYS YLTH SERV GEL DETROIT METRO P 0

._

SECOiOARY ANAL DETRDIT AREA e P DATA

DEMO INVOLUE INDIANS REG HLTH PLAN '                  73 ~685

REOUESTE a S LISTING
COMPONE     Y REGION
06/74 COUNCIL __

COMPONENT TITLE

r -...       - .

DIRECT     INOIRECT
REQUEST     . REQUEST

PROGRAM STAFF

EHS PLA% AND COORD
H'f?T $ERV CEORD . - " `,
HLTH CAREERS RESOURCE CTR SE M,ICH
VOCATIONAL EDUC

CATHETER CARE EDUC

PT EnUC HYPT MGMT

                346~582

                750,000
_ _                124~694
                    ._
                 88 r200

                113r463
         51t511"

                 38~967

IMPLEMEN SYS HYPT CONTROL

HYPT VARIA@LE POPULATION

DUAL NURSG CARE ASSUR

IMPACT ECONOMXC FACTORS HYPT PT BEHAVIORS
HYPT SEiV COORD

VALUE HSHE RECORO 0 P CONTROL HYPT

106 t995

36~314

83,533

40 9500

61,260
35 roo1-

879448

35t483

84,594

28 9900

43 1454


      f.477

.__

   0
0.
. ._
  0
0


  0


  0


  0


  0


  0
0


  0
0 ..

  0


  0

  0


  0


  0
0 ..
0.


  0
_. 0


  0

lo-23
     +

TOTAL
REQUEST

346,582

750 * 000
.I241694 `. ..

88r200

113t463

38 ~967

?? o ???

40~674

106,995

369314

831533

40,500

619260

35.001

87t448

35r483

849 594

28,900

43*454

7,477

73,685


            1974


I-_ *-
        ._                .          _    .~. __

3 MICHIGAN        PRDG YR 06

__--. __-.._- __









             


        





-.  - .- -___.

3UTH CENTRAL     COMP
--- - _  _ - -_-_- -. .__  NQ -

099

100
1or -
102 -
103
lC4'

105
106
107.


10 :,


109
110

111
112
1i3'

114


115

COMPONENT TITLE

06/74 COUNCIL

EDUC OUT PT DETECT t HGMT HYPERLIPEDEM ATHEROSCL

HYPT SPOT. CHECK

BATTLE CREEK HOSP COiT EOUC -- ,

ECHO

SUPPORTING PARTNER HYPT CONTROL

PRCTUTYPE HYPT CNTRL PRIVATE PRRACT SETTING

EVAL PRSCEDURES HYPT CONTROL

EARLY DX RX RESP FAIL CRITICALLY ILL E fNJURE0

`r(DRKSH17PS DUAL CARE LONG TERM INST
ESUC PROG AUTCMRiED PERITONEAL DIAL RENAL FAIL

CE:JT NURSG PREP PROG HINORITY STUDENTS
W(ISG H@HE CONSULT & TRhlG

DEVELOP TEST NEW CRT-TERIA ENTRANCE NURSG

YED INFO SERV VIA PHCNE PHYS DENT AND NURS
EXAiG PKESSOR RESPON NOX STIM RISK HT ATTACK STR`-

GUIDE ASSESS QUAL

C3HPRE RELAXATION

11i-. - PT SELF INST OIAB
123  HYPT PLAN COORD S

CARE PROVID BY NURSG HOMES

THERAPY ESSENTIAL HYPT
MELLITUS CARD &. KIDNEY DIAL

E MICH

  DIRECT     INDIRECT
REQUEST     REQUEST

38,750

59,585

48,250

361861

869594

98,078'

51,263

46~742

58,878

569860

194,200

0
0
0 -

0
0


0


0


0

0

0

0

63~825
50,867 -'
151r4LZ - .-
          - -- -
30*451

77,593
37;10<
70*430 '-.

1591111

0


0


0


0


0

0


0
0

  38,750

  59t 585

  48,250

  369867

  86 t 594

  98,078

51t263

46,742

58~878

56,860

194t200
_
63,825

50t867

151~412

-.

 309451 .

nt593

37rlOO
_.
  70,430

     159rlLl



0    3t777,341

lo-23%

TOTAL
REQUEST

CF COMPONENTS

REGION TOTALS        3 ,m r341



                         MISSI'SSI'I'PI REGIO~JAL bED1CAL PlWWAN
                               RM 00057


MAY/JJK 1974 RWIEIV
                    -
$2,850,4OcJ
Request:
Committee Rccommcndation: $2,200,000
Overall. Asscssmcnt by Individual Revicl?Jz: Above Average to Superior

Critique :
Program 1cadershi.p strong and vi.ablc, competcilt progran StYlff, past
performance impressive, perceptive i.n establishing goals and objectives
to support accOmpli.shment of those pals, proposals congruent with
goals and mesh well.  Excellent CIIP relationships, well done proposal
that shows high degree of strength.
Reduced recommendation based on whether the large number of new activities
could be real.istical1.y accomplished in the time-frame, remaining for
the program,


JULY/AIJCIJST EWEill
Estimated Request as of May 1974.: $3,000,000









DRMI',`DoD
SCOB/6-S-74


MAY REVIEW STAFF SUMMARY

MISSISSIPPI REGIONAL MEDICAL PROGRAM
2500 North State Street
Jackson, Mississippi 39216

Prepared by:  Joe ~Jcwe.11.
Grant !I :  RM 00057

T.D. Lampton, M.D., Coordinator

CURRENT STAFF                  PROPOSED STAFF

Full-time Professionals - 9
Full-time Other       -4

Full-time Professionals - 13
Full-time Other        - 5

Total Staff ----------- 13

On Duty Since: 1970 (100%)

Total Staff ------------- 18

FUNDS REQUESTED:

Total Cost - $2,850,409
Continuation - $1,203,463
Program Staff- $491,074
New      - $1,155,872

Target Figure: $1,503,183
Estimated July Request: 3.0m
Budget Period:  7/74-6/75

ACTIVITIES PROPOSED: See attached printout

ITEMS FOR REVIEWERS ATTENTION:

EMS:

Project C114-Emergency Medical Service Program,is currently funded (6
months through 6/74) for $17,000.  This application requests $92,531
for the year beginning 7/l/74.

KIDNEY:
Project 17A - Renal Disease & Dialysis Center, is currently funded
(6 months through 6/74) for $54,116.  This application requests $151,332
for the year beginning 7/l/74.

Project 17B - Renal D$s.ease Organ Transplant is currently funded (6 months
through 6/74) for $62;130.  This application requests $178,400 for
the year beginning 7/E/74.

Staff notes there are beveral proposals in this application which
have traditionally been supported from other sources examples:
                           and Cl68 - Flouridation of

                        i
                        ?
CHP COMMENTS:            I
                         f

-_    Eleven applications        for disapproval by CHP "a" and subsequently

disapproved by RAG,  pr  'ect
     '7    /i Cl78 - Analysis of Health Care Data, NE Missiasipp.
was approved by CHP "a' agency and disapproved by the CHP "b" agency,
MRAG considered the          and approved the application.   The
CHP "b" disapproval   based on the age of the data to be analyzed.


MISS        PROG.YR 05

  e
REQUESTED FUI     ISTING
COHPCNENTS BY REGION
  06/74 COUNCltt

H CENTRAL

CO!tP
NO

       cob0

            Clll
._. ._-. _.-  . .-_-._--

_  _- ..-._ __ _.









         

Cl14

CL15
c117-
.-Cl26

Cl27


Cl28
.c137

Cl40

Cl42

CL43

Cl44

Cl45

c?.49

,Cl51

Cl53

Cl54 o

Cl58

Cf59


Cl61

Cl62

COMPONENT TITLE

DIRECT     INDIRECT
REQUEST     REQUEST

MISSISSIPPI REGIONAL MEDICAL PROGRAM

REGIONAL NEWEORN CARE PROG
EMERGENCY MED SERV PROGRAM - .- -
                               .
MISS OSTOMY t ED SERV

   425~899

   Il8r842

    809113

    16,000

QUALITY ASSURANCE PROGRAM                           73rOB9
CONi AND IMPROVFMSNT OF LRNG RES LIB . -               .16r300

AREA WICE UEVELDPi-iENT                             79r002

H&H BLOOD PRES SCREENING PROG                        84e996

SOLID HASTE MANAGEMENT TRAINING

SPECIAL SFRV MASTECTOMY REHAE.

_ _
        15,269

            2r700

CA'JCE': WZRKSHDPS FOR ?tURSES

SWDKING WITHDRAWAL CLINICS

INDUSTRY EMPLOYEE EDUCATIDN

FG3D SERVICE TRAINING PROGRAH

PDISON & DRUG INFORMATION CENTER

INSERVICE ED FOUR CD AREA

HOME CARE PQDGRAN SIX COIJNTIES

T V NETWORK HEALT!i E3UCATION     .

39500

29700

2r500

14,305

59400

28,040

7*153

389030

&ONTINUING ED NURSES FOR AGED       .
QUALITY SERVICE TO YENTALLY REiARDED
                                 _
HSSPITAL COST CONTAINXENT

PEARL RIVER CO HYP SURVEY

I     l&t200

    21~267

    20,716

    10?000

65,175

99406

12~418

6~257

    0


    0

    0

    0

29412

;   0


    0


    0


    0

    0
  '0

    0


    0


    0


    0

    0


    0


    0













TOTAL
R EQU EST

. 491t074

128~248

  92,531

22~257 '

73,089 '

16r300 ,

751,002 ,

86~996

17,681

2rfOO

3,500

29700

2r500

14r305

59400

28.to40

7ri53

38,030

16,200

21,267

tOt716

10,000


. e.
    n      1974


   ..-..      _ -

06174 COUNCIL

7 nfss           PROG YR 05

XYTH CENTRAL    COMP                COMPONENT TITLE                       DIRECT
        _ _  NO -                                             REQUEST

Cl63


    Cl64

-_ ---_ __.-_ - ._  _. Cld5

-.
         Cl66

Cl68

- -c `-`. I _ __ _ _ _.  _ _ c172"
_.   c17k

.

   _-._. - .

Cl-78

Cl79

017A

0172

c21

026


033


914


035
036 '
03; -,

038 .


032,

: TjF C3MPCNENTS     42

COHMUNICATION SYSTEH CHOCTAW HLTH SERV
HEALTH :ERVICES N CENTRAL MISS

MEDXCIL FOSTER HOMES

AFFILIATXON PRCGRAM IN FAMILY* PRACTICE

   8,883

   25 too0

   30t 594

   42 t946
:

FLUORIDATION OF PUBLICLY OWNED WATER SYS            5otooq
                                                        .
OUESTI3NAIRE STUDY OBS PED & INTEQNISTS                3t167

DISTRICT V CHRSNIC ItLNESS

ANALYSIS OF HLTH CARE DATA N E MISS

PIEKRE THE PELICAY

           J29t671
.             89825
             
             14t029

RENAL C!ISEASE & DIALYSIS CENTER                     108 t030

kE"dAL OlSEASE ERG&N TRANSPLANT                       122,256

REGIJNAL CANCER PRDGRAM

REGIONAL KURAL MATERNAL CLD HLTH CARE

PRECEPT'JR TQNG BLACK MEDICAL & DENTAL STUDENTS

PATIENT E. STkFF kC IN CHRCNIC DIS

C3NT ED TiI HELP HEALTH CARE PROGRAM

IMPQOVE QUALITY INCREASE HLTH MANPOWER

HtTH CAKE SYS DEV.AND IMPK3VFMENT

.
    1249015

  829459

20rooo

58,384

37t150

15otooo

150 too0



LOCAL PLAYNING AND CCXRDINATION                      150t000

HEALTH ECUCATION FOR THE PUBLIC                     150,000
                                                        
                  

                       REGION TOTALS        2.~549 9430

      0

      0


    0

  71054

      0


    475

201329

  lt175

  lt275

43t302

56t144

57t261

      0

      0

10 t 944

  71352

      0


      0


      0


      0

INDIRECT
REQUEST

300 1979

osn a o-231

.

TOTAL
REQUEST

8t883

25 t 000

30,594

50too0

50tooo

3t642

15 o't 000

10t000

15t304

1511332

1789400

181t276

829459

20tooo

69t328

449 502

1501c00

150t000

15dtooo

150t 000

2,850t409



                                          `. ' .                       Jsrll'
          *.                                    ----ma
        ..&'
          :. "

            ."                       RM OOO&


                                          . . .
     MAS/.JUNE 1.374 REVTE\`j                 
         ---                          


   -__ .^..
     Reqws in :   $3,010,113

     Com@ttee Iiecomincndat i.on:   $2,364,333
      

     Overall, assessment by individual revicwcrs : -  Average & Superior
   (The latter is compared with other RMPs)
              .
             
            
      C?Xi.Clque:
    Continuity of staff is a major strong feature. Program has turned around
     from heavy bio-engineering, computerized-systems analysis approachlto
     regionalized activities.
     Program is considered overambitious, especially in view of the short time
       frame. Concerns were expressed regarding staff increases for already well
   staffed central office, and proposed new staff component activities. Re-
.u     viewers found the request for new staff for coordinating health resources
     planning and development of a pilot model, in anticipation of new Federal
     legislation, unnecessary.  The data analysis activities proposed for planning
    purposes lack imagination and appear to be routine.
    Lengthy discussion involved the numerous EMS proposals: continuation.of
    several ongoing activities and 11 new subcomponents, altogether requlrlng
      about $600,000.  Reviewers expressed concern about the large proportion of      '
    funding requested for what appear to be fragmented EMS activities. They
     stated that the RMP should be certain that there is a State Plan, to assure
    that components are coordinated as parts of a comprehensive system.





     JULY/AUGUST REVIE'(J
    Estimated request as of. May 1974:'    $500,000.







                                 MC0 6/4/74



                                                                           "--4ii.
                                                                           <>$ ,









                                      ,


Pr0fe $ .,J.A C. : 0 `) c7, 1 . *  21                  Professional:  1C
  Ful 1 --ti;:;e  E                     Full -time  5
  Part-time    9                    Part-time   5

Other:       14                   Other:       10
  Full-Time  -vi                                            .--
                              Full-time
                               Part-time  B

FUNDS REQUESTED:      TOTAL $3,010,113 (IDC =349,908)
                      (exceeds est. target of
                       2,364,333 by 645,000)
Program Staff             744,679
Staff Components (26)
    (includes 7 new planning)   710,880
Total Program Staff & Components        1,455,559
Projects: (46),total              1,554,554
Continuation (16)                 692,031
New (19) and (11) EMS subcomponents*     862,523

  * 11 subcomponents are extensions and expansions of ongoing EMS
   activities, to facilitate the implementation of Missouri State
    Law - Senate, 57 which sets forth standards for vehicles and
   training requirements.  The application identifies the "new"
   locations.  Total requested for these 11 subcomponents =$290,205

CHP COMMENTS

Complete application was furnished "A" Agency and appropriate portions
to 6 Agencies; practically all B agencies responded favorably. A Agency
responded "no comment", leaving decisions to B Agencies. Questions and
issues requiring additional clarification were discussed on the telephone
and RAG responded to comments.  B Agency comments received for practically
all project proposals.

ACTIVITIES

EMS - Major expansion and additions to implement the State EMS legislation
   focus on improving EMS services, to meet minimum standards and
   promote training at various levels. RMP is applying to D/EMS (HSA)
  but understands that planning funds are limited this year.

a
.     PSRO - Quality Assurance, continuing ongoing activi,lies involving criteria
           development and data evaluation.         '

Kidney - Continuing ongoing; one new project involves training and education


Concerns:
---II

Coordinated nlanning for health i'esources - Program staff activity
           ..-. L..----__I-- .__.____ I_I_-..-.--_--_
?%r develop:aont of model fsr healCi-1 resources planninq, in antici-
pation of legislation; propose a central staff'activity and six
District liaison officers, to work with CHP and local areawide
planning bodies.  Total request for activities is $306,000 identified
for 7 "new" program staff components.

Program Staff - Request increase in staff from present 30 (full-time
equivalentjto 45 FTE and other expenses, for total program staff
funding of $744,679.  This is exclusive of the $710,880 requested
for the 26 program staff components.

Summary of ongoing projects, compared with request:

The application requests 1,554,554 for 46 projects. Sixteen are
continuation, 19 are new and 11 are new subcomponents of EMS
activities, representing expansion and extension of ongoing activities,
at different locations.  Among other new'activities are high risk
infant care projects (CPR), education and training of burn center
team, improve quality of data (establish criteria and training
activities).  Several studies and surveys deal with manpower needs
and utilization, for "health resources planning" purposes.

July 1 - Expected Request is $500,000.

L. Resnick MC0
Revised 5128174


                   


.- ,.   . . 0  _   . _ - - - .-  .._ _. -_


-    MAY A r1974 --.   _ _. _   - .

_                   _.  . _-. - - ^.

:D CONTTNENT     COMP

--11 - .--- -_ _._- ^_ NO _  .,.. -_.... -   -.

  _ .  _                          ._ --

coo0   PROGRAM STAFF                                 581,732     1621947     7449674

.









.

                                                       
      Ib            

_ ._ _ _      REQUESTED   NDS LISTING..
             COMPONENTS BY REGION

.-.._--_ ._-._. . .    __ .  W/74 COUNCIL _ _.... . . .._.       ,...

  . _ _       
COMPONENT TITLE'      .' . ,.   _ _  . .-. ". .    -..  DIRECT ..  INDIRECT .'   TOTti
                                                         REQ'J'ST
                                                                           -
_-.  .- _ . . .  _-a. I      .  .  ..,.  ,. .._  I"   .^ I".- REQUEST -.. ..,. REQUEST . . . .

_ -*_.       ,."
           0x6  PROG EVAL GROUP   ' ,  ' .                       25t350  6t495  319 845
                                                                           _ -... -. -       - ..-
_-_ .---.-
        t0;14--             ..- _-       ._, . .- . ..-.-...  ,._~ .   _._ . . .  .-.  ._-_.- .._-,..
                HLTH PKFFILE PLAN STUDY                               9,000             0        9,COO
_- . ..____._ -.- -I
            co15  &AL' HOSP SYS       " I _ -   .--____- .
                                                    9t05q       2,314      11~364
        co21 .- DIAL ACCESS NED CONSULT -' `. --".            -   
_..- ".. _. ._  -. -... *.-  1.                                 2,100    540 -'    2~640
          _--I-.
        co22 -' ..                         __-_ _ .,...
           ST~;E' RENAL DIS SUPPORT *        ___. .-- . . ._._.   . . . . . . . . . _   -,, .I..__ * ..I.  .
                                                             47 t300 , -.-..-. .x2rlx7 . .  59,ct17  _

                                                                           ._
          ) __-. ._ Co24 -- C&T KFG CMIK RESOURSE UNIT _ __. .,_ _   _... . -   .- -_. . - _ -
___ . _ ,._ .- --                                 23,400"  5,997      29,397
          PLXTGRAI) EOCIC PROGRAMMING .-.  . _.  - _-.   .._.       
__-__ .-..-  - .  ,__..~ co25 --                             17t300' --  4t607.  21,907 '. .

,,*-, .--". 1 ."I **.-                                       .,. .   . . . ..-. .*w    .,  . .-,                                        I
            co23   JCAH AUDIT UEVtLOp                    39350 *"  892 `.. .   4,242
                                                                           
___.- ..__  -... _.- .-.. co29 -.- SHARED TRANSP CHRCN ILL ISOLATE6 --             39750 .'   996  4,746
          NORS CLlNICAL TEACH PKGS -.
       co31 I-                                    . .   -  _ _.. .
__ . . - .._- _.--.- -- .                                 101775 ~ '.  X.536 -'-   12,311
                                                         _ _., _ .-_ " ___,_- -_.. -.-..- ..----- .-.---        ..-. _--        -...           _ _ . . . . _    ,.
____-- ._---_-----     --.. -
             co32  INNER CITY CONSuME'R HLTH EDUC -`.'                     26t600       7,075      33,675
                                                         ,_ __ __ _ _._ ___.._._ -. ._.- ._ .- ..---.-                      __.._- -.
_~_- ------ .-
        co33 - .I' CE.NT~DA+A BANK' END .STAGE KIDNEYPTS       '         179575 ..-- .  4,503      22,078

                                                        __. _ _.-..-  _ _..__ ___._. _- :. __   .-.                     _.-             .
_.-___ --_-.---- .-     _-_..                         __ _._ __
             CO34  HYPT- OATi ACTION- AND `.EYAL                 43;250 .-.-   11,080      54,330

                                                                   ,-.--.-- -- ...-.I-_..I .-.. 30,200 .'-.  8,030 - -- - -           _ _... .     
          -. _.
        co&- N-ET\&%- HLTH "- ...-  _. __ ___,_ .."_- _-..-. .._...-. -- _ ..-                                    389230
                                                        .
                                                    f  __,._.._ _  I .__-..-._.- -._ - . - -          _ . _      -   .
_____ .-_. __ .---                               _._.
            EVAL- COkl4UNITY ACTIONS    . _
            co16                                                     . ltOO0             0     1,000 - ..

                                                        ..- . . ..-..-- .- --- ___ __._ .._.. . ._   7tb00 . --  _ -_  _
       C02d  HLTH CATA SERV     _ ..__ -._ _...... _                                         0     7,050 *
                                                                           b
                                                          ..-  ._._ "_ . . . . -...--. ._ -- . . _... _ ,_ . _        _. __.--. _ -      _ _- . .
__--.-_-_---...  _. .-- . .                  ._  .-. -I . . .._ c  .  _
              co39   EMS SYS KAN CITY               `.                         11875          498     2r373 _. _    _

                                  ___ ! .___ .._-__ .     . -... -_ -    101400  .._         ..-_ ._.                _
co40 -' Mb HLTH PROFILE ikiN BOOKLET                                              0       lOT400

                                                                           . .
_. ._ _. ._    -_ .- -.   . CO41 STATEWIDE PKOF NURSG-STUDY ..'                     48rOOO       0' -.. -48,000

                                                         _.__, ..-..-.   -" ..-- ^ . .._  --. .-.-`,.'         .,_. ."._        . - . _. .
._.--__- --. .---.. ---   -..
         tO42.  PILGT f&EL NEW HLTH LEGISihTION                  102,250'     18,675   XZOt925 (

                                                                       _.
. . . -.. co45 DIST LIAISON KAN CITY      ."                    31,000        0     31tboo


                   __._..._ __ _ -. __ - .- _ _.   ._.._
                                    CO,MPONENTS BY REGION                 '
__- ___._._ ___-_---_. -.  ------.-.---.-I_-  .__._,- -.-__ __.. .._..-. --_-     06/74 COUNCIL.. _ .___.._I .__ .___ ._

`9,. `XI S!pJRX . ..-~   PROG- YR O?. .-   .__

..~
ID CCNilNiNT

coqp ..-- - _  _ _ . _ . _ .    _ . COMPONENT TITLE    - --  - ._. - -. . DIRECT -`-.

.--_. -_--_.-_---_-_ NJ0 --.. -. -..-        . .--_ .    . .   ._- -.. - -..     . _ _.. _ . I ^ - ._  . . REQUEST

CO44  CdSi LIAISON NW MO' ~ -,                     . _         1.
                                             31,000'

.- _._  .._-. _.. .I . .   -`DIST LIAISON NE MO      . -'            _    ._ . .    .
              CO45                                                    31,000
                                                  .

_-_. .___ -._ -.. ._.  . I.  .--- -. ._.- .^- .-.-..  . .- - 1- _,. .__---  _. -._.. __  . . .-
               CO46   DIST LIAISON SE NO                               . 31r00O

.-. _- . c347 DYST LIAlSON SW MO                   31rooo

___- ._. ._ - ..__ .--..    DIST LIAISON CENT MO . -  _ _   .  _ ._
               CO48                                                  319000
_--. A-.- .__.-.--   . -- .
              026A  TRNG COMMUNITY HOSF `NURS FOR- EMERG' -  _ _...._ .--,, _.".. . .  . ".. - ._ _        ^ .._.
                                                                    44r200'

.---.- ;-      046 - -                _     ._    _ - .._ _ ,
                    HI BLOOD                         * 71,ZOf -.

___ _ _ _. _. -_ _ _.   
                083   GREEN HILLS COGP-HiTH'-CAR;-- .- ....          42rooo
_ II_-.,..-- ._._- -._--.     - -                           - .._.    ,. _. _ .I.- _..-..I . _ --. - ..- -
              086  DOCENT `NUKS OUTREACH" - "`.                            501735

092 ---                      _ _. ._ _ . . _    ._ . -. . ._ -..  " _.. _
    EiMS NE & NO CENT `MO                     85r623 -

___--._ -._-.-.._ .- _ 093 :- .- RESQU II                            ..~ _.   .   _..  . ._ . _  -. _ 141,838 .'

-____ .-_- ---.--                                .____..._ _ _  __   ___. . .__ - .-.--..-.._ -.. . . .._. - . ,-.
              093A  S W MO PILOT TRNG' MiMTS                   24,003 -

INDIRECT     TOTAL
REQUEST    *RECUESS

0


0

. . .-    _
      0
    a

      0
.`i2;450
   0
_   `0.. -
19,395 -

       -_._ _..
13P403      499026
  .:
    c .    14:, I:28

37600

--. . _. _- _._. .._. _--       ..- EM MED BASIC TRNG  _ . . _.  ._        _ .   _ I _._ . __ .                 .
              0939 .                                                     29~124 *        0
__ _  _ _ -   . . ._ 093c KAYSINGER EMT TRNG -.-.- - -    .-..     " _ _   _ __       19,410 .- 0

.I_--- -_- - --   __.. `. - ..__
                094   GREEN HILLS EMS `.  _ _.-. - . _. _ . .." - _. .- _ .._. _- .--,- -. .-   18,000 .. .- 
                                                                           0



._--_. .- ..- _ _.--__- _  095.  CPR'                       _, 0.   ..-_ I       28,000 .-    21092
_ ._ - _ _  _  _ _ .    NU4.5 ASSOC NEURO HANDICAPPED    .. ..    - .-~.  _ .._ _ 
               097                                  43;294' 15~078
-.____ --._-- ._  -_. --_                          _ .._.-..-   ..____ . . . . - ..-.-.. .-.- . . ._- . --...._. _        . _ -   
               102    I?lPf?OV REG TISSUE TYPING SYS . .                         48 r462            0
~--- ---.---._ -   -- _                                 _ - . ..- _
          INTER-HUSP KID,NEY TRANSPiANt SiRV          .- ..__ ---..-- .-_. -  . . .
               103                                16,250" - --_   0 -
         104A' .. flZARK.FXlTHILLS EMS PLAN IiPLE             _ _. _ _   19,700 -.-    0

--._----..-M.-e- -.  -. . _ . _  _
            EMT AMSULANCE TRNG .--  -.._. _ ._  .   -_,. - I-  -- -.- ._.- -.a. -.._ . .- .-.__. _ ..-*.. -~ . . . -     . ," -.-, . ._ -- . ..--..  . ..-.-
               1046                                                 8,400            0
. I.. ._   ._I _.  ld4C  003THEEL EMIXG ,CARE SYS IMPLE        ,.    . -  17,665 `:     0.
                                                                           _




LISTING . .

COJdPONENTS BY REGION

09 I~~SS0UR.l. "   PRGG .YR 07 _ _..__     .._     .       .

                    __ _ . _ . . ._-.- - .-.. _ . . - _     
                   COMPONENT`iITLE. . - -.     "
Mid CONTlbkNi-  .__ _.
               CUMP                                                    DIRECT
         - .-_-.-.- - NO ___ I__.- -__-,. -  -- .__... - ._..--   . - -I.- _ ._- . .- .-_.-_.., ..-- II,   .- REQUEST
,_ _-_- ..-

                     _ __._ _ _ _ -.
            CCNT EMS EDUC ENERG PERS - .- _  _ __ .   ._-.   . -    ,. .
.-~_ ._._ ___ _-_.
              1040                                                ZVOGO

.._-_ - . I_ _. .-.-..-. _ _ _    - - -                                             -
               105  INTENS &,RE NURSERY CPR ". -.'      -                   5,642

-- -___I___- --..-  _ I .., . .    _ . . .      . _._,__-- -.._-- _-I_ -es-.. -----I- - -.-..-.-.. --
                106    EMERG AMBULANCE TECMN                                19900
          CD&R&AL ERS TRNG  _. _. _-.  .- . .  . ..__ -  . . _ - -     -    --
._____ --._-.. -_-.. --.. 1CbA --                                                  679825
-.__ -_ . .._ .----.-.-    -.. --.-
                loba  EMERG AXP.ULANCE TECHi    .-.-                            5~200
  .

_I_-___-___-.II. -  . - _
              107   EM+ T&G -'           . ._
                            _ -. .   ,. _. . .- .----. ,- . . .._--^.I. _.- . . . ..- _-. . . --....
                                                                     58 t718

       .__ _.._ -__ _    .                            _... _.
           ?Mi?.G MED PERS TRNG AUDRAIN      . . .._-  ..- ..--   . .i-
                107A                                                  129184
__  -2 _____. ._ .._. --. 1078 -  EMS TRNG HANN 16AL             _ _   _ _ ._    ., _ ._
                                                                        6tOOO

-_--. ~----   --.-.-
                 108   GREEti `HILLS IN iERV TRNG                            9 t700

- ____ ._ _..-- - ._.._ -.._.-    ..- .
               110  `DUNXLIN CNTY COMMUNITY bLO$D PRoG ---' -         31550

                                                                   _   _  _ _ -.
                111   INDEPENDENCE PLAN COViRE HLTH SERV - .' -.                 34r 842
____- --.-- --.  .-..- ..--_ -
              112   MIDDLE .&SK NEVBDRNhFANT .MGMT   ____.._ .- . . . ^_-- _._._.. ."._. .-_..--
                                                                        67t572

- ___. - .__-_. -.-_- -...-  .  -.  -... LONG TERM CARE PARAPROF CONT ED          __- . . _ _  _ . .._. -- . -.-
           113                                                  27r700
_- . ___ -... __.- __.   _-...    -                                .     -.  _ ._ __. . . __-.  - -
              ' 114  GF(EEN HILLS ME0 AtJD1-r WDRKSHOPS                          .2t400

INDIRECT
REQUEST

._ ._
         0 0
 
         0 0
_.. ,_' _
_.. ,_' _     -
              -
         0 0

     ??676
     ??676


          0 0
.
.   27r910 ~
  27r910 ~
     0 --
     0 --
      0
      0

    .
     .  0 .-
     0 .-
".
".
        0
        0

0
.

51200,

_ _ . _ _  -. - _      . - - .
         0    b-7 t .`Fz .---  - ..


            _--. _.._       ---. -- -. ..-- _... __
         0      27t7a

_.. __  .- __ -....       .^ .- __ _ -...  . .._ _ _
        0        21400

                HLT; ii- AND-INVOLVE _-- _.  __.._I,_.._._-_ _-.~,.-. -..... . ..-.-_..-_ .----          __..... .- ,.-__
                                                                           _.-     -. _._ -._-.
-___ll____l _--.-. WESCENMG                                                                           -.  -.  -. -.
                                                                           _   ._  _.
               115                                                   72,990            0      72 PS'S
                                                        o
-_--._-. .------.  -     .---          HOSi PERi  `-.  ???o??????? ?????? ?  ????? ??? ???? ??  20t000-    -. ????????    ? ???? ?? 20,00\~     -- -
               116    EFFECTIVE  UTILIZ                                                            0

_    . _. _. .-- _ _   _

-12ts50 -.   .-- . ..__

                                                      ._ _ _, __ ____.. ._  ._.. -... ._. _L .-_,           . . . .._ ..-- o  ..-.
                117   LAKES AREA HLTH MNPkfR- SURVEY                           12 t 850
                                                                        
.--          _-- -    -. -- --
            MN&i KiCRUIT- HLTlis-iARi IiiST `,         __  .._-_- .-. ._ -.- .- .-.-__.._ .- .       _,. ._ -_.____...- -.. -  .-.-. *
3                 116                                                   13t270           0    13,270
___ __.. ---- --___ ------   --.. QUAL CRI-TERIA HOSP SifTING  . ___ _.,._._- __. .__ __ ._-_ ___-... ..- --... _.         ._-_. __.._ - __..  -__ _.-..
                119                                                   23 9000            0      23r300
.._-^_- _ ~__-- _-._ ___ .__ _.  _ .-_                          __ __ _. -.. _.,... _ . _._. .-- _--.. _.-_.   . ..- _.
                120   KIDNEY DIS EDUi' ...                                 409000            0    40tooo ~. ~

---....-,- -.-.-_. -. i -. . - -                                                                          -- .- . . _.- -..._-
                             _                 ,._._ _ ._~ ,_- ...-l..l--...- ..- . . . . _-a -,.--..." -...m.  .-..-_ ,-_- .-..                                      - -..- ..- ._.
                121   COM!WNITi~ hASiD HYii                                34r045            0    ?4,0& ---- ,--
_. _. _____ -.. -.._ -__ .-   - _.
            SE HOME HLTH CARE AiD HOMEMAKER SERV .-.- _ -... _ _.... ._-._ .-.._ _ _.  . . . 2.         _._. _.__  -._ _ ..--_ _- .-.._       - - -
           122                                                   12t350            0      121350


                             REQUESTED F     LI STXNG       _                     _ _:_
                                         COlYPONEN      REGION
                                           ,_ 06/24     IL - _..-_- -....-.-..,  . : -.. . .   . -.---._ .

~"`:>~:jii:J.I __ .____
. .            PROS YR- -07 `-. _.-. .- ..-.--.        ._-..   .- .- . -. - ..-. ._.. _. _                       ._.. . .

-.: `.   123    START UP P T SHARE0 SERV
                 -.,
            134   GREEN HILLS C-WC -.
  .._  .  ._ _ _. ._- .  -. . _ ._

                                                              ._ 38 ,724.  .-._
                                                                           0  -- 38,724
                                  9rooo .... - 0  _ .

                                                                                   9,000 -. *
                                           -  .- .-.. . . .._. ". . _. -                         . . -               -. _ ._.. ._
125     R E t; P,XN CARE TEAN CEVEL AND ED      ,           34,450' - . . . o      341450

                                                                           
_ _        FiNPk!? SURVEY AND UTILIZ                  2'1,359  _ .-_  d  .          .___ .- ._.-. -_. .._
          L2b    !-iLTH                                                                 21,350
        STUDY DETERXINE NURS SUPPLY AND DEMAND -.- -  . -   .- ._ _               
          127                                                      5 r775       0..  5,775  .

._  ._ . _. _. _- ___... - 120'                         . ,... -. _ _,. _
          HLTI-! ED- LADDERS-`MID MO *                -  _. . -. .~ I -...  -._. 50~000 . -.-  .._ _.. _._.- .               _. -__
                                                                           0    50,000 `.

                              . .               - _..      _.:
129    R!$!?iL AXSULATGRY CARE                  52t00d. ."- o -  52~000

Ft. CL71:?L:tiZNTj .._._ _ 73:.   . ..-. - -. _- .---. _ . ._ ,. .-. _.__ _ .._.._  REGION TOTALS .__._. .~_ 2rbb0,205 _  -.349190a _. 3,010,113 _I   * .._ _ __

   _                                                                - .   .  _ ._             _  _

.                                                            __- _ _.      _ ___   _            - _    _       __

.-         - ._. . 1...    - .-... . ._ .-. . . . _    .._ __  _  _,_           -.                     

-    _. I..     ._    . . . . _    _..I. -...   ._ . . . . "..~. .I.. .-  . _. ." .   _ . _ . ._ _    ., _ ._   _ _..    .__ _

                                      I
.- .-.. _ - . ._- .._. _        -`.  . ___                       .__
                                                   _. ._ . ,_ .,                                                    

                                                                           .
. ..-. -- -.    _I^. . ._.,_     I ,. 1. ._- -_ .., ,..    . I      ."_,        . _ _ .    _ .     -- .

     . .    :. . . . . . I. _... _   -   _                         .  _



NM1 Mountain States  --

PM ooo 32

MSRMP is a well-organized well-managed program with a good
review process.  The region has experienced, stable staff
leadership.  The Regional Advisory Council is strong and viable
and controls program staff direction in terms of goals and.prior-
ities for the region.  The application proposes continuation and
new activities that are in line with program objectives, which
are well-thought out and properly reviewed.  The RMP has attempted
to reach out and provide good service to the four states and
appears to have a good working relationship with the State govern-
ment and CHPS.

The Review Committee questioned the marked increase from l/6/74
budget allocations to the proposed figures for the Areawide Neo-,
natal Intensive Care Program (page 105) and for all of the EMS
projects except the Wyoming component (see pages 92, 94, 97 of
the application.)  Staff requested and has received additional
budget information from the region which appears to substantiate
the requests.

3ULY/AuGUST REVIEW

EstimaCed rcqucst: as of May 1974;   $225,000


STAFF SUMMARY FOR MAY 1 REVIEW

MOUNTAIN STATES REGIONAL MEDICAL PROGRAM:   RMOO032

GRANTEE:  Western Interstate Commission for Higher Education -
       Boulder, Colorado

REGIONAL DIRECTOR:  John W. Gerdes, Ph.D. On duty since 1,/l/7.2

STAFF:  (FTE) Total - 29.6          Proposed:    38.6


      Professional 18.1           Professional 22.1
      Other        11.5            Other       16.5


FUNDS REQUESTED:  Total (D.C. and I.D.C.) $2,409,356

Program staff (Administrative)   255,316
Projects: (New) 16            635,440
(Continuation) 11          1,518,600
      TOTAL REQUEST       2,409,356

CHP COMMENTS:

Comments were received fran all four of the CHP(a) agencies and
four of.the seven CHP(b) agencies.  The Idaho CHP(a) Agency did
not endorse Project #313 - _New Health Manpower Developmental
Activities Phvsical Assessment Skills for Nurses (see page 232 for
CHP comments.)  It appears that CHP has misinterpreted the purpose:
of the project.  MSRMP is in the process of clarifying the issues
involved.  The Clark County CHP(b) Agency commented negatively on
four projects; it is difficult to determine the significance of
these comments.  The MSRMP, however, has responded to all CHP
comments.

ITEMS FOR REVIEWERS ATTENTION:

None of the activities proposed appear to conflict with other
Federal programs, such as HMO, PSRO, Kidney and EMS.


Mountain States.- Page 2.
        1
  I

a     CONTINUATION ACTIVITIES:

Of the 27 discrete activities proposed, 11 are continuations.
Significant increases in continuation budgets are noted for:

PROJECT

6 months           12 months
l/74-6/74        7/74-6/75

Page

#112 EMS-Idaho         18,500           240,275         92

#l13 EMS-Montana

26,000

144,749

94

#114 EMS-Nevada

17,131 .          195,760        '97

#212 Areawide Neonatal'
    Intensive Care      10,000           234,611        105

#312 New Health Man-
   power in Mountain
    States           15,301            96,030        181

WO/DRMP
5/20/74


.- a
  yhY 35t1974

COMPONENTS BY REGION
06174 COUNCIL

     
CCIHPONENT TITLE
            _ --

_.   .  . . .

   _   _. - _ _... -.. .- -.  - -
32. NCUNThXN  PROG YR Od

.
       _.
WE STERN         COMP
            ___ NO .

_. .~..
              coo0  PROGRAM STAFF REG OFbE
                                                 ._ .
         coo1  PRDGRAM STAFF IDAHO
        ____.---.
              CD02  PROGRAM STAFF HDNTANA        0

              co03  PROGRAIl STAFF NEVADA --
`.-.-- .--      :.
              coo4  PROGRAM STAFF WYOMING
_ .__ .__ _-___ _._ __ .- .    .-
             0004  AREAHIDE NEONATAL I C'    ... ."-

-_..-.    - .- -
.n           uoo5 , E H s

__- .._ -

POGb  HOYE HLTH CARE.MT STATES

_ __ _ _ ._  . _  -- -..  -- .
            0056

ACCFSSIEILITY DEVELOPMENTAL ACTIVITIES

   
              DOD9

SPECIALIZED SEKV DEVELOPMENTAL ACTIVITIES

_     _-  
             DO10

.__I ..___ -_-.-.- I- DOi

- -- - --.
              0012
__ *    ..- _
               DO13

CONSUMtR PARTICIPATION DEVELOPMENTAL ACfIVlTIES
                                              . .
MECHANIhiS DEVELOPMENTAL ACTIVITIES
NEw SKILLS DEVELOPMENTAL ACTIVITIES

NEW HLTH HNPWR DEVELOPMENTAL ACTIVITIES

^-. __-..- -.-  _----  .__ 022 .-

NEW HLTH HNPWR MT STATES   . .   .

^.. .
      023

KEG HLTH TRNG NFTWORK

         q26A
  .__. .-   _ - _.. _..- - _. -
--Y                0266
                      .
                031

ENS IUAHO

                           .*        
Eus MOMTANA

REC EREAST CA DETECT

REG ME0 AUDIT SYS DEVELCP
ME0 i"DIT ?ROG DEVELOP MONTANA -

REG NURSG CARE AUOfT PROG

DIRECT    ENDIRECT      TOTAL
REQUESr     REQUEST     REQUEST    -

65,802

3bt4ti

38 (096

349094

391863

I  2071969

  181 d60

  811331

  38,116

  32,890

  20~898

   lr955

  48~525

   6r813

  89,074

  259r282

  222 ~733

  131,071

  80,676

  177 r547

   19rlll

  68.r236

12,126

  6,954

  7,345

  6r466

  71306

26rbri2

141 SOD

21419
.3,78Q


:  3,023

  ltbb3

    244

  3rfBO

     105

  69956

  209416

  171542

  13 r678

13,011

  29~8.58

  4tOb7

  fr835

77,928

43,418
           `-. .-
46,241
60,560 '

47rl69
234rbll -

22,561
2,199 --.   .-


52~305

6r918
96,030 ._    _ .

279,b98

240t275

1449749

93,687

207~ 405

23,178
76,071'


                                         .


MA e 74

REQUESTED a LISTING
COMPONENTS BY REGION
   06/74 COUNCIL

MUUNTAIN _ .   PRO6 YR 06

STERN

   
     COMP                COMPONENT TITLE                        DIRECT
__..    NO      .-                        -.                         REQUEST

..-^    ._. _..
             034c   PHYS OFFICE LAB IMPROVE .                           22,529
_^ _        035                               _                
                 EMS SYS DEV SHERIDAN CO                           219294
---- ._- _  --___. 037 - -- - HiPl SCREENING HYDblING -      ..- - .- _      .  . -  . .
                                                          36,143
                                                     .
_-. .- ._
              039  -SHARED iERV PROJ                                30,290
- _   ..- -
           040  WY0 ACTIVATE0 PT -               `31,345
.-. ..-- -___ .__- 041  CV' 01 S CONSIJLT               . .._         -. `...
                                                    , 17~645

.- -.. __._~
            0.42   DlS DETECJ HYOHING                             28,741
_   _
             043  ;ILTH CARE IWPROVE RELATE0 PSRO                      53r784
..---. _.- -_.. _ ,^_ .._ 044 -- Cu AND KIDNEY' DIS REGISTRIES   _ _. .     _                I
                                                              39r838

045    OPERATXCN SEARCHLIGHT                              50r035
                                    ._

OF CCMPDNENTS...~....32... --__._. __._.     ._ _" _ _   REGION TOTALS       2~168,250

--._- -..-....-- ._..._... --_..-- --- -I ."_._. .   . ---. -- - -    .-.-_ _     -_

:NDIRECT
REQUEST

1~814

lr663

2,879

2,722

1,663

Iv361

2,268

9*912

3,176

`3,932

241,106

                   I
TOTAL
REQUEST _

249343
22,957 -
391022 -

37,012

231006
19,006 .---

31,009             ,

63r696

43r014
53t967

2.4099356 .-

-.



RMP Nassau-Suffolk

RM 00066 __

MAY/JUNE 1974 REVIEW

Request: $1,096,910

Committee Recommendation: -O-

Overall assessment by individual reviewers: Poor

Critique:  This application requesting support for an expanded staff
(from 8 to 15 professionals), six ongoing projects and one new project,
was discussed at length by Panel B.  The reviwers pointed out that this
FU@ had previously been an I?MF'-CHP agency under one director with
priorities for the two-county area developed jointly by the RAG and
CHP Council.  The dichotimous arrangement was terminat.ed last Fall,
with the RMP concentrating on the non-planning priorities.  In the
past year the RMP has had three coordinators, but the program appears
to represent a holdover from the original coordinator in the grand
design of previous activity and programming, The present staff, it
was noted, appears weak; no member has an advanced degree, including
the coordinator and the backgrounds of the proposed new staff are in
the fields of social sciences.  The reviewers were concerned that staff
does not have the leadership qualities and experience that are needed
to develop health care programs based on the stated priorities.
Furthermore, the reviewers questioned the effective functioning
of the Regional Advisory Group and the grantee during the hiatus
of staff leadership.

The RMP has not complied with the RAG-grantee policy although it is
understood by staff that this may be finally near resolution,  The
problem up to now has been a preponderance of corporate board members
on the Regional Advisory Group.

After considering the history of this RMP together with an analysis
of the current application, Panel B recommended that this RMP grant
have an early, orderly termination. The Panel reconsidered the
recommendation upon reviewing all its actions, but came to the same
conclusion. The Committee concurred, While no funds are recommended,
Committee urges that Council and DRMP make available
funds that may be needed for appropriate phase-out costs. additional

JULY/AUGUST REVIEW

Estimated request as of May 1974 :

$850,000


NASSAU-SUFFOLK

Regional Medical Program

Coordinator:  Rajeshwar Prasad

Staff:   Full Time Prof.

      Full Time Other

Total          11

Funds Requested: May 1st          

Rtd 00066

On duty since: April 1974
        2-l/2 yrs.

8    Proposed:        15

3                     7

22

Total  . . . . . . . . . . . . . . . . . . .   -1,096,910

Continuation.. 46$.....,..   ( 682,760 )
New,.......,..!;l!........   ( 50,000 )

Period of Time Requested:

All projects core staff and activities are within 6175.

Activities Proposed:

Refer to Management Information Systems @IS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975,)

.


                                             RM 00066
     I
*                                         Nassau/Suffolk
List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.
Project 21, Nassau County EMS Project requests $288,750 a substantial increase 'over
the 43,015 & 53,308 the project received to date, Also Proj. 22 is requesting
5116,516 a request over its 43,014 & 53,306 (See EMS below).
HMO project:

NONE

EMS project:  Projects 21 & 22 represent $405,226 or 55% of the 732,760 dollars
N/S RMP is requesting.  Of the $405,266 EMS funds, $229,998 or 56% is for
equipment.  EMS Project 21      requested 208,000 for equipment.  The HS
consultant in EMS equipment has been asked to look into this request since we
received additional information and still cannot make any judgements.  The
NYS/EMS Department Gee18 the Nassau request is to expand the existing gaps,
NCR&D comments have not been received as yet.

PSRO:

NONE

Kidney: The existing kidney projects were reviewed by one outside the
region consultant (Arkansas).  He indicated both projects were complementary
and supplementary but might be brought into a closer working affiliation.

CHP comments:  Favorable.CHP comments were received.


        __ ._ ..- ._ _. ._ ___. _ _

    MAY m 4~ _`.


.._ .-_ .__

.

_ REWESTED      LISTXNG
   COHP.ONEN      REGION
    06174 COUNCIL

NASSAU SUF      PROG YR 04

TERN

COHP
. ..-..NO _ ._-

     COHPONEtiT TITLE
..__..     ._        - .   _

                                                       .
COO0   PROGRAM STAFF
   .SUFFOLK CO DATA BASE STUDY FOR AMBULATORY CARE    ' -
coo4

-._---.- --.__--._. -    -_.-.
          CfYHPREHENSIVi HOHi CARE PROGRAM.             _ . I _ I .
           001

009   REGIONAL DRUG INFORMATION NETWCiRK OF L I
014  NASSAU SUFFOLK REGIONAL ORGAN DONOR PROGRAM

;- -- .- __ --_.-_.    _ _.
           NASSAU COUNTY EMS .PROGRAM' - ..         .  .
           021                                         .
       022 S C `3% TRAINING PROGRAM
-.. _ _ _ __-
            023   &NAL OISEASE COOROINATION & ED -PROJECT

__-- -_ -.._ _-. _._ __._ _. _ --. __I __ _. _.. ._   _   _    -_ _     -. .-.- -. -.          _ _ _

IF CDMPONENTS..    8       .                      REGION TOTALS

---------.- ---. _. . -- __---.--_*._ _ . .   .-     _. . ..-   - _ - - -  _ _ _.      

"..   _ -_.--.- _..__..._ ._... - -.. _ - ._ _ _   

A-         .-_ -- - .- -.- _ __ ._,._- .1..-- _._-._ _-__ --. ---.-

.-. -.-.--- __.- _~ _.- - .._ -      . .-.       -. -.

.-. -_ _-. _.. __. .-  -_-. _._. ._

--.             -- _-...--_- - .- _-_._ ..- .-. -..-      - --

                  .
_ .- _ ._ .-. ._. -

-.-----.-- .- _- --. -- _-_---- .- ----. -. .-    -..-.-.     .   . _ _

. .



   DIRECT     INDIRECT
..I REQUEST  f$QlJEST

3641150

50,000
102r312 .--

78,615

209303
288,750` -
:X16,516

76t264

&t096t910

;



-- _.          













_

23

TOTAL
REQUEST

3641150
                  

50r000

102,3l2 - . -.. -
78?615 --' -

20~303

288~750 -   -. - .

1169516

76,264

lr096~910

..- I ..-. .      _ .   

---. __. -_._-... _- --.. .- - -          ._



RM 000 68
      -

e  May/June 1974 Review

Request: $962,937

Committee Recommendation:  $912,000*

Overall assessment by individual reviewers:   Above Average

Critique:

Review Committee considered the Nebraska RMP continuation grant
application request of $962,937. Reviewers felt that the goals
and objectives are well described and within reasonable capacity
of Nebraska to carry out.  There is a close relationship between
the goals and project activities included in the proposal. For
example, the two major program thrusts involve six health service
education activities and ten different home health care proposals.

On May 22, 1974, DRMP received a letter from the Nebraska RMP which      .
contained copies of three out-of-state Renal Technical Review Committee
comments pertaining to project #52 - Statewide Renal Disease Support
Plan. All three reviewers had negative comments toward this activity.

Program leadership and Program staff were considered satisfactory.

Estimated request as of May 1974:  $150,000

*

Review Committee recommended $912,000 which was $50,000 less than
requested.  This recommendation was reduced by that amount to comply
with the AD HOC Technical Review Committee which in essence disapproved
Kidney proposal.

July/August Review

MC0 6/4/74


STAFF SUMMARY FOR MAY REVIEW

NEBRASKA REGIONAL MEDICAL PROGRAM:   RM 00068

COORDINATOR: Donald Matthews, M.D.     8n Duty Since 4/5/74

STAFF: (FTE) Total - 11.5

Professional: 7
F.1;. fi.     6.5
Other       5

Additional proposed: 0

FUNDS REQUESTED:

Total (D.C. & I.D.C.) $962,937

Program Staff                   279,780
Staff Components                  51,195
Total Program Staff & Components       330,975
Projects (34) total
Continuation (9)                631,962
                        285,030
New (24)                   346,932

Target Funding Amount: $840,000

CHP COMMENTS

All negative comments from CHP "A" and "B" agencies except for Project #47

e   have been addressed by Nebraska RMP Regional Advisory Group. A follow-up
     letter from CHP and the Nebraska RMP's response is in the process of
     being submitted to DRMP.

ITEMS FOR ATTENTION

1 - Kidney - Project #52, Statewide Renal Disease Support Plan is a new
  project activity requesting $51 920  Nebraska RMP has complied with
Federal Regulations for interim'approval from S.S.A (see page 456 of
application);  DRMP Staff recommended out of state technical review
  for proposal;  Dr. Matthews, Coordinator, agreed and project is
  presently being reviewed by three out of state kidney consultants.

2-- Dr. Uatthews provides 50% time and effort. Mr. Buettow, Deputy
  Coordinator is full-time and has been with the Program since
  April, 1968.

3 - July 1 expected request - $150,000.


`m 1974         _

.  -        .                    .         06/74 COUNCIL

5E NEBRASKA

PROCl YR 03    

!I2 CU?ETINENT     CC?!?
                NC

              COO0
. _  -- _  _
             coo2
. . _^.__ -- _.___ ._
              008
         039

_-.- _
        015

        020


        c23

        025
     02-s -

           ^
        $25


         Li'i

_
           COMPONENT TITLE

.-                              

PRQGKAN SThfF -

LEARNING RESOURCE CTR ,
NW NEBR HLTH ECUC -SERV CTR .
CF?i NE9R COMMUNITY HLTH EDUC CORP

COWPPE EDUC AND DETECT CIAR

TEACHING REHAB

NU PLATTE COMMUHITY HLTH EDUC CONSORTIA
M E CENT C@!-fMIJNITY tlLTH EDUC CONSORTIA

S w ::E5R HLTH EiUC SERV

S E NESS tGti!UN:TY HLTH EDUC CONSORTIA

---.... .- .---._- -_ 034 --' H&ME HLTH SATELLITE FRIEND -        -. - _. ._

            035  HC)ME HLTH SATELLITE GENEVA

               035    HOGyE HLTH SATELLITE %AHGO
--.. -~. _._ .- - .__                                             _ .__.. _ -. -
               037   H(C7:4E .HLTH SATELLITE WEEPING WATER


               038    DAY RX SERV ELDERLY AND DISASLED
     -  -
               c39    HDME HLTH SATELLITE CALLAWAY
-._ .-.-. _  - -- G40 .---- HONE HLTh SATELLITE DUNNING 3              _

              041    HG?!E HLTH CARE AGY YORK

             042    NCME rlLTH SATELLITE CRAWFOR
.- -.-_ -... ._.  `043    HCYE HLTH SATELLITE HARRI SCN

044    H3ME MLTH CARE DEVELOP

DIRECT
REQUEST

235,fiO

42t860

33r300

40tooo

27.000

33,000

17,730

47tooo

32tOOO

27,030

20,000

5 too0

5tooo

'5tOOO

5tooo

  19t150
  4 too6

   5tooo

   7,500

   39625

   4r7a7

  13t200











-.









   . .



















.-

INDIRECT
REQUEST

441650

8,335
.
     0


     0


      0

     0


     0


     0


     0

  0


     0
-_.
     0


     0


     0


     0
_
     0


     0
  _.
     0


     0

     0


     0


     0

.a
OS      lo-23

.

                   ;
TOTAL
REQUEST

2799780

51t195  .
33,300

48tOOO

271000
33tooo

l?t 730

47tooo

32tOO0

27t 000

20,coo
5tooo

5tooo

5tooo

5tooo

19t150

5tooo'
.

5tooo

7t500

3t625

4t787,

13tZOO


5 NEBRASKA        PROG YR 03

Ir, CONTINENT
-.-I.. ._.- ._^. ._

-.

.- _ _  .._ _.

.._ --.. _.  __.___-.. ._

CClMP
`NC

045


046
047.


04P


0451
050-.


051


052

053

054


0'5

. ..- .._. -_  _
              056

r CF .UPlYCNENTS   . . 35

CCMPONENT TITLE

EARLY DETECT CLIb!ICS FLGERLY

NURS CLINICIAN SPECIALIST. INNER CITY

MATERNAL AND CHILD HLTH OMAHA RESERVATION

NE,IGHl?ORHOGD OENT SCREENING

D=NT HLTii EDL'C
.

^

DENT ?T MGMT HANCICAPDED

&lMPRE NUTRITJCN EDUC

STATEWIDE RENAL DIS SUPPORT

SHACtEO HOSP ASSOC RESOURCES AND EDUC
CYI LDREN'S HLTH `EVAL CTR

CRITICAL CASE ME3
CHRCNIC RESP CIS AN6 ALLERGY -     -

INiT PHARM- SERV

_.          _             REGION TOTALS

-.. __ .-_ ._ _ _  _

DIRECT     INDIRECT
REQUEST      REQUEST

4,OOb           0

33,045           0

121150            0

11,652           0

5rlOO            0

15,300            0

33,688           0

51,920            0

17,300            0

23,695        0

28,500            0

27~200            0

51120           0

9101552      52t385

US .e O-23

TOTAL
REQUEST

4,000

33,045

12~150

11~652

59100

15r300

339688

51r920

17,300

239695

28r500

27r200

St120

962t937



Iti? 000 42
      .--..

~tcr~~~c!:'t: $3,970,024
         -_._ -_--. .---we- ----c_

CcmnJ t1.c~ J:ec:ursi1:c17cJ;!l..j cm :  $3 190 000
                          .--l---L ._____- --

(jv(~r;jl]. ~:;s(-~z.;IIIcIIL by :Jud~.viclu;il. rc!vic'wcrs:  Superior in all aspects
                                                -w- __---__I

cri Ci.C~Ul~ :  Panel B considered NJRMP to be a superior region in all respects:
strong, effective leadership; an excellent, experienced staff in terms of
numbers, skills and competencies; and a RAG, not only representative of the
Region, but one whose members have remained interested and active in
reviewing the accumulated.data to determine needs of the health care
delivery system and then charting a programmatic course to meet those
needs.

Programmatic efforts have been tailored to span the entire set of Goals
relating to access, quality assurance, categorical and cost containment
as well as a beginning exploration as to how CHP and RMP may prepare for

*    new legislative developments.  The Region was commended by Committee for
     some of the fascinating areas in which the program has been iuvolved;
     particularly new issues such as better access, emergency medical service,
     quality of care assurance, improvement of health care services to the
      inner-city poor, setting standards for quality for certificate of need          /
      type activities, and for the assistance given to the development of CHP
     "b" agencies in N.J. (major support given to development of 3 of 4 existing
     "b" agencies in New Jersey).. Relationships with CHP within the State
     over-all appear to be good; however, one "b" agency director submitted a
    #scathing letter recommending disapproval of the entire RMP application.
     It was later determined that this "b" agency director had held the position
    for only 4 or 5 months and that after review of the application, the "b"
     agency board recommended approval.

Committee concurred that this was a superior region and would well utilize
funds made available to it,                                                       .


                                                      
                . I                                  
JULY/AUGUST REVIRW                                   ,'

Estimated request as of May 1974:  $600,000


NEW JERSEY           Regional Medical Program

Coordinator:  Alvin A. Florin, M.D.

Staff:   Full Time Prof.             16

Full Time Other              8

Total

24

Funds Requested:

Total  . . . . . . . . . . . . . . . . . . .

3,970,024

RM 00@2

On duty since: 1967

Proposed:      16

        10

26

, Continuation...........,.   ($3,145,024) ( project); $825,000 Program Staff

* New.,.,..............,,.. (

1

Period of Time Requested:  July 1, 1974 to Juhe 30, 1975

Activities Proposed:

Refer to Management Information Systems (iUS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)

.


*      ."                              mnnnL3

New Jersey

List any continuation project or staff activity for which substantial increase
over annualized current funding is,requested.

HMO project:     NONE

EMS project:   #28 - Continuation of pre'viously approved activity

PSRO: Quality of Care Assurance Project f34 proposes to establish 8 PSRO
organizations in the federally designated areas for N.J. by assisting in
organization, incorporation, staffing, and enrollment of participating M.D.s.

Kidney: Project #33, Renal Dialysis and Transplant Program - Continuation
and expansion of previously approved activity.  Produced a statewide plan
for ESRD for certificate of need.

CHP comments:  Comments from the CHP agencies are attached.
It should be noted the the NJRMP played a major role in establishing three
of the four "b" agencies in the state,

m/5/20/74


HAY       4
. . . 0 _-.  .-:.  ..:.

NEW JERSEY _   PRQG YR 05

&RN ..  COHP
------_- - _._. - __-_ NO 1-

COMPONENT TITLE

-

coo0   PROGRAW STAFF

010   CDHMUNITY HLTH XMPR
   PRIM ~HEUHATK HT 01s     . .-   ._
025

       -..  028 -- EMS                              .

       033   REHAL DIAL AND TRANSPLANT
-:  ._ -__  _ 034A  EUAL CASE ASSUR - PSRO

       -034f(  QUAL CARE ASSUB - SPECIALIZED SERV`
                                                   ..
           Q35A   CD&T COHTAINMENT - HOSP SERV
- - -- ..___._
       0358 -  CDST CONTAINMENT - HOME CARE

         036   CO!6MUNXTY RASEG HYPT CONTROL

DIRECT

_              REQUEST

               825,000

            lr048,400
.- -. ..I . ._ . . . _
                254,680

                72 9920

               226,080

           2251000 *

184,944

482~200

---        -l%o,ooo
  
         5101800

INDIRECT
REQUEST _.

  0

  0
-_
  0

  0

   0
. 0

0


0

0

     
  0
;

                 I

TOTAL
REQUEST

825 9000

1.048r400
254,680 `-- - "-

  72,920 *

226 F 080

225rOOO

1841944

482r200
140?000

510,000

COuPCNENTS -...._ 10 . . . . ._ . _

_ _     _. __    REGION TOTALS __     3r970r024   0 ..-- 3t970r024      -

---* ---.. -_-._-._. -_-_- _-- ._ - ___ ._ _ _      _   _._  -. _.        -    _ _. _. _             `- .`.  -._ -_- .    .-.. . I.._       _ ..-

  .- --. - - -. ..-- -- ---   -..-  -____ --.  .--          _.        _   . .
                 o
                         ??  ???

                   o

.---_ -_ -..-   . . . . .   .- ---_.- -_..       .-   -



     _... -..



RM OOOA

l~ec,ucst: $2,774,838 '                                   i

Committee Rccommc~~c~atio~~:  $1,644,754 *

Overall assessment by individual reviewers:

A'ERAGE

o

Critique:

Review Committee considered the NMRMP continuation grant application request
of $2,774,8'38 to be extremely ambitious.

Tne reviewers noted tnat tne seleci;ion or' a staff pnysician as new
Program Coordinator will provide a continuity of program leadership. '    .

The present program staff seems to be adequate and capable.

     In reviewing the criteria of program leadership, the reviewers felt the
,@   Programs' Executive Standing Board was too dominant over the Regional Advisory
     Group in the decision-making process.  The RAG Budget Committee needs to be
      reactivated and more involved in the budget decisions.

Reviewers were confused about the relationships between NMRMP Program Staff     I
and individual project directors.  Although several project directors are
located in the same quarters as program staff, they operateLiindependently
but complement'program staff activities.

.The requests for oroiect

              ~~ #18
Health ~Educat         - EMS in Rural Areas and project. #25 -
       .-ion for the Public were too ambitious:.-'-The reviewers felt
that the project ot jjectives could not be accomplished within one year,
Both project; did not adhere to DRMP Principle of Decremental Funding.

Estimated request as of May 1974:

0

          

     * Also, project #25 - Health Education for the Public should have a technical
*    review site visit by out-of-state consultants who are familiar with the
       RMP process.                                                        4
                                          .

I                 MC0 6/4/74


rJ     4
              STAFF SUMMARY FOR MAY REVIEW

NEW MEXICO REGIONAL MEDICAL PROGRAM:   RM 00034

COORDINATOR:  Richard A. Walsh, M.D. (Acting)    On Duty: 5/l/74

STAFF:FTE) Total - 24.5            Additional proposed: 5

Professional: 15.5
Other:        9

Professional: 5
Full-time 3
Part-time 2

FUNDS REQUESTED:   Total (D.C. & I.D.C.) $2,774,838

Program Staff                   653,664
Projects (11) total              2,121,174
Continuation (8)               1,917,366
New (3)                      203,808

CHP COMMENTS:

CHP "A" and the two official CHP "B" agencies met on April 11, 1974 for a
joint CHP Review Connnittee meeting.  Comments are included on pages 62-
72. Dr. James R. Gay's May 1, 1974 cover letter to Dr. Herbert Pahl
contains a response from New Mexico RMP RAG which is included as
attachment #l.

ITEMS FOR ATTENTION:

,

I.



2.


3.

Project #18 - EMS in Rural Areas; $911,106 request for substantial
increase from previous two years of support.

Project #25 - Health Education for Public; $302,955 request for
substantial increase from previous two years of support.

Richard A. Walsh, M.D. is AEting Coordinator of NMRMP for 5/l/74
to 6/30/74. James R, Gay, M.D. expects to resign 6/30/74 but will
&main as consultant to Dr. Walsh. The NMRMP RAG will forward its
recommendation for the permanent appointment of a Coordinator after
the May meeting of the NMRMP Executive Board.


`0 5r1974

REQUEST
COMPO

OS LISTING
BY REGION

    _ ..^_ -. _ -               .     ._         06174 CWNCXL

34 NEW MEXICO      PROG YR 06

MID ~~NTINENT     COMP                COMPONENT TXTLE
..-- --._- --.. --...--.NO-- ._     ._     _ ___ _. . _ I

.- _- _-. --.. _ - _ coo0                     - .
                  PROGRAM STAFF

.- _ ~_ _ _-. _ __
              018

----.-..-- .-- .---. -__. 020 -

_. .__-. -. _____.._ .._ _
               025

               OZR

               029


I                 030

               031

-- ._- -..--- ..-._ ._ _.
               032

033

034

---. -.- -- . ..---_-_.__ -
                035
        

UO OF COHPONENTS     12


-- -- - --..  -.-. -- . . .._ _    

        _ ~.


. - -  -_--.- .- . ..__. _ -


     .._.



EMERG HLTH -SERV - -     .

--Sk' &ES                   - .._ .


               .-

HLTH EGUC
STATEWIDE HLTH NEEDS ASSES
                          .-
HVPT
940NATAL INFANT TRANSP -

STATEWIGE GENtTIC CTR
C@MMUNIM HLTH RESiXJKCE DEVELOP - ..      

`HLTW RESOURCES REGISTRY

REG HLTH RES PLAN AND DEVEL
POiS!3N CONTROL/DRUG .-INFO CT.9 `. - -'
_ .      _                 _ _ _
          .

REGION TOTALS

                - .- - - -   ^ _ ._.   .





                                  


.- -.        - -   _ . _         _..- _





                      

.-------- .---.--. __...

. .

DIRECT
REQUEST

565,38?

8429932

.
  43~563

     215,012

     699360
._
     99,060

     29,833

     5OIOOO

     16X*257

909550

4br115
192;608

2~465~677

INDIRECT
REQUEST

88e277

68r174

4,587

27~943

59737

12r729

lr713

10,473

27,891

16,862

7r349
37,426..

3099161





             #

TOTAL
REWEST -

653r664

911,106
        *
489150

3021955

75,097

111t789

319546

60~473

189rl48

107,412

53r464
2309034

2r774r838

.


a


~orrJ;iittcc m!cornnc!lx.latioll:   $2,500,000

.

&era11 assessment by individual reviewers: Average

  ._
- . .


Critique: This application requesting $6.4 million for two years, was
reviewed in depth by two reviewers, one of whom had only the written word
~to study and the other who had been on the site visit two years ago.  Both
xeviewexs were impressed with the proposed projects that address a real
laeqd in New York--namely, a better network among the clinics and the public
md private hospitals. But.the reviewer who was a former site visitor w&s
also impressed with the improvements that had accrued in this program despite
pha,se:out and other uncertainties--the change in grantee, the quality of staff

    leadership and the increased functioning of the Regional Advisory Group.

  :    l&e Committee was concerned about the advisability of initiating projects that
9 :   weded at least two years funding which was requested; but they concluded that
     a number of the projects represented the culmination of several years planning
      and development, that the projects were needed, and that other sources of funds
  1      cay be forthcoming if the initial efforts prove effective.  The Committee felt
        @bat additional staff were needed.  In consideration of the population served
3 I
c i      by this RMP and their health needs, the quality of the proposed projects and
     ehe improvement in the management and grantee-RAG relationships, the Committee
     mecommends that this application be approved at.$2.5 million level and that
     l?his region be given a high priority for distribution of funds in the July-
  I
  1      August review.

i

i
  i



-i
i .(

JB;ZY/AUGUST REVII%
Estimated request as of.May 1974:'  $2,000,000 ':

          a"



.            


Rt4 00058

NEW Yw    Regional Medical Program

Coordinator:  Jesse B. Aronson, M.D.              On duty since: 13177

Staff:   Full Time Prof.                  7

Proposed:     7


          0


           2

Part Time Prof.                  5

Full Time Other


Part Time Other

3


0

Funds Requested:        7/l/74-6/30/75

Total  . . . . . . . . . . . . . . . . . . .   4,330,808

0

7/l/75-6/30/76

3,033,819

Continuation.,......,....  ( 859,430 )

New
   ,*,*.,.*.....*.....*..  (2,436,289 )

Staff-Central Core Activ. (1,035,089 >
Period of Time Requested:

.

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C

will be placed next to activities which extend beyond June 30, 1975.)


m 00058

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested,

HMO project: Project 837 - Comprehensive Medical and Health Care Service
at Maimonides Medical Center - This may or may hot be an HMO, depending
on the payment mechanism,

EMS project: Project #62 - Treatment in Municipal Hospital Emergency
Rooms - This may or may not be an EMSS start up. It certainly is not
comprehensive; i.e., it does not purport to establish a system. On
the other hand, it does not appear to "tie in" to an overall EMSS activity
in the city or the state.  Perhaps, it is an excellent, highly needed
project; however,  it still seems to sit in isolation and is not even
(apparently) coordinated with the New York State EMSS effort.

PSRO:

Kidney:

.

CHP comments: The CHP review;, although cursory, was acquired and was
favorable.

Conclusion:  This program  is on the move and needs encouragement.   It is
more structured, better managed, and appears capable of making an impact
on the complex workings of the New York City health care system in the
near future.  There is little doubt.that money spent in this geographic
area would be reasonably well managed and would find itself in areas of
critical need; however, it is difficult. to visualize the current stafE
and organization effectively administering nearly 5 million dollars in
the next fiscal year.  A reduced funding level might encourage a consolidation


    (streamlining) of the multiple hypertension, kedney, manpower and
0   primary care activities.  To bripg these clusters under some sort of
    an umbrella would seem to strengthen the overall program and make it
     more effective with fewer dollars.

E0/5/20/74


8 NYC HETRO. ._~  *. PROG YR 04      *

ASTERN      C0MP -
-w---w - _._. NO. -._ _ .._ _. _   COMPONENT
                                        _ __ I

TITLE
-. - .     _

             coo0  PROGRAH STAFF
.-.. --. .--. ._ - __.__ .
         coo1 --- HYPT PRCC DEVELOP
---..---- -.--- -_  -.- --.- . ..- _ _

coot  IMPACT: NATL HLfH INS ON HLTH PROG

034  nwwR ~NFO CLEARING HOUSE

-. - .-.- _ _ ._  037 COMi MED & HLTH CARE SERV
        03R" - AMi HLTH CARE ELDERLY

041 \  PEEKSKILL AHRULATORY HLTH

04L-  HOSP SATELLITE AMI~ULAT~RY

--. ---..-_ _-__-* .-.. _  _.. .-_. __
              045  PLAi Rfi AFFILIATION EDUC

              04R   NY NJ REG TRANSPLANT

          

, '



      -  _   _

CARE CTR

CA-RE --                  ._

  - -_ -. . .-   

- - -.-_-_-.- - --..   ._    _

052  EL BARRIO YOUYG PEOPLES CLINIC'-. -. ..' -_ .-'

              053  HLTH MNPWR COUN~ELLING ~ERV .- .- --
--. ---   ..-- -. -    _ .,_                                        __.
      .        054  I.NS;.EH.ERG HED -~ ..- - ._.
I__-.---- ..-.  .- - .._._. .- - - --   -.. _. _ _
             oss  DEMO DEL COMP HOME HLTH iERV - _. . .._   -- - - - .  . . _ ._   _

   .- -_
056   `NURS PRACT ---

057 -- ,- HYPT REFERENCE LAB    -'

-.-------.----_  _ _. - .--.. -
             05P  USE UNION'MEMBER COMPLIANCE MECH HYPT CNTRL .-. -_ .

._ -.. .-_ -  . .___ 059.- _  DIAG WED SOtJCGRAPHY TRNG

  -
            060   `XGAN ACQUXSTTION
--- ..I --.- ____--    - .--..
         EVAL HYPT OX-RX b HOSPi    .-
             061                                     .         -

-

062  IMP CARE PTS SEEK EPISODIC T RX MUNIGIP HOSP EH RH

DIRECT
REQUEST

INDIRECT
REQUEST

371,779      88t514

  66,300      15,978

397,500      95,798

2941624      -0
itl22.603            0
70.26i)'          0

214~926            0

4751562            0

190,804 --'  . __ _  _
                 0

120t693 .- 0

20t241 -- -'o

192t044           0

183t500           0
               .   .
513,257            0

173t725             0
              
354481            0

-

OS     lo-23

TOTAL               *
REQUEST _

460,293

   82t278
.-

493t298 - .
       . .._-.

2949624 c
ltl22t603 c
-?O.t260 - --

214t926 C

475,562 c
190t804 -' .

120,693 ~- C

.' 2ot241 --- ..-

1921046

183tSOO

513t257

173.725

3541481

120,637 0     120 t637

182t332           0     182t332

107t160            0     LO7t X60

96,653 '.'- .Q`   96,653

947 t632            0     947t632



             

c

C

c


C

c

-.--.-.-    -- - .- -. - ~_  .  . _  _. _  _         


NYC UETRO _  PROG YR 04

STERN          COW
.- -. _-__   --.-NO. .._.

. . -.
OF ChblPONENTS     22

- I   _. ._    

- -.- _   - _ -. ~. _ _ _

.__- __

_   _

_ -... -   --.-   - _-...- _-  -. -- -----. _ -


                 -.

.

._

LISTING      .*
                                     OS?4       -23

_ _.                        _                                     -.      _

                                                                           1

COMPONENT TITLE                        OIRECT   INOIRECT   TOTAL
. . .       _.                     REQUEST   REQUEST - REQUEST -

- .

REGION TOTALS      6,216,715    200,290   6,417,005

._. .__ :-. . . . __                              _.     __            _
                                                                           .

-_         --_            _.       

_.     -.- -    --.. - . ^._.                 _._              -

         ^. -

.._

.__.. _. .-. _. ._ -_ _ _.-. -   ._

.-. -._ .- ._ ..__._ ._.  


.."RIsA --"II-"-


l&l 00006

Iommi.ttcc lCcconvllcrltlnt:ion: $2,375,522
--         ---
Overall. ksessment by Individual. Revi cwers :  Superior
--

Grit i quc :
-_.-
The reviewers regardc.1 Lhe EK.XW as a supcri.or progyam, whose past performance
has been outstandi.ng in terms of designing programs to meet the needs
and providing servj ccs to arcas that are deprived of health care.
Al.though there has been a change in leadership, the IEW Exccuti.ve Director
having been with the program as Deputy' Director for five years,
was thought to be quik adcqtinte in providing leadership and direction
to the program.
The: Regional. fldvisory Group's performance j.s consj.dcred good, CUP
relationships are good and the program staff though small. appears to
p0:;z;CSs the necessary skills and competence to manage alrd monitor
program activities.

The present application, although over-ambitious and some of the
activities inappropriate, is believed to be congruent with
obj ecti.ves and priorities .

the region's

Reduction in reconm~ended level based on the fact that some
were considered over-ambitious and some were consid.ered to
for DRMP funding ,

3ULY/AlJGIJST REVIEW
Estimated Request as of May 1974: $400,000
--

DWJ'/IKID
SCOB/G-6-74

proposals
be inappropriate


f"' -

MAY REVIEW STAFF SUMMARY


                Prepared by:  <Jeanne Parks

4D   NORTH CAROLINA REGIONAL
      MEDICAL PROGRAM
     4019 North Roxboro Road
      P.O. Box 8248
     Durham, North Carolina 27704

Ben F. Weaver, Executive Director

CURRENT STAFF

Full-time Professionals - 9
Part-time Professionals - 0
Full-time Support Staff - 3
Part-time Support Staff - 1

Grant /I  -: RM 00006

On Duty As Executive Director
Since: 5/l/74
Was Deputy Director 1969-5174

PROPOSED STAFF

Full-time Professionals - 8
Part-time Professionals - 1
Full-time Support Staff - 3
Part-time Support Staff - 0

FUNDS REQUESTED:

Total Costs - $3,258,255
Program Staff - $456,344
Continuation - $875,378

Target Figure:

$2,702,000 ----
(7/l/74-6/30/75)

New       -$1,926,533      Estimated July Request:  $400,000

Period of Time Requested: #AlI projects will terminate as of 6/30/75.

CHP' COMMENTS:

It is the policy of NCRMP to involve CHP agencies in the development
of projects at the time a project is being developed.  Therefore,
the review and comment procedure is a mere formality since the agencies
are aware of the project content and have had input from the beginning.
This application contains 15 continuation projects which were previously
approved for multiple years funding by the appropriate CHP agencies.

New activities included in this application were submitted to the appropriate
CHP agencies on March 28-29, 1974.  In many instances there is no active
CHP agency in the area where proposed projects will take place.  In other
cases projects are statewide training or other type activities of a
broad nature which are not applicable to individual CHP "b" areas.
However, projects were sent to five of the seven approved CHP agencies
within the State.  All agencies gave verbal approval of the projects
reviewed prior to the RAG meeting, but asked to be given until May 1, to
submit formal letters of endorsement to the NCRMP.  The letters will be
forwarded to DRMP as they become available.  The "A" agency is currently
in the process of being transferred from the Department of Administration
to the Department of Human Resources.  The Director of the "A"agency

e and the Director of the "b" agency (elected by the other "b" agencies)
    are members of the RAG.


- `IO- -

North Carolina Regional Medical Program

ITEMS FOR REVIEWERS ATTENTION:

EMS:

No new EMS activities are proposed.  Project 1149 - Emergency Room Training
For Community Hospitals is a continuation activity, which was
funded for a total of 24,472 for the period l/1/74-6/30/74. The region
is now requesting $79,848 total costs to continue the project through
6/30/75.

KIDNEY DISEASE:

Project #28 - Care of Patients with Chronic Uremia, is a continuation
activity.  It does not invision any large increase in funds, but does
propose to expand the capacity for dialysis.

PSRO:

Project f63 is a continuation proposal which was initiated April 1974.
It is designed to develop an educational program for all physicians
in the state which promotes the understanding of peer review techniques
and increases the capability of physicians to perform such review.

Project 67H - Rural Health Clinic Operational and Equipment Assistance,
requests$243,100. This activity requests support services for access
to primary care tied in with National Health Service Corps appointments.

Project 1169 - Statewide Network of University-linked Hospital Libraries
in North Carolina.  This is a request for $362,993 to develop a network
of 59 community hospital libraries, which will be linked to the
major health science libraries of the state and to the resources of
five schools of health science at the University of North Carolina.

DRMP/DoD
SCOB/S-20-74


  ._                        

) Y CARCLINA      PROG YR 06

HJTH CENTRAL     COMP                COMPONENT TITLE                         DIRECT
         --. -    NO .-                                                   REQUEST

COG0

            coo1
_- _...._. ___- -___
              028

031

03bA

           054
         .
           058

061

             063
     -.. _
            066A

0663

566C

._.     
             ObGD

066E'

PROGRAM STAFF

!4ED AIR OPERATIONS
CHRDNIC UREMIA .                    .

CDMPpE CARDIAC PACEMAKER EDUC

RADIATICN RX PLAN SERV
ALBEMARLE HUMAN RESOURCES DEVELdP SYS

ARt"a HLTH EDUC SYS FGOTHILLS

DIACETES SHARE YOUR SKILLS

P.LsE:-IARLE COMPRE SPEECH AND HEARING SERV

WALSTbNl3UPG COWMUiITY CLINIC.

E,FZk\G "X TRNG CC%?b:UkITY HOSP

u.:>,SgqE W&L P T
CKAVEN C;YTY HOBL HLTi CARE

AREA HLTH EDUC SYS REG C D & E

ST?OKE REHAF!

CHILDWOCD CA


PSRCI

HYPT EDUC REFER

DURHAM HIGH 6 P EOUC

MCGEL CLINIC AND COMPLIANCE
INDUSTRIAL HYPT .-

HYPT PHYS EDUC

3771097

50,000

_'- --_
       48,403

21~424

83,117

    34r308

    35,000

539103

809404

54,481

          631725

         47,742

39r397

63i381

179998

.20,000

125,215

309240

52,008

33,440

43,840
`31,325

INDIRECT
REQUEST

79.247

     0

     0

3t720

15,656


     0


     0

     0


     0


     .O

16t123

     0


     0


     0

tt181

     0


      0

31665

6r303

4,053

5 r313

3t797



      034
.Y o-23


. -                    -b

TOTAL
REQUEST

456~344

50,000
489403

259 144

981773

34,308

35,000

539103

80~404

54,481

79,846

47,742

39,397

63,381

20,179

20t000

12?r215

33r905

58r311

37*493

49,153 ,

35* 122


  MAY 15,1974 - _ __ .--       _


  _ . a - .. ---..--- ..- ..    - .__

I CAROLINA _.    PROG YR 06



I CENTRAL - COMP         _ _..


         .___ NO ___   _ -. __ _ ._ ._

COMPONENT TITLE

_ .     __ _. . _. _ . , .- ._.. .   .   -.

                                               .
          066F  HIGH b-P pU8 EDUC
  _   ----_ 066C -- NUQS TRNG
-"-.- -. _.   .- -                            . _.
         HI~-I SCHOOL- HYPT EDUC 6. CNTRL     
          066H
- -~-_ -_ ._ . 0661 -. EDGEGOMSE CNTY HYPT CNTRL a._
-. ._. -- ~_. .-
          Q66J  SHELBY HYPT CNTRL
.__- -- ---_ _...    ._
           D66K  HEG .R HYPT CNTRL -

066L

          067A
- ._.__-_ -----...   _
           0673

          067C
     .~ .-.... Ob7D
       067; -
_.. __-_-.--_~ __._.- 067F
      Oh7G
. _  . _
           06x+
      067I ~-
      db7J

069 )

069


070

DIRECT  INDIRECT -    TOTAL
REQUEST _. REQUEST.     REQUEST _.-_.

                      . .            ----
                 34,750      4~211

                  5tooo            0
..-                              .-  .  ._. _ _
                  649100      11709

                  31~985           0

                  30,000            0

.-.    144rooo   .. " -0

NCl?MP HYP PG;LI 1?4PA$T MEASURE AND DESCRIPT

ST&T DATA DASE RURAL PRIM CARE DEVELOP
OEVELDP GUIDEBOUK i. MATERIALS RURAL`CLINIC DEVELOP

DOCUWENTARY FILI4 WI3 LEVEL PRACT RURAL AREAS

PH~S RECRUIT DEt?O

pHYs. STAFFED RURAL HLTH CTR DEMO .-    .-


                                              ." -.

CDNT EDUC PHYS EXTEIvDERS RURAL PRIH CARE

N C RURAL SATELLITE CLINIi WORKSHOP

    38,975
-.. .-
     31,875

     58,000
-.
     16,400

38,961

5*000

-..--.-               .-    -.
    65,809

30to00

--.
  144rooo

30*000

41*500            ,

90,000
319155

38~975

      _ _ __  -     
31,875

58,000

16,400

RURAL'HLTH CLINIC OPERATIONAL & E&P A-SSIST  _ _. .-_ .._     . 243r100 '. -- o' - 243t100 .- --. -

RURAL.H;T)? SERV EVAL                  



QESIDENT INCENTIVE
~CCMSiJf~tR / PRGVIDER CHNC .- . .-
STATEUIDE NETYORK UNXV LINKED HOSP LIBRARIES
.
PERXNATAL NURS SPECIALIST TRNG

                            _.
_
      20,000           0      2orooo
._
       10*000       0    10t000
      54,646 29tD21 -.  839667

     354~ 572    8,421 -~  362~ 993
                    
      839626     `7,081      909707

                                                           _ .             
_ . ._. .-.._- _ 071 - ELEM SChOOL HLTH CUERIC

36,540

3b.540

071    PFiGBLEb! ORIENT XED RECORD WqRKSHOPS                   32,123       8,872      4or 995

__- . .- . .-._ ..-       - -. ._-._ .--. __                 _                    ..-..                    __.


   MAY 74
-0                                  *
                         _
- .:  -   -.--   -- - -.`. -: .-(.  -.  --  `-
              *
N CAROLINA      PROG  YR  06

1l-H CENTRAL   CDt4P .'               CDMPONENT TITLE
_. ._._._ - ______ _-_. NO __ .                 .

073 CdNSULT & TECH ASSIST DEVELOP HLTH SERV DEL MODELS        60,98L       6r212

                   -. .-
.             074  HOME ~~Tfll ~ERV CRAVEN NORTHA~~PTON ONSLOW ROUAN co -
_._-_.. ._ _- _._. - _.._ -- ,___ - --~__-_ _ I _   .___   .    _ --   .-

.C!F COMPONENTS     46                       REGION TOTALS
                                                 I .

--T---.- -.__ .- .__._ - _ ._    _        _ _ _. . ._ _      .

-

_-__              --.     ..-

                                          .- _.
      .

.   _ _.     "                                        .._ .

. .

DIRECT   INDIRECT       TOTAL                 T

REGUEST     REQUEST    ..~ REQUEST

103 9694           0

   679193

  103t694
.-

3.052~670     205,585    3r258t255





@Y/JUM`: 1974 REVII'W

&?qucst:  $774,057 '
(&mittcc Rccommcndation:    $582,517                                                 *:
                      Averaqe and Below Average    :i r ',
Overal. assessment: by tndividual revia\rers:                                            .: 1
                                                I! i 1,
          .                                       :11
                                      ; 1, i
                                                                  ;:I i
                                                                           'I.
Critique:                                                     ;f' ;s
                                                                  I. ;e

Continuity ,of program is achieved through a small but well oriented central
program staff. A full-time deputy director is being requested to strengthen
program direction.

Reviewers considered as unrealistic the request of $400,000 (Z/3 of project         i
dollars) for Biomedical Communications System, at each of 4 AHECs (Area Health     '(
Education Centers, supported by previous grant from Health Manpower Bureau),        1

with huge investment jn hardware, computer linkages and other new equipment.
The RMP subsequently advised it could reduce the request to about $3001000,          ,i.
and slow down linking facilities with the base centers.  Reviewers believed    i
the project overly ambitious, and recommended considerable scaling down      1
in view of other priorities.                                                   ,i
                                                                           t

'Concerns were expressed with regard to data projects (2 later withdrawn) and ,  !..
a contract for guidance on implementing Certificate of Need Legislation.            ii
Reviewers reconanended more emphasis on improving capability of allled        11
                                                                           :
                                                                           )

professional health personnel in delivery of services.
The need for a 3-bed unit for kidney dialysis outpatients whi.ch was

'questioned was approved by CHP A and B agencies, as well as Social Security
Admini The request has been given high priority by RAG and CHP.

JUI.,Y/AUGUST REVIEl?                                 Ii
                                                                           .     i
                            O                                                L
Estimated request ES OE May 1974:                I/
                                                      :                I/

MC0 6/4/74


STAFF SUMMARY FOR MAY REVIEW

1) NORTH DAKOTA REGIONAL MEDICAL PROGRAM:   RM 00060

EXECUTIVE DIRECTOR:  Charles Arneson, M.D. - since September 1972

STAFF:FTE) Total - 5.6              Additional Proposed: 1

Professional: 4
Full-time 2"-
+ Part-time 2

Professional: 1

Other:
Full-time 2 2

* Executive Director and Computer Programmer

FUNDS REQUESTED:

Total (D.C. & I.D.C.) $774,057 (exceeds target figure of
                582,517 by 191,000)

Program Staff (total)
Projects: (10) total
Continuation
New (10) **

CHP COMMENTS:

$145,940
628,117 (see note)
62:,117

"A" Agency Executive Conunittee to meet 5/15 but favorable comments from staff on
general review, especially projects related to medical school expansion and
further development.**  Three active "B" agencies reviewed and commented; approved
manpower development projects.  Concerns about data collection and forms. RAG
considered all comments on review; disapproved some data activities.  Identified
priorities. (!j/20/74 - A agency comments received.)

ISSUES:

#95

#97

     Note:
         **
8  July 1

Biomedical Communications System - establish at each of 4 AHECs and
given high priority by all reviewers at all levels. Requesttotals
$400,000 (about 3/4 for communication equipment and stations). Upon
questioning Region , reported that it could consider some modification
and reduction of portion of equipment (#95); est. reduction of $104,000.

Kidney:  Establish satellite hemodialysis unit (3 beds for outpatients)
at United Hospital (under supervision of Minn. Regional Kidney Disease
Program) and seeking exception from SSA of freeze. High priority and
under study during past grant period (equipment $18,131).

RMP advised 5/20/74 that 1 data project and a study proposal (#lOO and
#lOl) were withdrawn (approx. $28,000) reducing projects to 8 and
total project $ to $600,000.

- 0 Request expected.

1. Resnick - MC0
Revised 5/28/74


-. m ,I974


._ _ .._      -.       _   . _ __ _ . -         _

DS LISTING
BY REGION
UNCIL

60 N DAKOTA       PROG YR 04

?liD CONiINENT                   
               COW                 COMPONENT TITLE
.-- -.-. .._..- -_.-. -.I_. _  NC                 

._   ._   coo0   PROGRAM STAFF

           093   FEAS STUDY DEVELOP OF RESIeDENCY INT MED
_____- -I ---.. -.  -.-- -.
         STUDY.REi GRAd PROG -t3EHAVI&Af SC1           _ , - I
           094                                           ,            _
           095    &IOHED CMNC SYS
       096.                                                    - ._
               EVAL APPLICATION COMPUTER IN HLTH CARE

--A---.---- 097 -.--
_-- _. -... _. -.
                096
. ..- -.. -. _ _ .- ..-. 099.. -

---- --. _- --.- _
tiithhrawn 4++-

Es? SATELLITE HEMODIAL UNIT

PRO3 REVIEWJEF N 0 CERTIFICATE OF
PLAN HUUAN SERV CTR
DATA ANAL AREA HLTH PROBLEMS

              .
NEED

.- -_

Uithdvak -- ks-~-  GROUP STUDY IDENiIFY COMMUNITY HLTH PROBLEMS     

-. ._ ._   _ 102 .- D&LOP HLTH DATA COLLECT FClRklS

_-.- .__._ -- -__. .- -... __- __ _. _ /                                         _

`10 GF COMPCNENTS 11                                 REGION TOTALS
                                   .



_- ..-._._ -.-  -_ --__.- _-     .-- - .   _ _                         . .-

.

.-. .._ _ _ - _. _ _-._ .-. _-_. _ _                                         

. .._



DIRECT     INDIRECT      TOTAL
REOUEST REQUEST      REQUEST

145;940' -

13,775
              _.. _
9r620

400,000
369617
48,191' __ .____.

25.006

41,700
20,072 - v. -

St142

251000
        ._ ._- -

774*057

.

0


0
  _._.
0
   -
0

0
   .
0


0


0

0


0


0



0





_









  -.  _

145r940

13,775

91620

400r000

369617

489191

25~000

42,700

20,072

St142

25,000

_ .-.

.



RMJ?

I-?M

MAY/JUNE 1974 REVIEW

Request: $1,039,670

Committee Iieconmlendation: $7i10,000
Overall assessment by individual reviewers: Above average - superior

Northern New England _
-__u

00003

JULY/AUGUST REVIEW

Estimated request as of May 1974: $800,000

Critique : This application requesting support for staff and seven
ongoing projects presents a coheJ rive program with staff activities
and projects clustered around well-defi.ned objectives .  The 1W.P
continues to be involved in the evalua.ti.on and improvement of the
medical care system through the mechanism of disease management
committees. The Regional Advisory Group has been actively involved
in the development and support of established program prlorl.ties.
It is a major strength in the program.  The relationship with other
state agencies also appears strong.  The staff is now directed. by
a new coordinator who has se-rved on the staff for some time.

The Committee was concerned about the budget, however, which seemed
high, particularly the program staff portion. The Committee recom-
mended that this application So approved at a reduced level of
$700,000, but believes the RMP should be in-a high priority for.
an increase level, pending satisfactory review of the July application.


Northern New England

Regional Medical Program

Coordinator:  Edward Francisco, Ph.D.          On duty since: 6/30/73

Staff:   Full Time Prof.


      Part Time Prof.

Full Time Other

Part Time Other
            Total

Funds Requested:

Total  . . . . . . . . . . . . . . . . . . .  1,039,670

. Continuation.............   (608,870

( None

Period of Time Requested:

RM 00003

>  - 7 Projects*

1

Proposed:

14

Activities Proposed:

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)

*Although all projects in their request are continuations, most are only in their
second year of funding,  Two projects -- numbers 37 & 38 appear as new projects,
but are actually continuations as the first 12 months were funded via the contract
mechanism from the "core" budget,


RM 00003 (NNE)

e List any continuation project or staff activi.ty for which substantial increase
   over annualized current funding is requested.

HMO project:

NONE

EMS project:  This request is for the third and final year .of RMP support.
The amount requested is higher in the third year as the program can now
increase its training capacities and devote greater attention to the
development of local ambulance districts; This next year activities
build on a long-range EMS plan that Vermont has effectively developed.

    PSRO:  Vermont has long been active with issues surrounding "quality of
   care,"  The state has pioneered with the "Problem-Oriented Medical Record"
   and ways to relate it to measuring quality of care.  The NNERMP since its
e inception has devoted considerable attention to quality of care with heart
   disease, cancer, respiratory disease, etc., as well as extensive data
    collection.  In addition, the Coordinator is active in the development of
    a statewide PSRO.

Kidney: This application requests an increased level of support, but it is
stated that this will be the last year of RMP support,  The increase is
primarily to support the kidney program staff and training of personnel
to render end-stage renal disease patient care,  After this year, the major
financial bunden associated with meeting initial training needs should be
substantiately diminished and the program in a position to function on other
funding sources,

CHP comments:  This application requestB continuation only, of activities
previously reviewed and approved by CHP.  The "continuation" application was
submitted to CHP and CHP has verbally endorsed it.  CHP has chosen to devote
its attention to new RMP proposals developed for submission on July 1.

E0/5/20/74


NO NEW ENG      '

- .     _ . _ _

PROG YR 05 '



`ERN
_ .._ .____ -_

COYP
_.  NO _ __

     COMPONENT TITLE
_ .__      ___ _ ._.         ._

            coo0
._- -..
            QOb
_.______- --_---- -.
            007
___. .-. _~ - 009 -


            011
.-__. _ -.   --.. -
            012
-_
           037 \

PROGRAM STAFF

REG END-STAGE KIDNEY RX
-INCREASE CAPABILITY RURAL AHEWLANCE s ER PERS -
REG HZGH RZSK INFANT & MOTHER PROG -
                            I .

REG RESP DISEASE PROG
AMBULATORY PEDIATRIC CARE ST JOHNSBURY --
VCJL PROBLEM-ORIENT HLTH CARE INFO SyS

           038   TRNG SERV CTR DISORDERS OF CMNC
_-. ._. _.   ._. -_ -- _.._.. ..- .._ -..-         _-. .^ _._ _ - - _ . ._ .   . -- .

IF CUHPONtNlS

s                               REGION TOTALS

_-_- .__.__.. -... -_-__ ~-    -----. -. .-.    --  . ..- _   _. .- .,-. . .

I_ -. .._ .---.                   _ _ _ _  _ -`..-  .._- .- _     .

_.

.

_____._-___ -__ ._. __ -_.--_. -_-- _ -. - -.- --._-- -._. _._. _, ___ _ _   -- ._ -.   .

                                                         .- _
                    f
- .____.____ -. -._- ___. - ___ -. - .-_ __ _ _. _-._ . .._ _-   _.  . . - ._  . _..  .    1-


                                         _.

____ __ _ .-. _ - _.. ..^ -.. -- __ _ _ . -.-      -.     -.           ._.


._                                  _'

DIRECT
REQUEST

  430,800

  62,700

  89,740

  145,954

  53,425
46,000'

  76,200

  79,068
-

983r887      55,783   .lsO39,670

__ --

INDIRECT
REOUEST

    0

99854

21335

15,808

4,670

    0


    0

239116

TOTAL
REQUEST

430r800

72,554
92,075 .. - .. --

1619762

58,095

46*.000
769200 --

102,184

__ __ _. _ _ _ - .^ ._.__ - .---. . . _  -. -.                


m


NUKlHLA?Ib l'&blUAfU MIAJILAL YlWW.Aivl
RM 00021
         .

MAY/JUNE 1974 REVIEW
          -.

Request: $1,889,395                                          _

Committee Recommendation: $1,700,000

Overall Assessment by Individual Reviewers: Below Average/Average

Critique :

The past performance for this region has been excellent, with internal
management considered to be one of their greatest strengths. Historically
Northlands RMP has been using a contract mechanism to increase extramural
participation.  The region is continuing this approach via the active
involvement of the various committees of RAG. These funds have been
used for the most part as seed monies of short duration to study and
develop new approaches to the delivery of health care for the constituents
of NRMP.  The region has been successful in the past in finding other
sources of funding after termination of DRi@ support. As of June 30,
1973, the Program Coordinator left and the Deputy Director was
appointed to his position.  The past Coordinator has remained active
on a voluntary basis in terms of providing advice and counsel.
Prior to the phase-out this program had an adequately experienced
program staff.  Following the rescinding of the phase-out order, the
Board decided to retain a small nucleus of program staff personnel and
purchase by contract the various consultants that would be needed. This
created concern with the reviewers as to the adequacy of staff in
terms of fiscal and program monitoring of the various activities proposed.

In spite of the past record on local support, concern was expressed
by the reviewers relative to the generation of local support for the
proposed AHEC's.

The reviewers felt that good work had been done in terms of the
development of a program call the Foundation for Health Care Evaluation,
but expressed concern as to whether existing staff could properly
guide and monitor such a program, and (expressed concern) as to
the need for further information on this program. The reviewers
generally expressed a concern for the lack of specificity in the programs
presented. To reiterate, the reviewers expressed concern relative to
staffing, lack of activity in primary care, possible funding in the
PSRO+ area.

*The above concerns were considered in arriving at a recommendation by
the Committee.  In this application the region has requested funds to
support the initial staffing of two CUP "b" agencies.

JULY/AUGUST REVIEW

Estimated Request as of 3la.y 1974: $600,GOO

SCOB/DRMP
6/h/74


NORTHLANDS REGIONAL MEDICAL PROGRAM, INC.
375 Jackson Street
St. Paul, Minnesota 55101

Prepared By: Joe Jewel1
Grant #    : RM 00021

Robert Wilkins, Coordinator

Current Staff:                Proposed Staff:

3 Full-time Professionals

3 Full-time Other

On Duty As Coordinator Since: 7/73
Deputy Director Since: l/68

5 Full-time Professionals

4 Full-time Other

FUNDS REQUESTED:

Total Cost - $1,889,395
Program Staff - 200,223
Continuation -(1,463,022)
New       -( 226,150)

Target Figure: $2,116,240 (7/l/74-6/30/75)
Estimated July Request:  $600,000

Period of Time Requested:  All activities to terminate as of 6/30/75

ITEMS FOR REVIEWERS ATTENTION:

Excludingthe amount requested for Program Staff (CORE) support, the
region is requesting $1,689,172 for operational activities via contracts.
The percentage of the proposed program to be beamed at the following
health care areas or systems are:

Percentage of

Activity
Community-based Health
Education and Manpower
Training

Total Request
   39

Quality Assurance

$326,676                      20

Hypertension

$191,985                      11

Emergency Medical Services

$281,506                     17

Kidney Disease

$149,777

     CHP Regional Agency Support    $ 64,610                      4

    The plans for these activities are described in the program report section
     (orange) portion of the application.  The requests for EMS and Kidney proposal
e  are for the continuation and expansion of currently funded activities.


(. Page 2
Northlands RMP Summary

e   Last year the region allocated $25,000 to develop a State EMS Plan.
   The requests in this application are to begin to implement the plan.

The Quality Assurance Requests are for the development of standards
to complement the Professional Service Review Organization(s) when this
is settled in Minnesota.

CHP:

The region outlines its procedures and expectations for the involvement
and support of health planning agencies in the May 1st cover letter
to Dr. Pahl as well as throughout the application.  An April 25, 1974
letter from the Executive Director of the Southeastern Minnesota Health
Planning Council (Rochester) is included in the application.   This was not
received in time for consideration when the RAG reviewed this submission.
The (b) agency recommended "disapproval, approval with conditions and
denial" on three of the five requests it reviewed. The region has
assured DRMP Staff that the concerns expressed by the planning agency
will be solved or satisfied before the proposals are presented to RAG for
funding considerations.

The region is requesting funds ($64,610) to support two unstaffed CHP (b)
agencies in South-Central and Southwestern Minnesota.

DRMP/DOD
SCOB/5-16-74


URTHLANDS     PROG YR 05

CENTRAL     CDMP
           ND

- .    -- . .._
           COO0
  _.__ - _ .- -_ _
          LO3
-.__ -..-.. --..
           loss
       - . .._
            106

_..

COMPONENTS

COMPONENT TITLE

        . -.

Pl?OG STAFF                                      200,223            0      2009223

KIDNEY DONOR RECOV t TRANSPL
-`A V TECWIIQUES
&AL .ASSUR OUTCOME -- -

WAL ASSUR OUTCOME

ASSIST CURL CARE EVAL    . -

hSS>ST CUAL ASSUR 7?ECHANISM
SWERV MGHT TRNG
-HLTH CARE S k MINN      .

CLINICAL PASTORAL MINISTRY ED,UC

CRITICAL C4RE NURSING
C E & TFNG N M N1N.N   _._ -.. -

S E MIp;N PRUdRAh I#PLEWATIDN
CDNTI:WING EDUC HLTH `PERS S C MINN
Ir'tST CENTRAL MINN CHEC PROGRAM
NL'RSE AID CURRICULM          .

           DIRECT     INDIRECT
,-       REQUEST REQUEST

       279500
. . .
      47,480

2O?OOO

     73,135
I
     30,000

    158~926

    129,628

     25rooo

     10,000

24,339

.               25,000

25,000

25,000

,25,953

       0

  2f800
..*_ 0 -'


      0


       0
    0 --.

  10,199

CURRICULUY OFFERINGS IN HLTH DCCUPATIONS
MAY3-CiXF!UNITY-EASED HLTH EOUC

HLTH SC1 CO!!MUNXTY HLTH ECUC

MANAGEMENT TRAINING REG LEARNIIIG CTRS

AGASSIZ HLTti PLAN E%ERGENCY

CEVELC?? PUeLIC INFORMATION PPOGRAMS

       25.600            0
.._ I    10,000         0

       10,000            0

        79,396      18,419

        10,OOG             0

       17,294             0

      0
 11,410 -.

       0

24~615


    0


     0

        0

        0

                      "b

TOTAL
REQUEST

27t500
58,890 ' `-.

20rOOO

97,750

30,000

1589926

129~628

25~000

lO*OOO

27,239
25,000 -

25,000

25,000

25,000

36,152

25,000

10,000
10,000

97,815

10,000

17.294


      ,1974
Q.      . .

21 NORTHLANDS .     PROG YR 05

SOUTH CENTRAL     CCIMP
. .               Nil

_. -. .-. -_ _.. _

.- ._ -.

1255

126

127

127s


128
129s'
131s

135s


138

13"


140


141
142

143


144
     -
1'45


14tr


147
-  -..

0 3F COMPONENTS     42

COMPONENT TITLE

RIN-DAK CHP EMS

METRO AREA EMZRG SERV STUDY
?1ETRO AREA EMERG SERV STUDY      -



INTERSTATE EMS

PLAN FOR COHPRE EMS

PLANNING CDMPRE EMS

STRENGTHEN LIiCAL DUAL ASSURANCE

MCDiL HYPT DETECTICN MGMT

COMPRE ORGAN RECOVERY PROG

IMPROVE COKNUHITY SASED MNPWR DEV

SE ?!Ii\!N EMS PLAN & HOSP GESIGNATXON
REG Ix CHP SD CENTRAL      

CONPRE HLTH PLAN SW .
                    *

METRO AREA CHEC

RESOURCE CTR REHAS ILL

PLAN EMS PERS

AUDIO VISUAL PT EDUC ON HYPT
!?INN `o'?T OF hLTH HYPT

SEUTH CENTRAL EMS

S W EMS

DIRECT     INDIRECT
REQUEST     REQUEST

lOtOOO           0.

10 9000           0

15,000           0

10t000            0

lOtOOO            0

. 118,428      17~823

   20rooo          0

  119,135      14r080

122,277           0

95*1&S     ;       0

lO*OOO            0

349842  1        0

29,768            0

25,000            0

19,254       59555

28,650       4t311

7,035       1,735
       ~-
50,000            0

10,000            0

10t000           0

_                     .

    REGION TOTALS      1~7789448      110,947

!eJ
US      IO-23

1

  TOTAL
REQUEST

10?000

lO,OOO

15,000

10,000

10,000

X36+251

20tooo

133,215

1221277

95,185

  10*000
.
  34r842

29,768

25,000

24,809

32,961

8,770

5OTOOO

LOI 000

10*000

1~889,395



                                           WnLU vluA.lcI1 nLu.lu1Y.t#.L l"uiU.LLaud lTIL"Luuu',

.                           RM 00048





MAY/JUNE 1974 REVIEW
$2,820,536
Request:
Committee Recommendation: $2,205,636 plus 100,000 for Project 27(d) to
              fund Toledo, Lima, Dayton, Ohio activity.

Overall Assessment by Individual Reviewers: Below Average/Average

Critique :
This region was reviewed in depth by two reviewers neither of which had
ever site visited the region.  This region has had a change in
Coordinators, as of July 1973.  The new Coordinator has been a member
of program staff since 1969.
Program staff is considered to be adequate. Regional Advisory Council
relationships are excellent, and all program activities are congruent
with the goals, objectives and priorities established by the Regional
Advisory Council.  This RAC has a long history of being one of the
better ones in terms of decision-making.
This region historically covers parts of Indiana, West Virginia, Ohio
and Kentuclky, with input from the medical schools in Kentucky, Lotiisville
and Cincinnati.  The region is entering its third triennial year and
has been considered to be in the upper quartile of regions within the
country.
The Ohio Valley Regional Medical Program at the request of Division
of Regional Medical Programs had agreed to accept applications from
the three phased-out Ohio regions. This meant accepting fiscal
responsibilities as the Grantee and staff responsibilities for monitoring
and evaluating any activities submitted.
Assurances were made by DRNP that should such activities fit within the
region's program priorities and objectives this would not effect their
funding level.
This region's past performance and accomplishments and their relationships
with CHP, -Appalachia and other agencies, including surrounding RMP's
are considered to be excellent.
In arriving at a reduced funding recommendation, criticism was leveled
relative to the tripartite nature of certain projects as it relates to
the three medical schools.
Concerns were expressed relative to the length of funding of certain
demonstration projects that had been receiving RMP support beyond a
three year period.  Another concern was expressed relative to financial
stimulation of the Home Care Programs under third party payees.
Such coverage has not yet been too successful.

                                (CONTINUED ON PAGE 2)


PAGE 2 - OHIO VALLEY REGIONAL IMEDIC.& PROGRAM
      RM 00048

JULY/AUGUST REVIEW

Estimited'Rec@eSt'as of'May'1974: None

DRMI?
SCOB,'IX)D
6/6/74


r

d              MAY REVIEw STAFF SD&MARY

e

0

OHIO VALLEY REGIONAL MEDICAL PROCJ?AM
1733 Harrodsbury Road
P.0, Box 4098
Lexington, Kentucky 40504

Prepared by:  ,Jea.nne L. J'arks

E.L. Angie Hebbeler, Director        On Duty Since: 7/l/73

CURRENT STAFF

Full-time Professional staff:  9        Total          15
Part- time Professional                proposed:
               staff:  1                      0
Full-time Other              :  4        Total proposed:  16
Part-time Other              :  0                      6

Former member of Program Ikvelopmcnt
staff since 1969

REQUESTED: (Target figure: $2,294,728)

Total Costs  : $2,820,536
Program Staff :    503,710
Continuation :   2,150,303
NW            .
              .    166,523

This region does not anticipate submitting
July 1, 1974.

Period of time requested: All
projects are scheduled to terminate
6/30/75

a request for funds for

CHP c-s:

No problems noted.  All proposals were reviewed by the CHP(a) and (b)
agencies prior to the RAC review.  Page 87 of the application lists
each project and the CHP(a) and (b) agency reviewing the project.

ITEM5 FOR REVIEWERS A'l-TENTION :

E%lS - No new EMS activities are requested.

Project #36 - Advanced EM.J is a continuation activity and currently
funded through 6/30/75 for a total of $14,585. The region is now
requesting $44,239 for the period 7/l/74-6/30/75.

Project #37C - Area EM5 Development - Kentuckiana is a continuation
activity and is currently funded through 6/30/75 for a total of $16,769.
The region is now requesting $26,159 to complete the development of
coordinated emergency medical services plans for a 17-county area of
Kentucky and Indiana.


Page 2 - OHIO VALLEY REGIONAL MEDICAL PROGRAM

Kidney:

Project #44 - Computerized Time-Oriented Data Base Implementation
         Renal Failure

This is a new activity directed at the creation and computerization
of a time-oriented data base for end-stage renal failure.


HAY

OHlO VAL

PROG YR 05

H CENTRAL  COMP
_-._. _   .-  NO _

           coo0
      .
           COO4
-.--_ ----_.. coo5
-_
           COO6

005A

._.- --. . ..-_ -.. ..--. 0058 -'
                  \
          .005c

         . 005Q
.- _._.. - -I -
            OllA
     --
           0118
        ._
            311D

    _
       SlfF

      -.
       OflH
..-
        OllI
- -._ _ OlIJ -

OLlK

PROGRAM STAFF

-

REQUESTED F

COMPONENT TITLE

HLTH MNPWR SURVEY DEMO

E;FCT uF HARRIERS IMP NUR~ COORO~`~IS PLAN

HLTH DEL SYS NEEDS & EVAL STUDY.

UN14 CONT EDUC RESOURCES

                                  _-.
UNIV CONT EDUC RESOURCES

UNIV CONT. EDUC RESOURCES

UNIV CONT. EDUC RES - MULTI-SPONSOR

                                _. _ - .-
HOME CARE

HDME CARE - DANVILLE KY       .

HO'IE Cb.2.E  - GEORGETOWN @iI0

--.









.

                                    -
HOE CARE - DEVELCPHENTAL AWAROS

HOWE CARE  - MAYSVILLE KY

HUME cisaE - LEXINGTON KY -

tfi),t!E; CARE _ ASn`AND KY ._      -- -.-

ELDERLY HLTH SUPERVISOR - LOUISVTLLE KY--          

   -.
             015  `CLINICAL ASSDC
_.-_.. _ ..__ I_. 020 `- pIALYSlS TECHNCLXIST - - -

            G2lA  '.R;G PEDXATkIC HT CLINICS


             0215   SfG PEDIATRIC HT CLINIC
       -021c-  REG PEDIATRIC HT CLXNICS                        .



             022:   RURAt PRIM CARE

DIRECT
REQUEST

417r550

15,000
6rUOO -`-

lr500

   44,55?

   29,976

   129695

   15,000
  38,253

   25,000

   35,512

  200,000

339210

    105 r69f

     559880

45,405

62,691
36,865

20,283

   22,965

    20,547

15tOTI

INDIRECT   TOTAL
REQUEST     REQUEST   `-.-

86,160

0


     .O
   0

18,861

14,798

.44,774 _-

6r347     19 r.042

    0
89217 -

    0

119133

28 9971
_
15r650

  6,220

101175

.   8,749

      0





0sn-w
-. a? 3


               F

503r710

15TOOO

6rOOO
19500
63,418

15,000

46,470

25rODO

467 645

2007000

33,210 -

105,697

55,880

45,405

919662

52,515

26r503

33r140

29,296

151077


MAY 1 m---

    __ .___ _...., -.--- -

REQUESTED FU     STING
              GXON

Iii10 YAL  PRDG YR 05

4 CENTRAL - CWiP
L ___ ___._____ -. NO ----     ..-

COMPONENT TITLE

024   STUDY CLINICAL RESOURCES NURSG STUDENTS

02&A  iNIV

. _--_--I-__- --- -  -----
           026B

UNIV

UNIV

ARE4


AREA
AREd

AMbULATORY CARE - .
4HfiULATORY CARE ..             _

         027A
    - _.  0278

        027c

         G27tl

027E   SDHHET - PENFiyRI L' L

027F

SOHMET - SE KY

SOHt+ET - LAKE CW8ERLAND

5 0 r; ?4 E T - sn OHIO

PHYS ASSIST UfILIZATION

PRtXLEM-ORIENTFD MED RECORDS
h?;CUL.~TL?EY CAKE .- DEVELOPMENTAL CC.MPONENT ,

A~VANCFfJ EMT

C27G

027H

-
        029

03;

           03b

           037c
.___ _ _. _. -_-.
            C42A

042t

C42C

. _

AM%!LATDRY CARE

HLTH EDuC SYS

                   .
HLTH EDUC SYS

HtTH EDUC SYS

Sl-!H?.?fT - DfVELDPMENTAL COHPCNENT

AREA EMS DEVELOP - KENTUCKIANA

REG DOSXbtETRY STANGAKOS OEVELDP *

KEG tX?S IfiETiiY STAt:DAirDS DEVELO

REG COSii'lETRY STANDARDS DEVELOP

-__-. _.__ -._   043.' - -CHILDREMS H&P EVENING HED CLINIC

C44  CCMPUTERIZED THE ORIFNT DATA BASE RENTAL FAILURE

DIRECT
REQUEST

                                    3.
INDIRECT - TOTAL
REQUEST  REQUEST

29r900

34,251
'44,241

411750

27,005

82,657

78,963

150,000

529426

371456

22,650

31,975

14rooo

105~000
'150,000

44t239
26,159

4?150

9,662

8,850

21,778

72,575

16.134      50r385
                        . .
        ._ ___ ^
209224      64r4bS
20,125 -. 61~875

12,211      39~216

37r343  -120,000 ..

3??357     116~320


    0     150r000
i4.045    66,471



14~293   46*268

  0 - 150,000 `.

39491      47,730

0      299900

0      37~456

2*50C  25,150

0   1*-r OOQ


0   105t000

    0     26,159
`1,800     5,950

3,162      12~824

11050       9,900


    0      21.778

22,170      94,745


-

MAY 1

REQUESTEC FU a STING
COnPCNENTS     GION

06174 COUNCIL

It?10 VAL       PROG YR 05

3 CENTRAL   cow            COHPC!NENT TITLE
            NO._--       .- .  .

045

CONT EOUC EXPANDED FUNCTIONS--DENT

_..                             _-

?COMPONENTS __ 45 .I_ _._ __._ _     _ .

_.

          .
.-

- _ __ _ . .    - -

-.

.- . .._. - ,____- - . ..- _.- .'      _   _..

--_.- . ..-__ -- -_..  _ ,- _ I ._ _ _ . - _. _      _...

-

_ __

-

AUXIL

REGION TOTALS

          OSH-PW *   t
._ .

DIRECT     INDIRECT       TOTAL
REQUEST     REQUEST .   REQUEST

5otooo       0 -    5otooo

2t399t350  .42lt186 - 2t820.536.

                    _


_ _ _  ..____._ __. ..-       

_ _ _. _    -. _ - -   -

._ _ .._...-_._. . .-. - :-. -.-



    ,


a

a

                                   RM 00023
                                                                   -


MAY/JUNE 1974 REVIEW

Request: $1,382,243

Committee Recommendation: $1,062,237

Overall assessment by individual reviewers:

Average and below average; the
before theeopportunity to study
concept and objectives.

latter was based on review of the application,
a comprehensive statement regarding the RHDAP

Critique:

Reviewers noted that the program had turned around from a heavily oriented
continuing professional medical education emphasis to health care delivery,
promotion of areawide institutional participation and regionalization, with
primary emphasis on quality of care improvement, sharing of services, and
cost containment.

Concerns were expressed regarding the additional staff requested (7 new
positions) and the vagueness of staff component activities. Questions were
raised as to consumer and community involvement. Staff pointed out that the
RHDAP concept stems from the Health Services Education activities, initiated
through community-wide institutional consortia, beginning with the coronary
care monitoring program and the telelecture conferences, with emphasis on
manpower development.  These activities involve community hospitals, local
health institutions and organizations.

Reviewers observed the strengths which result from the furthering of
community hospital and educational institution consortia, with outreach to
rural areas with limited resources.

JULY/AUGUST REVIEW

Estimated request as of May 1974:   $448,000

MC0 6/4/74


STAFF SUMMARY FOR MAY REVIEW

OKLAHOMA REGIONAL MEDICAL PROGRAM:   RM 00023

PROGRAM DIRECTOR: Mr. A. Donnell (Hospital Admin.) - since January 1973

STAFF: (FTE) Total -*lo

  (formerly Pl. CHP)
Addt tional Proposed: 7

Professional: 7
Full-time 6
Part-time   1 (50%)
       * to be full-time July 1

Professional: 4
Full-time 4

Other:       3
Full-time 3

Other:
Full-time  3"

FUNDS REQUESTED:  Total (D.C. & I.D.C.) $1,382,243 (IDC = $96,635)
                     (exceeds estimated target of
                     $1,062,237 by 320,000 )

Program Staff              $400,372
Staff Components (3)             83,315
Total Program Staff & Components     483,681:
Projects: (9) total            898,556
Continuation (6)             727,356
New (3)                  171,200

CHP COMMENTS:

Oklahoma Planning Corrrnission ("A" Agency) commented on each project separately;
generally concurred, but noted concern about possible duplication in pending EMS
application to new EMS Division , under PL 94-153. (Similarly questioned EMS
aspects of RHDA, area program proposals, but so far no approvals from D/EMS).
An overall statement from "A" agency will be furnished DRMP.k Four "B' agencies
confirmed approval of individual proposals and also noted approval of total
program proposal.

      * hfas furnished 5/23/74
Activities:

EMS - training expanded; communications expansion through RHDA programs;
  requesting l/3 more than 12 month base and reaching other locations.

RHDA - Regional Health Development Area Programs - 4 locations; area-wide
  multiple county programs of cost containment activities, sharing services,
  joint personnel utilization, in rural areas; (non-profit hospital organi-
    zations - manpower development, education activities).

#34 - Strengthen regionalization through expansion of areawide planning support
  for 4 locations in Western Oklahoma. (Two had been initiated by Core with
   unexpended funds.)                                                          .,

#43,45 & 46 - These three new activities involve primary care and referral services;
      also education and training to improve manpower resources, and
       focus on rural area needs.

July 7 - expect to request $448,030
                            L. Resnick -MC0 - Revised 5/28/74


n      1974 . ~_
*
       -- - `- .-

.    


      _-._ _

-

3. OKLAWOffA

PROG YR Oi

                                                                      
ID CONTINENT   con6 --           COMPONENT TITLE                       DIRECT
               NO _ _ ._         _ _- -                       ._ ..^     _ REQUEST
._.  .-...-. _ . . .  ._- -. _._.

    :       coo0 -  PROGRAM STAFF                                 387~062
- _ .~ __. -   025  EMS TRNG & SYS DEVELOP .                    101',622
_~ -._.. __-.----- " - 032A- - R& HLTH DEVELOP ADA                   --               86,035

0320   REG HLTH DEVELOP ARDMORE                              95*419

033    REG HLTH DEVELOP BARTLESVILLE                       861913

---._.^.__---. ^- -                                                 _ ^   .- _.
             034A   CONT AREAWIDE HLTH PLAN`NW OKLA                62,130'

   0348  CflNT ARiA!JIDE HLTH PLAN SW OKLA               62,136

  039   RCG HLT.H DEVELOP ENID                             126 9352
_

.- _..-_.-. -_-. .-..--.       -
             041   REG HLTH DEVELOP LAW&N

106r755

-043.  UPDATING KNOHLEDdE & SKILLS.RN'S & LPN'S-               91,000

             045    MflBL EYE UIS SCREENING SEKV
___ .__-.- _... - _ _- .   __
               046   PT. F.EFER'-& TRANSp' S;;.- .- -

3 OF .COMPGN"NTS 12 -. .__ -.    -.

47*500            0

32 e700            0

REGION TOTALS       1.2859618


       -

96,625.   1.382~243

INDIRECT      TOTAL
REQUEST  ^ REQUEST

969625

    0

    0


    0


    0


    0


    0


    0


    0


  0



4839687

lOlt622

86to35

95,419

    86t913
_ .                     _
    62t130

62 t 230

126t 352

106.755

91?000

4?*500
321700.

--..- -._ - ._   .     _. . . _ _

.  . . ..--.i      .


,


    Oregon
RMJ'  --- --CI

IZM 000 12
      *I_

--



Crf. ci.C] IIC? :

As in the past, Oregon has continued to be an exemplary, well-
managed program with strong leadership.  The Region has a viable
Regional Advisory Board with a good review process.

The relationships with CHPs are good.  These agencies are
apparently involved in program planning.  New staff has and is
being recruited to fill existing vacancies. The ongoing and
proposed activities are well-developed and in line with program
objectives.

The Committee recommends that this application be approved at

the requested level.

,

WOB 6/6/74

.

. .


e

STAFF SUMRY FOR MAY 1 REVIEW

OREGON REGIONAL MEDICAL PROGRAM: RM00012

University of Oregon Medical School, Portland, Oregon

COORDINATOR:  Julian S. Reinschmidt, M.D.   Since- 12/l/70

STAFF: (FTE) Total - 15.35            Proposed:  15.35

Professional 10.35                    Professional   10.35
Other       5.00                     Other         5.00

FUNDS REQUESTED:   Total (D.C. & i.d.c.)     $1,201,357

Program Staff (Administration)
Staff Components (9) - 3 new activities
Total Program Staff & Componenta
Projects (8) total

  633,330
  356,995
  990,325
  211,032
$ 1,201,357

CHP COMMENTS:

As a mstter of procedure, all project applications are reviewed by the
ORMP-CHP Subcommittee composed of representatives from each of the CHP
8genCies in the state.  Further, applications were sent to 14 area-wide
CHP groups, of these nine did not respond formally.  Of the five CHP
Agencies which did not respond only one critized one activity, the Fami.ly
snd Self Yelp Education Program (COOK).  This criticism was addressed and
reflected in the conditions on which ORMP approved the activity.

ITEMS FOR REVIEWERS ATTENTION:

None of the activities proposed appear to conflict with other Federal grant:
programs--such as, HMO, PSRO, KIDNEY, and EMS.

CONTINUATION ACTIVITIES:

Of the 17 discrete activities proposed 12 are continuations. Only significant
increase in continuation budget is noted for EMS Consultation (CO06) which
goes from $48,593 for six months to $158,910 for 12 months. (See p. 66).

NEW ACTIVITIES:

CHP Agency Priorities (CMJ), Family and Self Help Education Program (COOK),
Chicano Health Task Force (COOM), Oregon Cryopreservation Eve Bank (#31) and
Management Training Program for Hospital Personnel.

e

.f              DRMP/DOD
               WOB-S/17/74


       111   15.1974 _- -
-- il)
_. -__ ~ _._         ^_ _   _. . __.- - . . - _.. -    -

12 OREGON-       PRDG YR 06

          .._
WESTERN      COHP `- - -COMPONENT TITLE
_ _- .-- _ _ _. -  _.~ NO - ._ _ . _ _    _ _

         coo0  PROGRAH STAFF
..--   .- -_ .-.~ _                                      -_
               COlA  PT ORIGIN STUD+ .-

-.-___-___ --_ - --. _    -.._ ._ -.- ..-, a _.. -...  - _..
              COlE   RENAL 015
         COlF OREGON COMPRE CA                 -
              COlG   STATE EMERG HED CONSULT SERV
"___. ._ _ ._._. --. .   -coikl -. QUAI. ASSUR

3 -    ----                                               -
               COlJ  , STATEWIDE CHP AGY PRIORITIES

__ _ _ -_ _
               COlK

FAMILY AN0 SELF HELP EDUC

---_---_._- _~_-_--__. -_-  _ . .
              COIL

-- -'

__ _ .._. .-    corn-.

Olti

PEER f?EVIEW CJUAL ASSUR

NH CHICANO HLTH TASK FORCE

OPER SERV REMOTE C C MONITORING

I__-._  . . . .- _  _ . 022--.-

.._,

- .-___ _ - _ _..  025.

, 02;

EMERG YED TECHN TRNG RURAL

Ct-MHUNITY STROKE REHAB

GROlJP PURCHASING

.- ._-_ ____ ._ --   __.-.
              029   AREAHIDE COURD HLTH DATA `INFO    . `-.

031-  iREGOt CRYOPRESERVATION EYE `BhNK

033    E M S OIST ORGAN12

035   HGMT- TRNG iiOSP' PERS      -`- .-     -.. ..`.

DIRECT   INDIRECT   TOTAL
REQUEST _ REQUEST     REQUEST

469,390     163,940     633,330

33~988    0    33~988

     _ _            ,    .-                     _ .~_

21800

119780

         158r910
-
          21,358

      0      2.8Od

       0      llt780

      0     1589910
_.._. -.        _..                -.     -.
      0      21r358

     100*000

      9,650
._.  13r509 -,

5rooo

23~409

359169

22,796

. 7,500
18,620 -

16,523

23 r6 10

-... - _  24~334 -"

NO DF.COMPONENTS 18 .

REGION TOTALS   998,346

203tOll   1.201.3~7

                                                                           .,+
                                                                           ._     _ -..
-..-- .__.. - _.._. -- _. . . .._ ..__ ._-. .._- ..- _- _ .-.   -.    - -   ..- -               .

--

       0     100,000

      0       9rb50
_            _.
      0      13,509

      0       51000

4,299      279708
                         -
12~907      48,076

br900      291696

   0      7,500
         ..-                 _  .-
    0      189620

69300      22r623

8,665      329275
       --. .
    0    .24* 334 ;"
       


-


Crl.tique:  Previous concerns of reviewers had brought future funding
of this program into serious question.  A site visit was conducted in
January 1974 to deal with the previous concerns in anticipation of thils
application.  The primary reviewer, having participated in the January
site visit, expressed complete satisfaction with the findings and      .
indicated that previous concerns stemmed more from problems of
communication than from programmatic inadequacies.  On the strength
of the site visit experfence plus his review of this application, he
recommended funding in the full amount requested,' This recommendation
was concurred in by the secondary reviewer and unanimously adopted
&y Panel B.

JWX/AUGUST REVIEW

. .

        
c.


PUERTO RICO        Regional Medical Program

Coordinator:  Rafael A. Rivera-Castano, M.D.

Staff:  Full Time Prof.                 4

Full Time Other                 8

Total

12

On duty
(Previously Assoc..,

Proposed:   11.25

9 1

I

       I
20.24

Funds Requested:

Total  .s#,*......****I..*   695,862

Continuation .***....*..m.  (570,491 ) 390,137 Prof. 180,354 Program'Staff

(125,371 )

Period of Time Requested:None later than June 1975

Activities Proposed:

Refer to Management Information
                             . . .

Systems (MIS) printout.  (Also, note symbol C

will be placed next to activities which extend beyond June 30, 1975.)


c ist

    over

any continuation project or staff activity for
annualized current funding is requested.

which substantial increase

HMO project:

EMS project: 13 - Health Planning Assistance - This is a program staff
activity.  It will be devoted this year to planning for EMS thoughout the
island.
l/20 - Cardiac Pulmonary Center (new> - has long range implications relative
to planning transportation needs for trauma patients.

PSRO: 1118 - Promote and Strengthen Integration of Health Services in Humacao -
(staff planning assistance for establishment of a PSRO was given last
year).  The development of integrated services on a community wide basis
is the long range goal, but PSRO concerns will almost surely arise as those
services are planned and developed.

Kidney:  Staff assistance was given to the Board of Health last year to
plan a program for the island .  Further assistance plans are not indicated

                                           .
CHP comments: A letter of general approval is contained in the application

E0/5/20/74


N&Y 15.1974 .-..

-.... *        ..-. - .- _ -

PUERTO RIG. _._...   PROG YR 04

.

iTERN         COUP                COMPONENT TITLE
.-.. _.    _-_ -._. _  NO.- -.                                _. -      .

            coo0   PROGRAM STAFF SUPPORT
_.~ ..-. ..-. -.   _-
           coo1   ACTIVITY NO 1
I-..---.--. .-- coo2 ----             . ..- .__ -
           ACTIVIr'Y ii0 2          ._ _._ _     

           coo3   ACTIVITY NO 3
_' _ ._ : _
            018  PROiOTE AND STRENGTHEN THE INTEG OF HLTH SERV IN H
: --- .----..  _  L  .020  .-ESTAE -CARDIAC PULMONARY RESUCITATION TRNG CTR

_-
          021   TRIG PROG TREAT CHILD LANGUAGE AND HEARING DISABIL

43,366.

OF..COMPONENTS __ _ _. 7-s ___- . _      _

REGION TOTALS       .   621r129

DIRECT
REQUEST

153,355.

   77r907
.
33r755

133r224

  108r136
  71,38k.

             :            




                                 .

_ . -. - -

INOfRECf
REQUEST

261999

13,716

101779

6,677

61203 -

4~416

t

TOTAL
REQUEST

1801354
91t623 ..
39t698 *- ^' "-.

144tm3

114t813

779589

47,782

695,862 ..- .

. _- _ ._ __. _     _ _ _   . _ _ _


m


Cr:i.ti.qui! : The reviewers were very impressed with this application which
requests continued support for staff and two on-going projects. (Two year
funding is requested for one project,) The display of goals, activities,
priorities and funding was especially noted as reflecting a well-ordered
program based on identified areas of need.  The staff, Regional Advisory.
Group and review process appear outstanding.

The CHP(b) is supportive..

.

In recommending approval as requested of this application, the Committee
expressed anticipation at. seeing the  nel CT proposals in the July application.

K13V:I El?
,~1IIx/hw.KT
          __-I__L
Estimated request as of llay 1374:   $1,080,000
      1

,


  (.' 1
e

,ROCHESTER

Regional Medical Program

Coordinator:  Peter D. Mott. M.D.               On duty since: h?r. 19a

Staff:   Full Time Prof.

Other

Total

Funds Requested:

Total  ................... $  361,437

.  Continuation .............  ( 88,652

Period of Time Requested: July 1, 1974

Activities Proposed:

5.75

3

a.75

> (projects);

1

KM ooqq

Proposed:   6.75

                  .-
8.75

to June 30, 1975

272,785 program staff

Refer to ?!enagement Information Systems (?XS> printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


     4                                          RN 00025
f                                                 Rochester

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.

I
HMO project:

EMS project: t43~ - Continuation of a pieviously approved project.

PSRO:

Kidney:

CHP comments:  The Genesee Region Heal& Planning Council recommended
approval of this application.

m/5/20/74


- _ _--.        . - _ _ _ . .-               -

RCCHESTER .-     PROG. YR 06

   _-. ..~.           -_ __ _.
`ERN       COMP          COMPONEkT `TITLE
-- - ----."- - --  NO _ _.._. _-__. _. _. ..__ _       .          _              .,.

F COMPONENTS- 3

~PROiR&U STAFF

RURAL PRIM CARE EVAL STUDY
---._. .- ___. *-
EMS PLAN AND' DEVELOP -  _.__ __-

_ _. _ _

REGION TOTALS

.

DIRECT   INDIRECT   TOTAL
REQUEST   REQUEST _ _   REQUEST -__

           -
224,324      48,461      272r785
            -
25,000       5r425      30,425
         .  c-           .-  -
47,845      10,382    S&227-- .k-

. .

297rl69      64.268  Ml*437

_   I `.. -      _. .._ _.   _. __. ._ .- .

----.-`----- _-.-. _..,_ _--_-- ._-. --. -_ ..- . - _-.-.- _ _ _. . _   -...--.-. - ---- ._._- .  _   -     - .-.. _... - -. -..   - .- .----_ -- .- .- . ..-   - .   -
                                                                           ,

-..-. ..-. _.."_ .._-..-_- -...-_I_ .__-__    _ -...__ ___ ..__ . - ..^...   ,. __ _ _          .- ._.                           __ _. ._--- ._ _   __- _ . .

--_-.--- - . .._. -.  -~  .-- _.____ -_-_ . ..- _._ _-_.. _._. -.-. ._  __- ._._ - -- ._. -. _ -. . .,

- ---..- -- _- -----_ `_ - -. _ - ..-.- -__ -_ ._   _ .._ _..   ._                           _

--.---_. -___ _- . . .__._ - _.-.. _..  ._ _       - _ . .-     _    . _ ._ ._ _

      .                     .



$3,000,000
Request:
Committee Recommendation: $2,200,000



1:
Average/Above-Average

:
Critique
Members of the Review Committee agreed that this was one of the better
applications from an obviously matured program.  The region has
established goa.ls and objectives with priorities carefully spelled outr
They are making a real attempt, in their cooperation with the CHP
and other agencies, to solve the health authority problem, During the
last 18 months the region has made good progress in restructuring its
RAC by disciplines of members as well as geographic representation.  South
Carolina RN? is consider&i to have an excellent local review process.
They were considered to have an experienced program staff under
strong leadership.

There are many divergent political forces at work in the region at the
present time, both medical. a.@ administrative, that affects the- future
of the health care agencies in this area.. The Regional Medical Program
may emerge as the agency to provide a platform to the resolution of
the health care problems in the delivery system.

In arriving at the reduced funding level, members of the Committee
were not convinced that the rather large amounts requested for
activities had not had time to be completely reviewed under the local
review process.  For example, escrowed funds were requested for:
regionalization of services, - for health manpower development and improvement;
for strengthening of quality assurance efforts and several other activities
which the region was interested in to accomplish its objectives.

In arriving at the reduced funding level, the reviewers also did not
believe that these particular activities were sufficiently developed
at this time to allow for proper review by this Committee.

JULY/AUGUST REVIEW                              *

Estimated Request as of May 1974: $500,000

SCXIB~IXID
6/6/74


F

MAY REVIEW STAFF SUMMARY

SOUTH UROLINA REGIONAL MEDICAL PROGRAM
80 Barre Street
Charleston, South Carolina 29401

Prepared by :  Lorraine Kyttle
RM#      : 00035

Vince Moseley, M.D., Coordinator       On duty since: 1969

Current Staff:             Proposed Staff:

6 Full-time Professionals        9 Full-time Professionals
0 Part-time Professionals        0 Part-time Professionals
11 Full-time Other             11 Full-time Other
0 Part-time Other             0 Part-time Other

Funds Requested :            (Target Figure - $2,444,287)

Total :  $3,000,000
Program Staff - $ 497,380
Continuation  - $ 983,512 (23 activities)
New      - $1,519,108 ( 2 activities plus 6 targeted thrusts)

Activities Proposed:

Continuations
5, -fntinuations" 8 are components initiated with October 1973,
awards and the remaining 15 were started with January 1974 6-month
awards.  The law country RMS activity (#88) is a CHP "b" sponsored
assessment of needs and resources study. Component #71 continues an
activity which designed curriculum and procedures for advanced training
for EMT's and which has ongoing enrolled students. Component #75 does
not propose to increase renal services but rather to share consultant
back-up.

EMarch 1, 1974, SCRMP issued an invitation for contract proposals to
its constituency.  It outlined five areas of activity in which SCRMP
was interested in extending its objectives:

, Regional development of Planning and Services
.  Regional Health Manpower Development
.  Strengthening Quality Assurance
*  Regional programs in Categorical Diseases
.  Improvements in Primary Care



These areas all directly reflect SCRMP goals and objectives set by JUG
in April 1972 to guide the program in its triennium.  One hundred sovcn
letters of intent were received.  Pages 79-8'2 list the 48 formal applica-
tions which have been developed through this response and which have
entered the formal review system.  They were discussed at the Annual


,South Carolina Regional Eedical Program

0

Conference with CHP on April 15 and will emerge from the comnlete local
review in late May.  Final CHP comments are Gticipated in mid-June.
In late June, final RAG discussions, priority ranking and contract
award will be made and the activities will begin July 1.  These
activities are grouped on the printout under the heading 032A through
032F. The specific activity addressed in 032F, Advanced Health Resources
Planning, is an advanced planning group to develop realistic responses
to emerging legislation in health resources planning. It proposes the
establishment of a body of participants with a balanced and objective
structure to logically build upon what South Carolina already has learned
and done in health resources planning rather than to discard it and
start over again.

CHP Comments:

Components #89 and #90 seek initial funding in this application.
The proposer of #89 is a CHP "b" agency. Number 90 is an activity
that was submitted for local "b" comment in the last review cycle and
the comment was favorable.  With respect to the initiative 032F,
Advanced Health Resources Planning, it was submitted to all "b's"
and the replies ranged from "premature" to "characteristic foresight"
and "timely proposal ."

e  Items for Reviewers Attention:
  The responses of the "b'i" to SCRMP's proposal for an advanced planning
  body, mirror the divergent currents prevailing in South Carolina in
   matters medical.

It is difficult at this point to forecast whether the existing
divergencies are healthy disagreements that are good checks and balances
or if they are forces that may prove to be counterproductive.

DRMP/DoD
5/20/74


REQllESTED
COMPONEN
    Gb/74

LISTING
REGION
IL

S CAROLINA   PROG YR 06

TH CENTRAL-  - -COMP
-. _  .._ _ _  _ .__  NO

CGOG

G32A

--..- - .._.-._ - -.._._ _- G32i

.
          G32C
  .-
          032D

.-   - .  _  _  -032E
     032;



.
   . 0608
_ . ._
       GbC


      067

__

       065
_ .
      069

070

        071
_ .~___... _ 072 .

073

       `COMPONENT TITLE '            DIRECT.   INDIRECT
_-                                       REQUEST     REQUEST

PROGRAH STAFF
RECiONAL'IZATION OF SER
HLTH MJiPWR OEVEL ;HPROV       `_.
           -.
STRENGTHEN QUAL ASSUR EFFORTS *

SPECIAL CATEGORICAL INTERESTS

PRIM HLTH CARE

ADVANCED HLTH RESOURCE PLAN

SCREENING HYPT CHILOREN

CI'UAL ASSUR OIAfZTICS

PERINATAL WA1 ASSUR

RURAL MC'BL HLTH

SHARED MNPWR CEVELOP

         353 t398

        . 539,499
       .
           89t916

          104,903

        404t624.
      .- -
         1949819

          164t847

           43t75G
      .
           551500

           48,750

           125tGG0

           229700

PEE DtE, H'JSP BASED HNPWR DEVEL

AGVANCEO TRNG ERTS

            13t412
         
                 18,450

CRITERIA IMPUCVE H?SP AND A!+BULATORY SERV               20,000

       074 '  UPPER SAVANNAH QUAL ASSUR                          19,950
                                                    
_ .__. -. ---_- .._ _
       075 -- _ &MPUTEhZZELI CARE RENAL 01s                       _     _
                                                             14,250

. .~
      Of6  . . CWVtJCXTY l+YPT CNTRL                                55tOGG

      @7&    SCREthlSNG UROPATHIES AN0 HYPT CHILDREN                  37,000
   -()io _  HOSP ME0 CARE EVAL SYS                             55 rOGO

      GBG    INTENSIVE COURSE NEDNATAL CARE NURSG                   33tl54

143,982

     0
   .
  .o -
   0

     G
   0 -

     0

16t250

19t5GO

16t25G

     0
    0-

     0

     0


      0

13tOOG

      G

    0


    G

13tGOG

    G

16t846      SOtOO

                     5
TOTAL
REQUEST

49rt 380

539t499
89t916 - --
104t903 -

4G4t 624

194;819

164;847

6Gr GO0

7StGOO

65tOOG

12StGOO

22tfOO

13t412
189450 .-

20rooo

4StGGO

19t950

14s 250

55tGGO

5GtGOO

55tGOG

-


5 S CAROLINA

PROG YR 06

S LISTING
Y REGION
NCIL

OUTH `CENTR-AL   COMP -_              COMPONENT TITLE
. . .-----...__ _- - -....  NO.-.-. _.. . _ _. _ _ _   __.          .._  _

081    CATAWBA AREAWIDE HLTH DATA BASE

082 -- -iiYPT SiUDY BLACK MALEi CHARLESTON CNTY

-..__ --_ -- _ .___.. -                              

083    DEMO HYPT CNTRL

-- -_.-~_..-..--_.-
              084

QlJE.IkC METHODS IMPROV `AMBULATORY CARE

              085
--.. - _._... _- ______.__
      -      086. .---

    -
087

OCONOLOGY RADIATION DOSInETRY
UUAL ASSIJR LAB PERS ' -^-
WktAHAH BIS HLTH PLAN

OR8

wi---

090

LOW t@UNTRY E M S_.STUM

UPPER SAVkN'ib.tl rLTH PLAN
&RSE HIDHIFERY

_  _ - -_. _            _.   _ - .   .I . REGION TOTALS        20710~1l9



_... -- -.._ .- -  ____ - . -       . _. _    -. -             . _


                                         


                             .                            .

    DIRECT
,.  REQUEST

   32,000'

     65~452

     53,495

     32rOOO

     25~250
    17,000'

    15,000'

     39500

      51500

     15,000

INDIRECT
REQUEST

0

21~798

  6r505

13rooo

9r750
  .O


    0


    0


    0


  0

.289r881

              O-23


_-                   *

TOTAL
REQUEST

32,000

87~250

60*000
45rooo --

35tooo

17tooo

15~000

3r500

5t500

15,000

3T000~000 _ ~



._



NA.y/JW!E 1974 REVIEW

Request:   $729,417

Committee Recommendation:    $729.417

Overall assessment by individual reviewers: SUeEBLQ&_
         .

Its goals and objectives appear to be achievable.

Critique:

The joint RAG and CHP Advisory Council provide primary strength in leadership
and in support of a small, capable staff.  Program proposals are considered
well defined and priorities well meshed.  With regard to Indian involvement,
several staff activities conducted on Indian Reservations, were proposed by
Indian RAG members. Cooperation is commendable, as is the participation of
the Grantee institution in program implementation.

Quality assurance activities are continuations of two program staff
initiatives directed at developing guidelines for use in establishing PSRO
criteria and the identification of continuing medical education needs of MDs.
These are proposed to be assumed by the 6D Med. Care Foundation which will
be the State PSRO when funds are available. The Medical Genetics service
began as a developmental activity under program staff funding, and will be
the only one in the State.  Its focus is on identification of birth defects, ,
to improve diagnoses and establish referral systems. It would be managed
in conjunction with training in chromosome analysis, while other sources of
support are being sought.

JULY/AUGUST REVIEW
               --

Estimated

request

as of May 1974:

$15Q,OOO

    MC0

.

6/4/74


,

STAFF SUMMARY FOR MAY REVIEW

SOUTH DAKOTA REGIONAL MEDICAL PROGRAM:   RM 00067

PROGRAM DIRECTOR: Mr. Donald Brekke (full-time)  on Duty since Nov. 1972
                          (Prior to appt. had
                         been deputy director)

STAFF: (FTE) Total - 6

Additional-Proposed: None

Professional: 4
Other:       2

Expect to use increasing number
of consultants and University
technical advisors, without
reimbursement.

FUNDS REQUESTED:  Total (D.C. & I.D.C.)  $729,417 (exceeds est. target of
                           571,095 by 158,009) *

Program Staff             210,921 - -
Staff Components (8)              76,252
Total Program Staff & Components      287,173
Projects: (11) total             442,244
  Continuation (6)               252,568
  New (5)                   189,676

* Funding base reflected program in planning status. Program approved
for operational status January 1974 by NAC.

e                                    f
     CHP COMMENTS:

RAG and CHP Council one and same; members of various technical and review
committees, represented on Executive Committee and actively participate.
Goals and priorities coordinated and integrated in a dual matrix - care levels

and functional objectives.  Priorities are manpower development
resources to improve quality care.

and

ACTIVITIES:

#3 - EMS - continuing at only slightly high level for expansion of training
    and for advance program in development of a total system (EMS)
       CATTAC.
#6 - PSRO - Quality assurance activities; emphasis on improved data base,
     medical record quality, base for continuing education of MDs
    and other health professionals in preparation of a PSRO; assist
      SD Medical Research Foundation .

Most activities requesting the same, less or only small increases above
current program (annualized).  Exceptions are the PSRO activity and the
development of the Sioux Falls CHES (presently a core component until
project director appointed - site selection has been made and will be
converted to project.  This activity will complete the Statewide CHES
program and enhance the total manpower resources development activity.

July 1 s- expected to request $150,000

L. Resnick - MC0 -Revised 5/28/74
     a




      n _______ .*. 1974. __._


              _. __ _ ___     - - __. __ .__ ._ .

7 S DAKOTA _. _   PROG YR 03 `__ .

S LISTING

ID~CDNTINENT     CDMP
. . . . .--  - _.__ . .  NO

- - - - .   _

- ---- - __ __ _. _ _ COO4 -

-.--- .-.---- ---_.-_.
        COO6 -

--. - -- __ -- . .   coo7

.-_ _.   ___ ._ ___  &8

---*.-es -... ---.-- _  ..___ __
             COO9
---. _-z __.... ---. __  co10 I
----~ -.- - __- :_ _ -.
             co11
-.------.. -_l_l_ _ _
             co12
-- . -   _  __ ___  002. -

---  -..- ---.-- --

-- --. . .._.-_ -_._

-_   _._

Cl03
_ _.-.
004
005 -.
obd



        COMPONENT TITLE                       OIRECT
-..                     _.                  REQUEST

PROGRAM STAFF                   149r568 '
SANA INDIAN RESERVATION PRECEPTORSHIP                 21250
NURSE RESOURCE LIBRARY .     `.         _.. .,_            .
                                              3rooo

ACUTELY POISONED PTS                                3rSOO

MGT HYPT PHARM PIME RIDGE RESERVATION                   6,400

PT iJRI;NTEG HED RECORDS '                  . .  17,262 '

RDhUD INDIAN HLTH HLTH OCCUPATIONS            39200 *
COUNCIL AFFILIATED HOSP    -                         1,140

S1OUX FALLS AREA CHES     --- --              I -.  39*500

L&IS ANG CLARK HLTH ED AND SERV CTR                   60,350

EMERG HLTH SERV                                    471301
OAHE- -C&nUNITY HLTH. EOUC SYS --. ._   _. - - . . . .-- -   - L._   . . . 45r200 -

HYPT EDUC PR`!ZV OFT REFER .- ..                3or800

PSRO                                 43;ooo

006 -.- CMNC D1SDRDFRS GERIATR1C PTS `.. - ;      ~ ..- - -. ^

_
        329956

Ol@    ME0 GENETICS                                       46,354

011   EST CDhT ED RECOCNITIUN                             10,300
Oli - ORGAN12 AWARENESS DEVELOP IN SiRV TRNG       --.
                                                    221000
013 ST -LUKE'S RESP OUTREACH                            30rooo

014  &TERN ~LTH SYSTEM CHES --                      48 ~066

..--.--we . - -.-.. .- --_- - -    ._-____ _ -.        - --..              . .

CF CDMPCNENTS     20                              REGION TOTALS         642~147


        -.

IN01 RECf
REQUEST

611353

     0
-.
     0
  ._  -0

     0

     0

      0


     0

      0
.14r 407

4,730

6,780

     0

     0

     0


     0

    ' 0

    0.

     0

     0


879 270

osn -0 O-23
             ,

_-.
   TOTAL
REQUEST

21&921

   2,250
_               _. ..-      _

 39000

   3rSOO

6r400

17,262 .-

39200

X*143


   39,500
  f4*757 -

52 to31

.- _- 51,980 .'

3or400

43rCcl

32,956

46 ~354

JO, 300

22,000 .-       -

48 t 066

7299417

---- -.-.. . _.                1 -


a


,

cr3 t: .i ct\K? : The Committee expressed concern over the lack of planning for
present and future activities.

The application appeared to be essentially a rebuilding of their budget.

The request was primarily for staff support-and a request to fill.10     .
vacant positions, plus support for 2 projects, Committee recommended
$250,000 in program staff support, $60,000.for grantee costs and $95,000
for ongoing projects.' This would in effect give,SVRMP some room for
expansion as well as keep the remaining 14 positions.  Further hiring
should cease until a definite program can be identified.
Committee recommended a site visit to this region prior to Council
meeting or if this could not be arranged, to have key representation
of the program visit DRMP to provide additional information regarding
future plans for the program.

i      JULY/AUGUST REVIEW

Estimated request as of May 1974: $705,.860
     \                                                 'Y

,

e                                                                       :
                                                                           ,


? o

SUSQUERANNA VALLEY     Regional Medical Program

Coordinator:  Chad Combs, T.hm

Staff:  Full Time Prof.:                 9

                                            ,
     Part Time Prof.:                 3


     Full Time Other:                  2


     Dart Time Other:                 0

                    Total         14

RM 00059

  On duty since: 5174

   As Coordinator with RMP
  2 yrs* 16
Proposed :

          4

3

0

-.
  23

Funds Requested:   1st
             May

Total  ..*.*.,.*......*...   721,606

.  Continuation., .C2), . . . . . . .  ( 32,634 )

. ..*...***.. ???? ? ? ? ? o ? ?   ( 63,000 )

Period of Time Requested:            .
Request is for program staff 6/75 continuation of three previously funded

activities for July and August 1974, and
6/75.

Activities Proposed:

Refer to Management
will be placed next

Information Systems (MIS) printout.  (Also, note symbol C
to activities which extend beyond June 30, 1975.)

one new health planning initiative


e List
    over

any continuation project or staff activity
annualized current funding is requested.

RM 00059 .(Susuuehanna

            Valley)
for which substantial increase

The FY 73 annualized level+for program staff was $599,435 d.c.

HMO project: NONE

EMS project: PIONE

- PSRO:
         NONE

Kidney: NONE

CHP comments:  One CHP will forward comments to Associate Director, Health
Resource Planning since they -fo)md it impossible to complete their review
by 5/l/74.


. .

SUSQUE VAL _ ~_ PROG YR 05 . . .

LISTING
REGION

ERN   CUHP         COMPONENT TITLE                   DIRECT
            NO .__     _                                             R EQUE ST
- _- ----. _

. _ .-
            coo0   PROGPAPI STAFF                             498,124
_. _-_ .   . _
           coo1   &HBULANT PATIENT DATA ANALYSXS                       5,000
-.-_ -I___..._A._- . -- .-
           CO15  FACILiTiTINC; DEV REG HLTH PiiN ..' - -.  `. 50*000
       040 - SO CENTRAL PENNSYLVANIA HLTH ED CONSORTIUM              8,472

041  NORTiCENTRAL PENN HLTH ED SYSTEM                     13,530
                        .

,,---.- - .- _ -   ._ _-... __. ._. ._ ._- _.

F COMPONENTS _ 5 --.   ~_   ._

-.

--                            .._        I

        REGION TOTALS        575rl26

.-  .-..   _.- .  _ -- - _ .

.--I..___ .-_-._-- _...-. - . --_ . -. .-.. - .-   .

                  _ . -        









.-      .._ -.









       

__ ._   . . -



INDIRECT `. TOTAL
REQUEST __ REQUEST

127,848 '625,972

11300       be300
                     _ _
13rooo -- -- -i3,000 *     _ _ _. _ _

3t195      llt667

lrl37      14t667
_                . .

146,480 -721~606

-.

      



`I'I~NNESSl.~E NJ)-SOUI'I I REGIONN,
   l\lEDI CAL, PROCRAM
Iv4 00018

MAY/,JINl: 1.9'74 lEViI%

$2,283,972
Request:

Committee Recommendation : $2,133,972
              .~----
Overall. Assessnm~ t by Indiv.klual Reviewers :  Average

Cri. t iquc :

This proposal was reviewed in depth by two reviewers and the consensus
was that this regi.on al.though it h.as a new coordina.tor, does have
adequate leadership ;uld staffing .  The new RAG is good and assuming
a proper role as dcc.i.sion-maker.  Past pcrforxinnce and accomplishments
were considered good, with activities properly addressing their priorities,
The proposed appl ication had 49% budgeted for continuation activities,
37% for new activities and 14% for staff and. staff acti.vities.
W-II' rcl.ationships have been good w.ith proper coordination and
participation.  One of the reviewers, who had formerly sit.e visited this
region, complimented the region for beginning to move into outreach
programs where the needs are so great.  In arriving at the recommendation,
tlnro lxojects were considered to be of low priority and the region
may want to consider purchasing films on dialysis rather than
producing new ones,  It was felt that the cancer activity proposed, in
view of time-frame, should be funded from other funds.

JULY/AUGUST REVIEW

Estimated Request as of May 1974: $850,000

Dnr/ir'/l~D
SCOB/G-6-74


TENNESSEE MID-SOUTH
REGIONAL MEDICAL PROGRAM
1110 Baker Building
110 21st Avenue, South
Nashville, Tennessee 37203

MAY REVIEW STAFF SUMMARY

Prepared by: Lorraine Eyttla
RM 00018

Richard 0. Cannon, M.D., Coordinator

Current Staff:

6 Full-time Professionals
(1 of whom is located as full-time
professional outside RMP office)

1 Part-time Professional ( at 50%
  effort of a consultant located
outside RMP office)

3 Full-time Support Staff

2 Part-time Support Staff

12 Total Staff

FUNDS REQUESTED:

On Duty Since: 9173

Proposed Staff:

8 Full-time Professionals

1 Part-time Professional

7 Full-time Support Staff (1 hired
since application was prepared)

2 Part-time Support Staff (1 hired
since application was prepared)

18 Total Staff

Target Figure: $3,118,179

Total Costs - $2,283,972
Program Staff - $370,866
Continuation  - $1,094,490 (18 activities)
New       - $818,616 (19 activities)

PERIOD OF TIME REQUESTED: 7/l/74-6/30/75

ACTIVITIES PROPOSED:

Continuation -  Although these activities are classified "continuation"
        most were activated as an operational component approximately

   November 1973, and some were activated within the past four months.
   Component #72, is the logical extension of a pilot project seeking to
   develop a telemetry link from patients in the field to coronary units
   for emergency purposes.  Component t82 concerns the treatment of renal
e  disease. However, the proposal does not seek to fund the expansion of
   existing chronic dialysis units.  The equipment purchases are not dialysis
    machines.


Page 2 a
TMS/RMP Summary

e New Activities:

#98, Upper East Tennessee Dialysis Project, represents an expansion of
chronic renal dialysis services.  CHP need certification has been received;
interim approval from SSA has been applied for but not yet received.

CHP Comments:

All projects were submitted to appropriate "b" agencies. Written comments
submitted on 10 of the 19 new activities (all favorable).  Verbal
approval has been received on all new activities from appropriate "b's"
with promise of written follow-up.  Mr. Boris Georgiff, Director of the
"a" agency is a member of the Regional Advisory Group and attended the
meeting at which this application was discussed.

Items for Reviewers' Attention:

.During the last year this region has faced some provocative issues
and has emerged with the following strengths and weaknesses:

- A revitalized RAG (operating with new by-laws) which in very
short order assumed the proper role of decision-maker.

- A small (one-third its former size) central staff that is
spread a little too thin but mobilizes itself totally and without
  friction.

- Improving relationships with a grantee which has assumed a more
proper role in the tripartite aspects of RMP structure (RAG -
Coordinator - Grantee)

DRMP/WD

0  scOB/5-16/74


  MAY 1                    _.


          _. . _-.

`ENN HID S.    .PROG YR 06

I CENTRAL-.   COHP
  _ _ .-.--- _  NO

      CC00
-  . _ _ _
          coo7
_-_,. _ __   -._--. _
           CO25
    _.
           057
         .~
           061
     ._ .-.---. ._
           062.
._. ._ ..-
           064
        
           065
       .- -.  067

         
COMPONENT TITLE

PROGRAH STAFF

RURAL STUDENT HLTH COALITION E TENN
_ .-

STUDENT APPRENTICESHIP FAMILY COI'iMUNITv HLTH
                                .

HYPERTENSIVE FOLLOW UP

SE HLTH SERV EDUC
nro EAST HLTH SEKV EDUC
COORO PEDIATRIC EDUC SERV SYS -
RE&JNALIZATION HIGH RISK NEWBORN CARE

CAYiE MIHES CDM+lU!JI JY cLINlc

068    NiJRSE CLINICIAN PRCVID PRIM HLTH CARE

        DO?
- _-
        072

HIGH RISK OS;
                      _.. .

UPPER E TENN EHS

           074

           078
..- _..-
            079

          0.50

            082
-.._ - 084


           065
      .
           OPP
-
            069


            090
        -_

WYNN HP~ERSHAH CLIKIC      .

APPALACHIAN NURSE HIOUIFERY CHILD PROJ
-ORGAN DON02 EDUC

UJILI.? REG TEACH PERS STRENGTHEN PUB HLTH ED

CHRLiNIC KIWEY DIS PT CARE SYS
' HYPERTENSIOY SCREENING ..     . -. -- -     

COORD SYS APPRCACH COST REDUCTION    .
-FIRST TENN REG LENT P'(@J

&GS CNTY PRIM CARE

__.          . _

PRIM CARE STONEY FORK TENN -

REQUESTED FU
COMPONENTS

STING
GION

06/?4 COUNCIL .

_.    
          OIRECT

- ._   REQUEST

         309rlTf
__
          5atooo
.-. -_. ..-. _.-..1 .



._









  ._


.

15,400
._
82,119

122,082

\5r158

'iOlt737

.125,131
  .
90,042

149442

339132

24t900

34,764

19,420

55r915

469620

125t056

12rooo

24,923

52,000

76,544

12.820

_. --



INOIRECT
REQUEST

61~689
2rllO

lr232
139302 -.

    0
6~484
'30,189

29t927
  0 -.

l&242

6r218

. 0

    0

3~923
  0.

7,022

    0
   0.


    0

    0
5t602 -

    0

TOTAL-
REQUEST

.370t866

52tllO
_.- lb632 --

95.421

1229082
219642

131r926

155~058

909042

15r684

39,350

24~900

34~764
23*343
559915

53~642

125rG56

12tooo

24,923

52,000

82~146

12*820


TENN flro S...   * PR9G YR C6

REQUESTED FU 0 STING
COMYONENTS     EGION
   06f-74 COUNCIL ---

H CENTRAL -.   CDMP             COHPONENT TITLE
___~ _____.._._ - __.___. NO ___ _        -.- -.

091

P. H HURL CLINIC'SERV --

  -.  _ _  ..__
,-           092 '--LIFE ADJUSTMENT SERV CA PTS

__

                                           . --'
- -_-.-. I_ _ -..    ..-. _. _
           093   PLAN ;UNG CA DETECT
                                            .
         -.-~ 054  HYPERTENSION HGMT CTR        I *

    _   _ __   _ 095 PNEUMOCONIOSIS SURVEIL AND !4GMT

__.__.___ - ---. 096 '-- V tj INFO CTR - ." -
                   \
          .O97   SE REG REHXB THFRdPY

.
      * . 098  UPPER E DIALYSIS

-. -_   .-. -
         053  TENN HOSP EidGINEERING & SAFETY- -

         100   CCJORD Mb!DWR DEVELOP

101   R&P HGiJSE CDMXJYITY CLINIC
                                  _ -
lC2 - HLTd STATUS C !?ZD `%`WR    `.

     lC3  ARCHA HLTH SERV PLAN
  .-
.       104  iRNG NURS PRACT CHRONIC CAdE

105   CkRFER LADDERS ALLIEC HLTH PERS

CF.-CCMPCNENTS .

_ _ __ _  - -. ^.._._. --

106  Di%T AUXILIARY %OGULAR EDUC

I

38 _. . _. ..-   ---. .-- - -- .

_ ._ _     .-

_ -. .









. ._

__. .__.. -_   .    . --

REGIm TOTALS -     2t072t122

              OSW-PU
    * 3


_-       _--.

DIRECT
REQUEST

   5,006

  24t620

  43t900

  71t856

  42t498

  20t610

  48t714

  25tfOO

  37ra00

  52t004

  699928
- ._
  12,770

.24t453

  74t225

  24t656

  5otooo

INDIRECT    TOTAL `.
REQUEST _. . .  REQUEST - - .-

   0 - -59006
it510  29t130
                        . _.-
. 8.856 - -  52t756
   0   7lt856 -
   0.     42t498
      .--
      0    20t610
                   
- 6t674      55t388
   0   25t700 _

      0  37*800

                        - __ _ I -
_ St&' -.- 18t695

      0      24t453

.-. I_

0      52t004

0      69,928

1



.

--


.

16t945    91t170 -

o- ..  24t656 --

0      50,000

21lt850   21283t972



           RM 000 07
. . . . ..

.

Request: $3,333,557                                                

Committee Rccommendntion: m

0veral.l. assessment by individual reviewers: m _ ww&+$age
                                                       
          .

Critique:

Committee recommended that the RMPT submit the RAG-CHP reviewed
contract proposals in July for a detailed review by the Review Committee.
Permission would be extended to the next scheduled Review Committee by the
June National Advisory Council allowing the Committee to review and extend
final approval of the contracts with their accompanying funding requests.
The procedure would allow the contracts to initiate in July, rather than
September, and would preclude the necessity of a Council review in August.
This expediency measure has been considered important from a management
standpoint.

The RMPT has been most effectively managed by an able Director, Mr. David
Ferguson, and a talented staff of very limited size.  Reviewers did express
concern regarding the capability of the staff to effectively manage and
monitor the very ambitious program set forth in the application.
Mr. Ferguson,.through the select contract mechanism, is expected to follow
through most competently by-DRMP staff.

Concern was expressed regarding the Requests for Proposals, the contract
language employed and the Sameness- in the language used to describe the
activities.  The submission on July 1 of the form 15 s (narrative) and
16 s (budget) should further alleviate the concerns raised. The relation-
ship between the new activities, the expected outcomes and the prospect
of future funding for the new activities should be clearly discernible from
W.the--:J~ly submissjon.


Estimated request as of May 1974: -$1,298,599 for contraqts not approved for
funding in yay application.

I


STAFF SUMMARY FOR MAY REVIEW

Prepared by: M.E. Murphy

REGIONAL MEDICAL PROGRAM OF TEXAS: RMP #07

COORDINATOR: David K. Ferguson - since 8/73

Deputy Director - since 6/71.

STAFF: (FTE) Total - 12
  Professional:    8 l/2
  Clerical:      3 l/2
Requested Positions: 5 (3 Prof.; ,2 clerical)

FUNDS REQUESTED:

Total (D.C. & I.D.C.): $2,;;;,::;
Prosram Staff:
Staff Developmental:  210:ooo
  Staff TOTAL:       529,111
Projects:         1,804,440

   r.-Continuatfofi (6):    348,000
   .*SJew (5)         1,456,440

CHP comments:  Received from all funded and appropriate '5' agencies
and the 'A' agency.  Comments good and responded to by RAG. Included
application.  Reference on page 21.

CONCERNS:

(5)
in

1) Project #glA:  EMS Manual Implementation is a continuation activity.

p) Project #106:  Renal Program of Texas.  Expansion of ongoing project.
  Activities consistent with the statewide coordinated comprehensive
  Renal Program of'Texas.

  RMPT application request is equal to target figure (140% annualized amt.)-
$2,333,551.  Provided application is funded, AS REQUESTED, no July 1 application
request will be made.

* Will include approximately 35 contracts in 5 areas of emphasis: 1) Health
Education; 2) Health Economics and Systems Demonstration; 3) Health Manpower;
4) Health Care Quality; and 5) Management of Major Diseases.

Status as of 5/15/74:  25 requests for proposals (RFP) distributed to 500
bidders (select universit$es, organizations, individuals, etc.) Received
130 proposals and anticipate 70-80 proposals will receive full review.,


Expansion and Continuation Activities
091A EMS Manual Implementation                  30,000
094A Community Health Nursing                  32,000
1OOA APACHE                            50,000
1028 Hospital Patient Education Program            35,000
1048 Planning a Community Hypertension Control Program   60,000
106 Renal Program Support Project              141,000
Mew Activities
108 Health Education Project                 286,400
109 Health Economics and Systems Demonstration Project 636,340
                                   160,000
                                 308,700
                                  65,000
                              $2,333,551

-

110 Health Manpower
111 Health Care Quality Program
112 Regional Disease Management Program

e       Total Application Request

   Application Philosophy

Mid-Continent Operations
Staff Analysis: Mary E. Murphy

Texas RMP: #07

The application requests funding for the period of July 1, 1974 through
June 30, 1975 for the following activities:

Program Staff
Staff Developmental
Projects/Contracts

$319,111
210,000

  The new activities, to be funded as contracts, are in the developmental
stage within each area of emphasis, 1) health education,
and Systems demonstration, 3) health manpower, 4) health 2)health economics
                              care quality, and
5) management of major diseases, 25 requests for proposa 1s have been developed
and widely circulated (See Appendix). Letters of intent are now being

received by RMPT and the full proposal is due May 15. The designated
Program Committee consisting of Regional Advisory Group member(s) and
related specialists will give the proposals an in-depth technical review. At
the next scheduled RAG meeting on June 28, 1974. Action will be taken on
the proposals selected for funding by the six Program Committees. Form 15 &
16s will be prepared immediatelJr,and submitted to DRMP. By requesting funding
for the new activities at this time, rather than in the July 1 application, it
                         --
will allow the contracts to operate for a full 12 month period. Mr. Ferguson
strongly feels that an operational period of less than 12 months hinders
the activity.  If reviewers have marked reservations regarding funding of
activities which do not present Form 15 and 16s, a consideration could be
given to hold the award until the forms are received after June 28, 1974.
Funds could then be released to cover Program Staff, continuation and new
activities, covered by 15 and 16s.  Therefore, the new activity operational
period of 12 months would remain unaffected.  If reviewers find funding at
this time totally unacceptable, then the approved contracts will be submitted
in a July 1 application which would give the contracts less than the desired
12 months operational period.


-2-

  The RMPT submitted an Arthritis Proposal for funding in the amount of
$356,559. Performance sites included Dallas, San Antonio, Houston, Galveston,.
Lubboch and Austin, Texas,  The proposal was to be critiqued by an assigned
body of reviewers.

Summary of the Regional Medical Program of Texas
  The RMPT is in the second year of its triennium. Present funding
(l/1/74 - 6/30/74) is in the amount of $775,832. Project Activities number 14
at a cost of $340,127.  Program staff numbers 12 full time, consisting of
8 l/2 professional and 3 l/2 clerical members. Pre-phaseout staff numbered 35.

  The Program Director is Mr. David Ferguson who succeeded Dr. Charles
McCall.  Mr. Ferguson served as Deputy Director from June, 1971 until August,
1973 when he became Acting Director.  The Regional Advisory Group recommended
the appointment of Mr. Ferguson as Director which became effective November 1,
1973. As a manager of the Regional Medical Program of Texas, Mr. Ferguson
has exhibited strong leadership capabilities.

  No major organizational changes have taken place since the last NAC
review in November 1973.  The grantee for the Program is a non-profit
corporation, Texas Regional Medical Program, Inc. The Board of Trustees
numbers six members.  The Grantee/RAG relationship is most satisfactory.

   The 1974 - 75 program is designed to utilize the contract award
mechanism.  Experience in 1972 and 1973, as well as during the 1973-74
period attest to the value of the contract as a management tool especially
for activities of short duration.  Experience with the contract mechanism
is most positive in Texas and it is the intention of the Regional Advisory
Group that it be continued.  In order for a project activity to develop
community involvement, carry out its specific objectives, evaluate its
effectiveness, and present usable results for general distribution is at
least a one-year tabk.

The application appears acceptable for funding in its present form.

a


M     ,1974
*  -- . . . . . .

37   TEXLS          P.RGG YR 06

4IC CONTINENT     CDXP
.- .._.. _ .._        NC! ._

            Cii~O
-.- ~. .  COO3

               091A
  _-- .- ---.    094A
         1OOA
- -_--. _..-- .__._ -._ - _ 1028

104A

106 '

   103


   139
  .llO
._.__ -. ._-
   111
  112

lrifX.CDMPfJN"NTS _ 13

-.-

COMPONENT TITLE

PROGRAH STAFF
PROGRAM STAFF CEVELOPHENT --
EMS MANUAL IMPLE' ----    ___ _~,.. ._ - .-


                           *

CI-JWWNITY HLTH NURSG

APACtiE
HOSP PT EOUC --. - -- '
PLiN Cw?MUNITY*t!YPT CNTRL     



RENAL SUPPORT
HLTH EGUC .-
HLTd ECONOMICS AND SYS DEMD

HLTti MNPWR
HLTd CARE @JALe-    . _.. ._..   .- ..-  _ _.    _ _ .

REG DIS-.HGHT

__ _ _ _ . _ . . _   -_      - -       .  REGION TOTALS


                          

             .-


_ _ __ _   .   _ _ _ .


           - _.


                      _


.__. ---._ I -.- ------.. .-.              









    _-                     _











  .-









   

DIRECT     INDIRECT
REQUEST     REQUEST

319,111

210T000
23,000 `-

259960

33r250

35 too0

51 too0

131,337

286 1400

636,340 :

160 9000
308,700 ._



65r000

    0


    0

7,000

67040

16r-f50

    0

9,000

9~663

    0


    0


    0


    0
  0.

2~2859098 48t453    2,333t551

OS      IO-23

F

TOTAL               .
REQUEST

319*11x

210,000
30tooo    -



32rOOO

50,000
35rooo ---

60rOOO

14L,OOO

286 ~400

636,340

160,000
308r700 --

65,000

-- -.      _-_    .-. . -



i::.!:' ,.TR.I+TA?E ____-..._ ,.._

I,,.! ! ,;),`I (j2
      ._.. -..

Crj. tiq1w :  The Tri-State PPP request for $1,886,907 which was for the
Massachusetts and Rhode Island portions only,  g enerated considerable concern
for the Review Committee especially with regard to certain projects which
appeared to be over-budgeted.  The reviewers in general were concerned with
the Rhode Island portion.since there appeared to be.a lack of linkages of
projects to an overall program.  k minimal interim funding level of
$850,500 was recommended. In addition, a site visit prior to June Council
was felt necessary in order to obtain additional facts not found in the
application. It was hoped that the site visit findings would aid Council
in their deliberations.

Estimated request as of Nay 1974:
                  --; .I
       \


  F. -
0

RM 000 62

TRI-STATE

     Regicnal Medical. Program
1-"-~-1-I-

Coordinator:  Mr. Roberi- Murrh.y, M,P,H.
                       2--~-"~~~&-&.                On duty since: June 1972

Staff:  Full  Time Prof,                  6     Proposed:       7
                     --1 .-I~~ .- -

      Part  Time Prof,                    5                   4
                     I-.-"--._I"~. Y.I.--.-.l-

      Full  Time Otli~~ h'                  3                   4
        -_-- ~- .--. --III--IIIL-y-

      Part  Time Other                    2                    3
        .-"..            "--"- "- 1"1-

                   'd'0t:d             15                  18
Funds Requested:ga:-t

Continuatl.on,GLk, a *. u I G.   ( 324,779 )

Period of Time Reque: :ed:

The program md all b I. one project requests support until June '75. Project
19 requests support u.: i.l June '76, a fourth year of support. Also, the
Region requests 2110,O'r: in its core budget to contract out     fiscal
monitoring of its proi:am after June 1975.

Activities Proposed:

Refer to Iknagement Ir i zrmation Systems (XIS) printout.  (Also, note symbol C
will be placed next tc activities which extend beyond June 30, 1975.)


                                  @i QQ062 (Ia
                                                                           ( _.. _ 3   >

t any continuation pr:,j ect 413" :2 taff acti.v:lty for which substantial increase

   r annualized current Fi~r:-1' 1 .,ig ia requested.
Although Project 19 does noi. i.djl."tl:.c '--nr a substantial increase over the 1972
supplemental appropriat%on; thcire iT3 no evidence of declining funding for the
fourth year,
HMO project:          jq:i:;E

E8S project:  Project 5ci Oi-gai:iizat:ion 6 Standardization of a Cardiopulmonary

Resusitation
from the EMS
of confusion

Program P..I.  'This pro:ject requests $40,160 and appears separate
Project IE: 1;~:i;,:,.-!:I.zatl.un,  which has been found to be in a state
(See Clii' i:o:rl:i!t.r!r.s a:t.so)

PSRCY:

Kidney:

CWP comments:  The CHP A ct 8 comments only refer to Mass. and R.I. since N.H.
will send in their activities July lst,

R., I. Pro&Xt 50 m  CPR '-
--* T----     .-.-."I  'i'his project was felt to be highly ambitious and has
a "dubious  organization arrangement.  TMG executive board, however, approved
this with pressure from the R.I. members with the condition that the EMS Advisory
Board of Project 18 approved this request,

Mass, Project_29 Re.~ionalization of Maternitv & Newborn Care, was denied by one
%S" agency, However,       -."-lp
         the "A" agency g%Fzllthe highest priority.

commended this p~:ojeci: not be funded, More information as to why the Tri-State
ecutlve Board CommJ.ttee approved this is forthcoming.  However,  we were told
the New Bedford por,tion of this project woti.ld he deleted,
All other "B'" agency colnmm~nts  a3xar favorab:!r and constructive.
            khC advice hefore funding.        'NAG will
incorporate 13 comments and the


STERN          CIXIP
.__-.  __ -  _ _ - _   NO

coo0

018

             019
._ _.
              043

               044
.-.L...- _I- .-.. ___ ---~.
              045

046

_

              COMPCNENT TITLE
_.     -.                            ^. _

-PROGRAW STAFF                    

EHSS
- .-_.

R I tiLTi SCL EDUC COUNCIL - -     `-     _   _ _

                              '
STUDY tiLTI-! POLICY IN MASS

STUDY AMRULATGRY SERV GREATER BOSTON
--TMPKDV CUAL CARE iURSXNG HOMES           . . . I.   -

HYPT -SCREENING L@# INCOHE CDMMUNITIES

INC ACCESS CARE MODEL CITIES RES
meCDOi .FA:IILY HLTH CTR DATA SYS    .    -. I_   _ _

REGIONALIZATION MATERNITY AND NEWBORN CARE

ORG AND STAND CP R I

-"_ .- - _ ..--___ ..-- __ -    _
             051   PREV Ek.`IRO'+tENTAL dIS
   . _ _   052  HLTH SERV TIME OF ECONOMIC TRANSITION

              053   FAMILY-PRACTICE RESIDENCY TRNG PROG STUDY

II `.-II-._-~----_-"-.. .- .- .--- _ _ .--- _.- - -. .-_ -- ,-.. _    -.    -   -.

CIF ~~~~~N~NTS 14 ~- --- - -- --    .- --     -       REGION TOTALS

                                                      .~


..-- -__-.. ..-_ -_  __ ..____. _. _-- __ .--- --._ -.. -     _.- ._._ __   _ _ .-_ _._._ .-- _ _. ._

                   L                                          _

                     .
     _         _ ..-     - -_             

DIRECT

654.560

123r474

201r305

$86,300

35 0486
43r34j

82r990

31,500

  * 131960

   819057

     4OtlbO
.
     349322

      250rooo

      17r500


    1.795.959

. . REQUEST

INDIRECT
REQUEST

16,000

    0

=3r743

    0
._.
    0

0

0

90 r948

TOTAL
REQUEST

670,560

123,474

201,305

23% ,000

35,486
`bf p 850

3Z~WcJ

31 * 5.00

P3*9eiO

84 9 800

40,160

34,322

250,000

17,500

l,0%b ,907

c

-. . . .._....- .-. __ . . ..- . .  -._ - ._                      . .



MAY/JUNE 1974 REVIEW

Request:   $1,290,482

Committee Recommendation:,  $1,000,000

Overall assessment by individual reviewers:   Average

Critique:  Reviewed by Panel R, this application was considered "average"
and reflective of an "average" program by two assigned reviewers.   Concern
was expressed about the proporti.on of vacant staff positions, the proportion
of hypertension related projects and a tendency by the region to "parrot"
national initiatives as a funding strategy.

Objectives and priorities were considered consistent with national guide-
lines and leadership was considered adequate. Notice was taken that
planning is closely coordinated with a "Governor's Committee" but in
reality that applies to EMS planning rather than total program planning.

A problem with one CUP(b) agency was discussed but not considered to be
of critical importance.  A motion to fund at $l,OOO,OOO was unanimously
carried,

JULY/AUGUST REVIEW

Estimated request as of May 1974:  $1,362,894


RM 000 49

e   VIRGINIA           Regional Medical Program

Coordinator:  Eupene P. Percz,.!E?..D,



Staff:   Full Time Prof.                9


       Full Time Oither                5
                        -__..-        -

Funds Requested:

Total  ,,.I,..,*...*.*....   1,290,482

On duty since:  7167
                --

Proposed: S

Continuation,........~~..   ( 1,290,482 > 581,602 projects; 708,880 program staff

Period of Time Requested: None later than .June 1978

Activities Proposed:

Refer to ?!anagement Information Systems WETS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


                                                   EN 00049
e List any continuation project or staff ac:ti.vity for which substantial increase
   over annualized current funding i.s requested,

HMO project :

ENS project:  The region has a contract with Tidewater EMS to employ a training
supervisor and a clerk; using previously unexpended contract funds. Project
COL'L proposes regi.onalization of the state to tie into rescue squad patterns
"for transport of newborns with emergency problems." Project CO28 will
contract for instruction of qualified EMTs and certify them as lay
instructors.  All EMS planning has been closely correlated with the Governor's
Advisory Commit tee.

     PSRO :  Project COO4 has 10 physicians (others being invited) involved in an
    outcome audit of ambulatory care rendered relative to present criteria; and
e  to develop new criteria for at least 18 diseases and problems as a result.
    Project CO31 will1 make servi.ces of a Quality of Care Assurance Committee
     xnd a Utilization Review Committee available to all EVIMEC as well as
    any others interested i-n joining.  Project CO33 wPl1 support workshops aimed
    at effective self analysis of quality of dental care rendered.
    Kidney :                                                  s

CHP comments :  Not sol.i.cited because all projects are continuations which
have previously been reviewed by CUP


  MAY 15r 4
Q     _~._.


_ --. .        _ - ,  -_ _

_ - -_

IREINIA    PROG YR 05

RN -      CCHP
-..-._ .._ .-._ _ NO

   ..-
          caoo

           COO4
__- I_. ---- -.._- .-.-- . -   -.-
           coo9


           COII.

           to12
- _ .- "- _-_ --__ -.
           co13


           COY4

           CR2R
-  ._._._- -. .- ca2.s


           ccsc


            CO.??


            CFZB


           co29


           cc!30
.-.. .._ ..--_. _--
          CO31
       _.
           CO32
      te33

                      -_

COMPONENT TITLE

PROGRAM STAFF

OuAL ME3 CASE REV - PRIM CARE PHYS
DIETItIAN TiG PROG 2 RENAL DXS 6 HYPT`

EHERG PERINATAL MED

FA?IILY CIuf?S PRACT TNG

                                       ._
BP SCSEFNING  - VA HT ASSN

PRIM CARE NUXS PRACT HYPT

tCiiM?RE COMWNITY RASFD HVPT CONTROL

SCREENING HYPT DENT OFFICE

PHA9f-l DRUG MGYT ED HYPT PT BY PHARN

PUB SCu CuRRIC HYPT - CIRCULATORV SVS
Euls TRNG- TRAINERS.

COST CCNTAINMENT RATE REV
ADLlLESCENT HYPT SCREENING.
~IJAL MEO CARE ASSUR - NOR FOLK -CONiORTIUM HOSPS

EDuC PRCIG CHILD ABUSE PREV

PUAL DENT HLTH CARE ASSESS     -

C&A , NURS-IN-RESIDENCE    ..-- .- - .-__ -

COB% -- PHYS-IN-RESIDENCE '
       .

COPC   PHARH-IN-RESIDENCE                        

_.

DXRECT     INDIRECT       TOTAL
REQUEST   REQUEST    REQUEST

7084880            0

30,ooa            0

539969          ;

         32,000
_..
        10 ,OUO

        40,000

12,850
441930

28rOOO

0


0

0


0


0


0
  _
0


0


0


0


0


0


0


0


0


0

50,000
         .-
10,000
            -
12,000           .  0

llr200            0

COHPDNENTS     20.                         REGION TOTALS       1.290.482            0    1 r290t482

""I. *"I--- --


,. ,o      I

708~880

30~000
-12v000
39v400 -   --.



54v 000
20rOOO - ..

25~000

739645
22r608 -

53*969

32vOoQ

10,000 -' .. -

40,000

12,850
44,930 I' .
28~000

50tooo
10~000 -- -
12,000 ~.

llr200
    .I.

            --                 _

-


m


RI41  Washington/Alaska
    __----..--.-- -"-.--

M,`iY/.JU;;E 1974 i!l:V1 IN
.-___ ---..----- e-_--e

CrJ t4 quc :

Washington/Alaska is a superior, well-managed program.

The RkG

is forceful and active in determining program policy and
direction based on'the needs of the area.  The technical review
committee structure appears well-designed and active.

Staff was reduced from 52 to 35 during phase-out.   Howeverr
recruitment of new staff is in process.  Staff direction is
superior.  There appears to be close collaboration with the
CHP agenciesin the.area.  The proposed program, as well as
current activities, represent a good balance both programmati-

tally and geographically.

The Committee recommends that this application be approved
the requested level.

JW..S!/AlJGUST REVXI!W
Estimated 'request as of Hay 1974:   $500,000
      \

                       WOB 6/6/74
                                          .

at '


FUNDS REQUESTED: Total. (D.C.- 1.d.c.)

Program Staff
7 continuation Projects
12 New Project84

Since - 1966

Proposed: 38.85

Professional 24.60
          14.25

$2,077,3LL

L,053,131
521,948
502,232
$2,077,311

     ~o~~~ts were received from the two CHP (a) agenci.es and five of the
      eight CHP (b) agencies,  The Alaska CRP (a) agency questioned the need
     for Alaska Health mupower Corporation's project, Physician Extender
     Placement Program (R7Q - page 89).  The Spokane County CHP (b) agency
     In commenting on the projects, noted that "i.t was apparent that none
0    of them wouLd directly impact our area.  If at all, their impact would
       be P'.ndbrect".  (See page 45) The Spokane group also expressed concern
     about the Gynecorps Training Program and a Clinical Laboratory Services
      pr0jtXt.  Roth of these projeCtE, however, were not approved by W/ARMP.
     The Puget Sound Health PLanning CounciL's Special Regional Project
     Review Committee did not complete its review of the W/ARMY application.
     The staff of the Puget Sound HeaLth Planning Council commented on 19
      projec t8.  Between the council and its staff concerns were (see p. 55-63)
      expressed as follows:  #47 Stroke Nurses Training --"difficult to assess
     need for additianal practioners'"; #?7 Patient Care Appraisal--"program
     an wmaceaaary duplication of effort, especially in light of the up-
      comitrg PSRO prograd!; #81 EducatLon of Nurses to treat Hypertension--
     gpecialized training in hypertension should be included in the nursing
      continuation education processtP.  Other projects for which the Council
     had concerns were not approved by WILtDiP.

  y 22 aLI CHY comments wiL.L be further reviewed by the W/ARMP Executive
  ttee end each significant negative comment will be addressed. W/ARMP
will submit wfrnutes af this meeting to DRMp.

ITEMS FOR REVIEWERS ATTENTION:
                           ,I-

None of the activities proposed appear to conflict with other Federal
programs -- such as Lipao, PSRO, Kidney and EMS.


WASHINGTON/ALASKA REGIONAL MEDICAL PROGRAM: RMOO038

University of Washington, Seattle
                    I

COORDINATOR:  Donal R, Sparkman, M.D.
                      ,+' "

Since - 1966

STAFF: (FTE) 30.85                 Proposed :  38.85

Professional  20.60                 Profes8ional 24.60
Other       10.25 :                          14.25

FUNDS REQUESTED: Total (D.C,- i.d.c.)        $2,077,311

Program Staff
7 Continuation Projects
12 New Project8

1,053,131
521,948
502,232
$2,077,311

CHP COMMENTS:

Coarnents were received from the two CHP (a) agencies end five of the
eight CHP (b) agencies,  The Alaska CHP (a) agency questioned the need
for Alaska Health Manpower Corporation's psojrct, Phyeician Extender
Placement Program (#70 - page 89).  The Spokane County CHP (b) agency
in commenting on the projects, noted that "it wa8 apparent that none
of them would directly impact our area.  If at all, their impact would
be indirect".  (See page 45) The Spokane group also expressed concern
about the Gynecorpe Training Program and a Clinical Laboratory Services
project.  Both of these projects, however, were not approved by W/ARMP.
The Puget Sound Health Planning Council'8 Special Regional Project
Review Cormnittee did not complete its review of the W/ARMP application.
The staff of the Puget Sound Health Planning Council commented on 19
projecta.  Between the Council and its staff concern8 were (see p. 55-63)
expreaeed as follows:  f47 Stroke Nurse8 Training --"difficult to 888888
need for additional practioners"; 1177 Patient Care Appraisal--"program
an unaacessary duplication of effort, especially in light of the up-
coming PSRO program'!; P81 Education of Nurses to treat Hypertension--
$pecialized training in hypertension should be included in the nursing
continuation education process".  Other project8 for which the Council
had concerns were not approved by W/ARMP.

On May 22 all CHP comments will be further reviewed by the W/ARMP Executive
Catmaittee and each significant negative comment will be addressed. W/ARMP
will submit minute8 of this meeting to DRMP.

ITEMS FOR REVIEWERS ATTENTION:

None of the activities proposed appear to conflict with other Federal
program8 -- such as HMO, PSRO, Kidney and EMS.


*WASHINGTON/ALASKA Summary
Page 2

0     CONTINUATION ACTIVITIES :

Of the 19 projects, seven are continuations, six of these continuation8
are projects which were initially funded a8 Functional Program Activities
(FPA) .  The FPA is an application to utilize fund8 for an "immediate
purpos etr and for which specific evaluation questions have been developed
t0 888888 it8 Value.  There does not appear to be any significant budget
increase8 in any of the continuation activities.

DRMP/DOD
WOB 5/21/74


    n   ' ,1974
.`- .-.Q. ----.-- --.-:I - -- .-
                                      -- -

_._                                

38 WASH ALASK .   PRCG YR 06

WESTERN -.   _.                                                      _.
              COMP          -C&PONENT TITLE-'
---_ -..- --. .___-_ _.-  WI - _.._. - . .._ - ._ _      - . .-.        .

               coo0   PROGRAH STAFF
         047 --  STROKE NURS CLINICIAi
---.----- _-.._ L.   . ..- -._
              Of0   PHys EXTENOER `PLACEMENT -. . .`-
- .--._I ____. .-_ ._~._  071  INUIAN MID-LEVEL HLTH PRACT
         072 TRNG HLTH CURRIC

-- --- -_.. ._._    ..__ .                       _ . .         _ .
               073   SE ALAiKA CONT FDUC ..

074   N\IP,S- PRAcT PREPARATION ~LACEHENT AND EVAL'

              075  `COtJT NURS EDUC COORD
-l---l..-- _-_. -.-- .~    _ ___                            . ~_._ _.. -
               076   PROFICIFNCY ASSESS H&P LABS
  --. .- ..-_.... - ._-  077 -. PT CARF APPRAISAL
         078 --                               ~_.
                    NURSlNG AUDIT

.-- ..-. -- .--____--.
              079 --WELL-ADULT CLINIC SENIOR CITIZENS' - ' .-'

               080   PACIFIC NW REG CA COUNCJL

              081    EDUC NURS TREAT HYPT
-I--------.-.                              `-       _ _   
               082    SHDRTENfO TIME HOME DIAL

.- --. ..-~ ._.. - _.._ -.
       OK - REG FARMHbRKERS HLTH- ADVISORY GROUP
                                                                     
              084    HLTH MNPWR CLEARINGHOUSE

- - . .._ - -.- ._-_. _    _-._-.
          085'  MIPJORITY HLTH SfRV EXPERIENCE' :     --

      .-_
               066  o ANAL REG NEEDS CARE NEWPORN

             083   HLTH POLICY PLAN -
. _.._ _ ._..   ._ ._. _. _   __. _ ___ _

_.

DIRECT

_       REQUEST

INDIRECT
REQUEST

9309255     122t8?6

699171

0

36 9793

72,173

_..
    0

6rOOl

0

  .
    I 110,810

    1649136

  --
  13,327

      0
-.
     0

42r645

37~844

39 (994

         21r700
. .
        219319

;     0


     0


     0

39789

3rOlO

42,290

68 9998

48,650

23,412

67,710

7r780


   0

8~222

3~096
5,880

ft740

3 OF COHPONENTS     20                               REGION TOTALS .   lr901*591     175,720    2rQr?*311

-_

_-

                  o
TOTAL
REQUEST ._ _._.

1*053* 131 -.

72,173

69001
110,810-        --



177,463            ,

62.D64

27~046

42tb45

37, a44

8r580

43,783

24,710

29~099

42,290

77,220

51,746

299292

75,450

. . -.                                                                      


m


. . _

(,. 1.. , .
>, i i I _-
    3, ; .i: , i `# ; .I . ,
           i'T:`J; i,' ' /
      __. ,...___ - - ._.. _ _ _ _. .

.

Critique:  The application submitted by West Virginia RMP was a request
for continuation of staff and on-going activities only. The request
for support of new activities will be submitted on July 1, 1974.

The Reviewers and Panel B members agreed that WVaRMP was a superior      .
region, not unlike Maine in that it is a state with few health resources,
many problems, poverty, etc., and that the WVaRMP has quite success-
fully been addressing these problems.      *

The Region was characterized as having strong leadership, an active and
dominant RAG (which is well represented by the sparce health resources
in the area), and a competent, experienced staff,

It was noted that the program enjoys support from not only the University
(the grantee) but also the State Medic&l. Society and State Government
as well,  The region was commended for its ability to attract "outside"
funds to support and expand activities planned and initiated by the RMP.

There were no dissenting votes on the motion to approve the application
in the amount requested.

:

                                                                           .
JUJ.X/AUGUST REVIEW

Estimated request as of May 1974:  $1,200,000
     \                          




I'     .

WEST VIRGINIA

Regional Medical Program

RM 00095

Coordinator:   Charles Holland

Staff:   Full Time Prof.


      Full Time Other

Funds Requested:

Total  I.*.*.,...,.*.,.*..  $ 663,132

Continuation..,.,........  ( 42,457

13

4

17

> (projects);

)

On duty since: 1967
(Coord. since 1967

Proposed:     15

7

LZ

Period of Time Requested: Juty 1, 1974 to June 30, 1975

Activities Proposed:

620,675 Program Staff

Refer to Management Information Systems (MIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)


moo045

W. Va.

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested.

HMO project:

EMS project:

PSRO:

Kidney:

CHP comments:  State Director of Comprehksive Health Planning recommends
approval of this application.  Both projects are continuations and have
been previously approved by the "b" agency,


   KAY      74


- .  a
  _ ._ _      ..-. _- _ _ -           

REQUESTED
COMPONEN
  06#74

0SM-P     -23
e      c

H VIRGINIA _   PROG YR G5

                                                                           t
       COMP -     COMPONENT TITLE -           
TERN                                                                DIRECT     INDIRECT       TOTAL
._. ._ ._- .-I-. _ ._ ..-._.. NO.   -_. . -         _ _     .                      .       .REQUEST _   REQUEST   REQUEST

  -_-
            COO0  PROGRAM STAFF -
_   _ _ 011 - SCHOOL HLTH PROG RURAL- COMMUNITIES
_.-___-.---- -   - -__ . . .
          LEGAL P.RiJ    - "             -_ .
            015
                      __-- .~  -










.~

491,590

13t829

219274

129t085   b20t675

     0      13t829
?t354 -- - 28tb28
         _

OF COMPONENTS. ~ 3 - .__                     # .
                                                    REGION TOTALS        526,693      136t439     bb3t 132

.--. --.- -- -._..- .-.- I___ - __-. --- _-._   . _ __ -..    _ ._ ._-..-._. ___ ._   -... .,_- ._. .     _        -- I *-            _.          _ I

._ .._. _.. _ _- _ .._                                                                    _
              \

--- --.. -.-. -_ .:~~---.--. _.,_- __ ___ .__ __- _____ __ _..._- __ _ _.. ____.. . ..__^_._ - _.._ __ ._...   ." _. ._-- -.. .- --.     .        . ,    _ _ _ .,. _ ._ . _ __.



----.- -.-. . -- _... -._. _. - .- -_-_.- _ _ _ _ _. _   _-.._ _. __..__. I ._ _.   _     ._.                   _

.

_ _____ _-.   ._ __- _                                 ._ _.

.

                                                                           - - -   _ _ .    -
---- -__ ---I_- --.- -_ ---- .___ -_-- _ _- _ . . _- _-_ -_ __ - . . -.-.-  -  . -    .   .-                         ._ I . _ _.-- _ -


_--_ - -


RMP Western Pennsylvania

RM 00041

MAY/JUNE 1974 REVIEW

Rapes t :  $1,985,273        Ohio Project: $170,285

Committee recommendation:  $1,370,285 includes Ohio Projtct: $170,285
Overall assessment by individual reviewers:  Average

Critique: This application includes continuation funding for staff and
16 ongoing projects in Western Pennsylvania area and one ongoing project
in Ohio which had been developed under the former Northeast Ohio RMP.
Two-year funding is requested for two of the Western Pennsylvania
pro j ects . The objectives of the program appear well throughout and
the projects well designed.  The community involvement throughout the
areas was noteworthy but the review process*with area committees appeared
somewhat cumbersome.

Three issues concerned the Committee:  the fact that the coordinator is
still the University Vice-President for Health Affairs, the kidney
project and the request for two years support for the kidney project,
and a nursing education project.  Staff was asked to clarify several,
questions about the kidney projects,  The Committee was informed that
the coordinator-director issue would probably be resolved this summer
with the retirement of the coordinator,  The RMP has always had a
full-time director and the coordinator has not received support from
the grant.  The Committee did not believe the two-year funding was
warranted.

The Committee recommends that this application be approved at a reduced
level of $l,ZOO,OOO pending clarification of the kidney project issues.
In addition, the Committee recommends continuation funding at the
requested level of the Mahoning-Shenango Area Health Education Center
in Ohio.  The latter project will be monitored by Western Pennsylvania
staff:                             .

JULY/AUGUST REVIEW

Estimated request as of May 1974: $650,000


WESTERN PENNSYLVANIA     Regional Medical Program

Coordinator:  David E, Reed, M.D.

Staff:  Full Time Prof.                   16

Part Time Prof.                    2


Full Time Other                   5


Part Time Other
             Total    ---&--

RM 00041

On duty since:  5 years

Proposed:    5 vacant

      positions listed

         and asked for

Funds Requested:

Total ,..,....,.....,....    1,985,873

, Continuation.............  ( 1,814,588 >

   New
e

,,,..I*..*.,....*.....   (  170,285 )Mahoning Shenangq Area Health Education
                       Network Inc. (044)*

-

Period of Time Requested: July 1, 1974 to June 30, 1975

*044 - WP/RMP has included in the consultant category of this budget funds to
    allow for WP/RMP administrative, monitoring and evaluation activities.

Activities Proposed:

Refer to Management Information Systems (PIIS) printout.  (Also, note symbol C
will be placed next to activities which extend beyond June 30, 1975.)

Project #25 Adult Nurse Proc. Educ. Nurse Adult Ambulatory Care is requesting
support through 6/76. $419,305

Project 826 Regional Renal is requesting support through 6176.  $312, 348.
              .


     .#
d                                           RMooo41
                                                  W. Pa.

List any continuation project or staff activity for which substantial increase
over annualized current funding is requested,

HMO project:   NONE

HMS project:                               ,
        COO3 Emergency Medical Services - This activity was initiated
7173, The overall objective of this activity is to develop a pool of
competent instructors for training the three areas of life support:
cardiopulmonary resuscitation and basic and advanced medical care.  1

PSRO:     NONE

Kidney: Project i/26 Regional Renal is requesting support through 6/76.
$312,348.  Increase the following activities on a regional basis: to
increase dialysis capability in Region; to expand the transplantation
capabilities of the H.C.; to train the required manpower for dialysis and
transplantation; to develop a communications and unfform record system.

CHP comments:  It is my understanding that the two CHP "b" agencies have
recommended approval of this application.  The Southwest Pa. CHP "b" agency
did provide a representative to be present at the RAG meeting. Comments from
both "b" agencies will be forwarded upon receipt.

E0/5/20/74


1 YPA           PRDG  YR   05

      .-       -
&STERN         COMP
---  ..- .--.. -_  ._ __ _  NO

           COMPONENT TITLE
_.

coo0

            coo1
MT--..-..- ---- .___ co&
.-. .._ - ~.   
            t003
_.
            coo4

017A

            017R
- .- .-.-.
             019
.-- - .--. ._ ._
             023

            025
           - _
            026
-... -.- --.- _.   _ _. 036 -

031

             037
----.  - -. _^ .- . _ 035

       040

            041
-- -.--.___- .._ 044

IF cG!4POFJENTs     l@

PROGRAM STAFF
EvAiJRES ACTIV
AREA LIAISON ACTIV

EHS TRNG

REG QUAt ASSUR ACTXV
REAVER CNTY LIPID SCdEENINi -
BEAVER CNTY LIPID SCREENING
BUCKTAIL RHEUMATIC FEVER
                               .
H PENN REG NEONATAL

_

,.

_
             DIRECT
           REQUEST

265t583

             551075
               :
             63,891

             60 rb54

90,023

35t079

21,643

29,189

67,512

ADULT NURSE PRAC iDUC NURS ADULT AHBULATORY CARE

293 r362

REG RENAL                                     253t038
                    

EiUAL ASSUR SELECT ALLEGHENY CNTY HOSP                53,320
WESTMORELAND. CNTY .QUAL ASSUR             _              27,630

LAUREL MT PUAL ASSUR
`b T AUDIT

EUCKTAIL NuRS AUDIT

16,856

_..
      18~090

         '19,160

BEAVER VALLEY HOME HLTH NURSG AUDIT                   12,853

MAH~NING SHENANGO ARES HLTH EDUC NETWORK INC .

170,285

REGION TOTALS      1?553t248

INDIRECT      TOTAL
REQUEST     REQUEST

741599

24,990

28t990

27t522

4lt387

9t138

9,469

7,648

23rb29

12519'43

59r310
.-_
     0


     0


     0


     0


     0


     0


     0

340tl82

80rOb5 .
92t881 - -

881176
131r415
44t217

311112

3bt837         .

91,i41- - -

419t305 c
312,348 c

_-.

_.

53.320 .'-   - . _

27,630

16,856

             -- .-   ,-
18,090

19,160

12.853

170,285

432tb25

1,985t873

lo-23
    I

.

--.-' - `~- --



*

*

!44Y/JmE 1974 RJXEW

Request: $4,577,325

Committee Recommendation:

WISCOXSIN REGIONAL MEDICAL PROGRAM
RM 00037

$2,000,000

Overall Assessment by Individual Reviewers:

Critique:

Average

The reviewers noted that this region having had a very illustrious past
history, is now in a crisis of leadership. With the exception of the
Program Coordinator, most of the present program staff members are new.
The reviewers found little evidence that the RAG has accomplished much
during the past year, although past performance had been quite good.
CHP relationships as in the past are still good overall objectives and
priorities are vague.  The proposal represents a series of poorly
conceived, fragmented project activities, some research in nature, others
(such as mental health, etc.) not in keeping with the usual DRMP
goals and may be inappropriate for funding. Except for the evidence of
past performance,there is little evaluation of what is currently
going on in the region.

JULY/AUGUST REVIEW

Estimated Request as of May 1974: $2,500,000

DRMP/DoD
SCOB/6-6-74


rt      .

MAY REVIEW STAFF SUMMARY

WISCONSIN REGIONAL MEDICAL PROGRAM, INC.
5721 Odana Road
Madision, Wisconsin 53719

Prepared by:  Jeanne Parks
RM#      : 00037

Mr. Charles W. Lemke, Coordinator     On duty since: Z/74

Current Staff:

8 Full-time Professionals
17 Part-time Professionals
5 Full-time Other
9 Part-time Other

Proposed Staff:

23 Full-time Professionals
3 Part-time Professionals
6 Full-time Other
1 Part-time Other

Staff - Contractural services not included in Program Staff Budget:

1 Full- time Professional
2 Part-time Professionals
1 Full-time Other
3 Part-time Other

Funds Requested :

       Total      - $4,577,325
       Continuation -
0               1,517,322      Target Figure - $2,490,701
       New          2,239,203     Estimated July Request - $2,500,000
     Program Staff -    820,800

     Budget Period: 7/74 - 6/75

Period of time Requested: All activities will terminate 6/30/75.

Activities Proposed: See MIS printout.

Items for the Reviewers Attention:

The region is requesting a total of $156,413 for the following
proposals which are in the Mental Health area:

Project # 84 -
Project #112 - Self Administered Sex Therapy Program   $ 1.8,263
         Evaluation of Mental Health Outcome     59,513
         Developing Program
Project #113 - Reducing Suicides in Wisconsin
Project #120 -                         39,862
       De-Institutuionalization Implementation   38,775
         Methodology
                         TOTAL       $156,413


Page 2
Wisconsin Regional Medical Program

While there may be a need for work in this area, it raises several
questions: (1) the appropriateness of DRMP funds to support these
activities; and(2) how do the proposals tie in with the goals and
objectives of WRMP.

The following activities are flagged because they are either research
oriented, continuing education activities or activities which are
believed not to be'in line with DRMP initiatives:

Project 847 - Health Line               $100,147
Project #56 - Comparative Evaluation of Diabetics    128,590
Project #53 - Crisis Intervention in an Emergency    22,196
           Room

Project #70 - Development of Seriodiagnostic       59,548
          Procedures for Gonorrhea in Wise.

Project #77 - Reprod. Info. 6 Data Collection System  51,360
Project#lll - Quantitation of the Cytotoxic Assay    35,750
Project #95 - Hodgkin's Disease in Wisconsin       41,625

EMS:

The region received approval for a three year period for the
establishment of a Statewide EMS Program.  Funds were provided in
the amount of $1,265,816 for two years only, beginning June 1972.
In addition, the region was awarded $118,850 additional funds for
the period January 1, 1974-June 30, 1974 for two components of
the INS program,

The region is now requesting $938,198 for the third and final year
of the EMS activity.

CHP Comments:

Copies of the WRMP application were forwarded to each of the eight
CHP "b" agencies for review and comment. Letters from two of the
(b) agencies (pages 66 and 69) indicated that the application was
not received in time for consideration when the WRAG reviewed the
application to submission to DRMP. One negative comment which
dealt with the technical aspects of a project.


.a.
   H     91974


        

REQUEST a OS LISTING
CONPON    BY REGION
06/?4 COUNCIL

37 WISCONSIN       PRCG YR G7 _

SOUTH CENTRAL     COW

.-: -   .._ _- --    -   NC


- .            COO0
      . .
                CC01
_.-.. -. .-.- ._- -. CGOi
          
              026
              
              G32
___ .I __ ._-. - -
              rj34T

                036A
         03ie
,.. - __
                040

              044
   
                0444
.- -- -... -
                04fd
     .      046'

          ,337
_ _
            051

052

c53

.-                 C56
           _
                058
         -001
    _-, __ -
               C62

063

._ .

COHPONENT TITLE                      DIRECT   INDIRECT -    TOTAL
                                     REQUEST .RECXJEST
                        .            REQUEST

PROGRAM STAFF                                    820r8UO
DEVELOP PLAN STANDARDS                           52,800
-&AL ASSUR FEAS STUDY ~                             5O*OOO
                             .

NURSE ASSOC PHYS TEAM                              28,368

STUDY UTILIZ FINANCE & CUAL HE0 CARE                    53,268

VC'L FCR STROKE                                    11,665

?iT CROIX VAL SHARED SERV INC                         16,000

SHARED HLTH SERV INC

EMS

CWT HYPT SCREEt!ING



569538

837,314

2br035

t4YD-f SCREENING RX                                  145,040

.SCH HYPT SCREENiWG .--. -- -

   . .              149 160

PT HLTH DljTCC!ME CRITERIA NURS PEERS                    74,557

HLTH LINE                                       ,84,189
                                          .,.
ALLIED'HLTH EDUC COORD COUNCIL                         409041
                            *

IMPRtjV UTZLTZ NURS AMRULATOKY CARE                     78,141

CPISIS INTiiiVEN EMERG RM                           22,196
DKAB TEACH APPROACH EVAL                         89,910

HYPT COMPUTER ASSIST SCREEN AND HGNT                   24~295

DFVFLOP YURS hCME CARE APPRAIS

COCRD DENT CARE QUAL ASSUR WISC

FACIL ST/WIDE HYPT SCREEN RX

149,300

35,050

55,700



lo-23

0  820,800

0 -  --52,800

50.000 *

      0

12,320

17~942

      0


      0


      0
'100,884

  49632

13~618.
29495.

301016

151958


      0

299454


      0

38,680

  9t128

      0


      0

  7,126

409088

71,210

llr665

16~000

569538

938t198

30~667

158r658

.-             -'
16r655

104,573

100,147
             ..  --
40,041

107r595

229196
128r590

339423

149r300

3510.50

629826

-.


PlAY a 4

_-.. ..". .I .~ -. . __.       . . ..__ .    . ._

REQUESTED F

06/?4 COUNCIL

WISCONSIN _    -. PROG.YR 07..

'H CENTRAL   cob+-. .. ..     CCHPONENT TITLE

I-..- -- ---_-.-.- Nff I..__ _ ._ .-_ __ _      _           _ ._     _

-_ _-   -._-~.
             064   EDUC P&S RIO EFFECTS RADI.ATION.
_ . .._ .-.  .__-_. _-
           065    EDUC DENT WISC

.--...._- __ ..- .___ _
            067   MOTIVAT CONSUMERS-MEET HLTH RESPONSIBiL - .- -

     069-- - REVEL ALT CARE w wxs
                 ._ -.
            070   DE&b SERIO DX PRO,CEDURES GONORRHEA WIS
- .- ---. ---                                                           .
            071  -CGMJ ET)UC c;% FA.MILY PKACT `.-
.~.   .--. 073                              -. -         . `.
             PtiYSIEAL ACTSV PROi; AGEC

..-.   .-. -                                    
           074  -PR;V MAiNT CVA DIS
      376--. -                                                 ,-
                COM'IUNX'TY NURSG SERV ELDERLY

._  077  R&P%05 INFO E RAT& CCLLECJ Si.S OEV XHPLE

    075    CCMP HLTH SYST INNOV MTHDS PRIM HLTH CARE DEL

-.. -- ._----_-   I __.- .._ _
         SELF ~&~NI&'~Ex THRPY-' -..' -    . __.   -.. .I
            084

._ .-- .._. -..
           087    DEVELGP TRANSITIONAL NURSG COURSE RN'S

            Gtcc?   HOME CARE DEVELOP' St WISC                

.-._I.. -_ -__ _ 094-. Pi&I CClR HT`DIS SC; CiILDREN -..   - ..-, ._-- ..-

  --HDbGKIN'S DiS -WISC                     
095

                 
            c97   FOX VAL SHAREG SERV EDUC hSSdC --
._. - .^._^.  -_-. --..   . . . .
             098   OUAL CNTRL DX RADIO,LOGY   ,- -'

_- ._-_ _ 104 -' PJ EDUC
       105 ASSESS EXPECT OUJCOtiES & PT SAJISFACT
       136 '-- .RURAL CLASSKOOM PAACT -

            111   IMHUNOLGG HICRO-CYTOTOXIC AiSAY
                   _ .

.-.









_

_.





_.

".

- osn-P a 23 *

DIRECT     INDIRECT       TOTAL

REQUEST ..-

REQUEST .REGUEST

91380

39,500
73,927 -

31rfloo
50,560
`21,777 ..'
15,861 -

14~200

45~842 --

51,360

49,730



  750     .  101130

  316      39,816
       -  _-..               .'
23 t 186      97,113

    0
-8,988

79420

5 9640

    0

     --
0

; 0

0

31,800

59,548

29,197
229501

14* 200

45 vi?42

519360

499730
18r263 -.

-._. . -  13,783 ---' _.  4~480. -

              .-
  20 ~204       19616      21,820

  44,400            0      44r400
..,.         .'              -               ..
  539698      169361    .70,059

  33,365       81260      41tt25
                        --
  92r500            0      929500

50r550   15,382      651932

51,380      23,435      74,815

155,181      67,536    222,717

?5,500           0      35*500




- .-. _ --. - I .-.. --      -   ._ _ .__ _ ._ _    _. ^.. .- _- - O&/74 COUNCIL       _
' .u~SCONSIN. '  PROG YR .07

IUTH CENTRAL -   CCINP
                NO

              112
       -113
- .-_-__-_ .- __.__-  115


   116

118

.- -, _ _ _-^ _. _ ___ _ 120 -.-
                    ,
OF CO!!POMENTS . 50

                     -- -
COMPONENT TITLE                         DIRECT     INDIRECT
            _.. .__            REQUEST     REQUEST

DEVELOP MENTAL HLTH OUTCOME MEASUREMENTS                429692,      16~821
REDUCiNG `SUICIDES WISC                       _
                                             32~491       71371
iifPi6; .MEAStiREMENT .PHYS PERFORH'HOSP _ _ ._ .    _. _
                                           52,748       6,765
STATEWIDE HOSP DISCHARGE SURVEY                     ._   141,069   1r433

NURS EDUC HIGH RISK PERINATAL 01s                   12tooo .          0
DE-IlkTITUTIONALIi IHPLE METHUDOL              __       387775 '       0
                _ _

     -          REGION TOTALS       4r068,4?6 508,849

. - -   _-_-. .-_--.   .._ -_. _                 _ . _                                                


                                   

-. .._ _ .,

--. _-_ ___. ._ _-_-._ -. .--- - _. - ._  -., . -.  " . ..__ _. . _ _ _._ _ .-..    ._ ._ ,_. __- .-. _.       -      - - -

       .


..--. - -_ _ . _ __ _ _

-- - -. __.. _

.-I ..____-.- ---- --.-

- _. . _ _ _.    . ._._. -_ .- . . .- , ..-   .-.-    .    .-- _          I..

,

-

- _    -- _. .- .                                    _.

.-

              - .




-a 010~23*

TOTAL
REQUEST

599 513

399 862
            ..
59,513

142r502

12,000

38 ,i?S

4r5YTt325