!











                                                                                      DISTRJ'CT        001@ TL'






                                 Carter's district lies within the Ohio Valley Re,--'@olaal Medical
                         z-,,  @qhch  has   a   current   aw@rd   totalling   $34',797.   The   regional
                  boundaries cross @Lo-ar state lines a-,id include what is known as the
                  C-'Lncin-iiati--Lex-'Ln,,,ton-Louisvi7..'Le tr4-aii-le--the Ohio Valley.  The Coordinating
                  r7, -dqu,-@--ters is a new, non-p-zof4t or,-Lriization, 'i own as the Ohio Valley
                             i?',2dica' Prograri and Dr. Willia-.ii H. McBeath is the Pro-rar,-, Coordina-
                  i'l C,             L                                                         b
                  tor.                  Re,,ional Advisory Group has been very active in helping to
                  set pro(7,ram -oal-s and in recruiting staff.

                  W-1 i-,@c Tost 1',e,-,io-cial '@liedica'- Pro-i-a7.-,s i-,7,c'Ludc parts of one states or cover
                  a  :o--al s;L-a@L-c-,, tl,,c O.i-Lo Valley       '.@ledical @A.-c)grar@i is u,,Iic@ue in
                  ir,clj-u"'4.nr., parts of four states.              activities   have    focused    on
                               re-'Ievan-", health data @-or this rc,,ional area which was prc,-
                        _Ly               due  -o  the   state   orientation   of   most   health   data
                  V70',IS  unaval      -        -
                  sysi:er.-.S.  These  -and  other  plannin-  activities   are   outlined   in   detai'L
                  -@n the attached material.


                       Carter may a!-so be interested in t-.-Lc ac@@.             o@ the nearby
                              1,1@Ld,-South Re-io--al Medical ProgrLLi.,, .--aa'quartered in ',\Tq-shville
                  at -zne Vanderbilt and Yeharry Schools of Medicine.  Descriptions of the
                  0 a-.-,lt4-onal projects now underway in this region are also attached.
























                  Yi@@ch IL968






















                                            G
                                                                                                                  Yos@- c@            i,,urLucky (101
                                                                                                                                           l@erLucky                                      o-:,-
                                                                                                                         couri--ies in                                        16   ccLri@L--@'Lcs   @-n
                                                                                                                  O'@-,7o       and       2       in       West
                                                                                                                  L@        LL;c         cori,)rlsL         the         Ci-,-,@-inn@,,, 'l.i-@-,@
                                                                                                                  Louisville                                                     Oh@@o      Va I       ey



                                                                                                                  C)'.'.'Lo  Valley

                                                                                                                                                 967
                                                                                                                  Jz-




                                                                                                                  @'@@4  797
                                                                                                                       6;D-      0    0


                                                                d                                                 85,000;000

                                                                                                                                                  o   'oe-in  in  Fisca'@  Year   1969
                                              C;          C (i O'@ I                                              Wil-L               H.    @'cBea'cll-l ,           1.@
                                                                                                                                                                 S  T
                                                                                                                            Chairmai:                  Lou            @I.Toza---
                                                                                                                                                       Pr@sidenL   anc'   Gercral
                                                                                                                                                       1.@ait @@la-"Lifacturiii- O@orcpa-,iy
                                                                                                                                                                                                  ZD
                                                                                                                                                       Daycon,                   0.1l'O
                                                                                                                  2.                  c rs h           :    @) @-
                                                                                                                                   -@cal                         8,   Prac',--ic-Ln,   '2'lays@c,",Ds   7,
                                                                                                                                                                                               Z-"
                                                                                                                                                  Administrators   5,   Vo,.,Lii7,'i:@,,ry
                                                                                                                           A,,-c,ncies  Z@,   Public  itcalti-i  Oil-:L-ic-@.a".s
                                                                                                                            Other  Health  Workers   3,   Pul,31-@@c   7



                                            o@               V-11,-Ly  i)ic)ora,.u                 is                                             an ii,,iincorpor--@c@d -,-)r7vaL:O-
                                         n
                                       L-,so@                        kroll,in  as          the           Oh@Lo           Val-.cy           Po-ional            Mod-@@cal            Pro
                                                        a    S'.-) C,' -@-i S o --r s  o j@ -Li-le                                    LcL               ivitios          L-he         'i'xo(@ion         wage         L'n@
                                                                          Ci                                                                                                              Y
                                       @---vL-          s  @-y  c              -i-,c@L-.i-,iat-;.    Coi                 of                                                    'Lii-ve--siL    o'      K c r, L t:@      y
                                                 c  a  --  CcrL-er          and          the          U-,iivers-.-'@-y          of          'Louisville-,           School           of                                  c
                                       bi,il'z-l       of                                  capabilities   arc   or  will   be   in  auxiliary  ac'visory
                                       -D3cii-@s   of                          -there            are            three            types:










                                                                                            -2-






                                                   Starclin-


                                                         Con,.mittec-      on       Mc-,dicl-'L
                                                   (2)                      or, Coi-,-,,-,Iulii@y  1-lo@l,)itals
                                                                             oil                   1-ic,-alth  Or,ranizat4-ons
                                                                                                                    0

                                                                    @arels--I-.ol.      yet      cons,--ll^ucted      but      will      be       used
                                                   as      review point                                               1)iiaso.

                                           C.      -,Ls'c           Forces--thc-          generalized
                                                           be  assured  by  L-,-e  Task Forces  which  are  not:,  at
                                                   present,       in       operation.       The        intended        areas        are        Library
                                                   Serv4@ces  a-,id                       Service  Areas.

                         Policy                                rests @.7iti'l  the  Executive  Board  of  the  Ohio  Valley
                                                                                       S4  SIC
                                         '@edica',-       -@ro-ram       which       con          of  a  representative  fro-,ii  each  of
                         t'r,,  th7--oc                        universities       a-.id       the       chairman       and        v4.ce-chairi@,an        of
                                                Advisory  Group.               obtaining       adequate       staff       has       been       a       ma@or
                                       -,:o  date,  but  fo.-wa-zc,  novcnLn@L  in  this  are,-  -'@s  now  evident.



                         "T!--,                of       the       -involvement        of      -.1e@iolL-,l  Advisory  Group  has  been
                         s',ici-i  as  to  -ivc  it  a  strong                              in  aci@,,isiiig  '-Iic  ',2r@D.-raTn on  ',:he
                                                   of                 (,oals."        Due        to        lead
                                                        Program             staffi-.-,-,        A,@,,ional      Advis,-@-zy       Group       has       also
                         been    c,-,I'Lod     u@,o-@.     to     secure     new                         i-,:k  the  r@,,ional                          !'cs
                                                 shown  great  interest  in  fully  acquainting  I.-hc-mselvc-s  with  tl-le
                         di             4- parc@      o---      the      re-ion.



                         S-'--.-ce           rc---ion    -:-s    -,made    uD    of    parts     of -@our  states,  it  has  been  e@.tromely
                         Lif -,:icu--L-.  to  ,ise  available  data.                   @,luch  of  the  basic  data work  trials
                           Plate     as     a     ,:e,-ion"     ILZi@s     take      for @-Tranteci     -'@s     not     applicable     to      -the      Ohio
                         va-. ley                       As      a      result,       the Ohio  Valley  Regional  Medical  "D---o-,ra-,i  ir.
                         @@'--s  first  year  of  pla-i                                                                   in-     the     kind      of
                                                                i-kiin- has  concentrated  on acquir    ,
                         data  base  that  is  a prerequisite  Lo  the  expansion of  the  progra,-,I.

                         ?'--anning       Stud.'.@..s  -  Current  on-goiii-  studies  include:
                                                                                       C,

                                           Def-7-iiit-7@o-i of program  ,oals.
                                                                                    tD
                                             r o i c c t @@@ o n  o f  d L,,i-,iand  a d  s,6     y o f p hy s 1. c i an  s  Czv  -.  c  O,,i  b  y  v     o u s
                                           subregions  within  tire  U-..:-o  Vz..@ !Ley                                                Pro@,rLi-,q.
                                                                                       -"I.cd  hoaltl-i  personae
                                                            inventory  of  a.L L
                                                                            latioi-  of  c'Lo,,Tograph4@c  data              for  p@isL              @7o@-Lrs.
                                                               and  co!
                                           Collection  of  basic                                       n,.ai-i-@)ower       and       hospital        data--
                                           distribution ol@  health resources.







                      L) V      y   @"2?



                                              Lirrent                           in c Iucle :  c c) i ic


                     ,ic           vail@y               Medical.            plarLnin,, f-r@Lli,,Cwor,<
                      u P,    c iL- 'Lvi LI-y                  as                                 in                 a,-Ld
                         c;   c I i a'@) a L  n .   T,,,o t:h@ory            this fr--,,.iieworllc is
                                             rc,.prcsci,@rs a critical mLLss of activity upo@-i                     Eric.-,
                                                       can cxi)L--ct i-,i--o areas such as continued, education
                                                                         L
                                     care units.       Thc, activity     components    include     cont-.nuir,,-     -D-,:o-
                                     CaL4
                                c--@du   @on,  library cxteisi_on        services,  prevertion-detectior,
                                coronary         control              a-id     stroke      rehabilitation       -,rogra-,,n.



                   in                         H-'@ll-',,@urton and Co-:,-,?rehens@Lve Health                    Oi'Lio
                                         iy,.-Cd--7cal Program -L.,;           on @i tasl@ force to dcteri.-iiilc-
                                       t:y   of the professional. and -,medical audit data system -@c) -L,-,c-
                  area.













































                     --ch     9'3
                    ,a-









                            ,@LV-@SOaY  CO@@,,7--'@TEE   FOII                                  @@lil;"DI@L PaOo-li@.S









                                          '@"Toza-
                                          an@- Ge-.qeral @lana,,cr
                                                        Cor"fja"y




                                                c         s



                                               Rad-,ation '.Therapy
                            T 7'.
                                         @Y c-
                            C                O'-, -1 C)


                            Dr.           P.
                            '@lro7u   o- cL.-id C-air-.ra--a of i),,.icsthc!siolo-y
                                                Kc
                            L;.iivc-rs-'--.y  o@   -,Ii@-ucl<y
                                            Kentucky


                                                   -I
                                           am        r  s t: c) I i c r s o i i
                                          are:                of PaL!-,olb(-,y
                               vc      @L-Y c),L- Lou-'@sville
                            U @@.L-rs



                                          -d G.  Gi-ulc-c,  Jr.
                                   of        Colle-c@ of i@Lcdic-'--,ia
                                            of C-'Li-,ci-,anati
                            Ciric4-r.nat4L,  Gh4.o


                            D:c.
                            Do,an of         Sc',aool of Medici-ac
                            U--ve--sity of Louisv-11@l-c
                                       cou-f,.Ci-l oil Drurs, Americ-,n Medical Associal@ior,
                                             Kentuck,
                            I- --asv-


                                             1,@.     Willard
                            \7iCe President for the Yod-Lcal Ccr@tor
                                            of      Ken'cucky
                            Lox     'L: o::,, L@er,'L-ucky

                                             D.       Wittrup
                                                 Uiiiversity '@,oslital






                                                                                                       2









                                      Ti  Ha@i  1
                        @cr,-Lu c  ',!'-ad-Lca'-



                                         0 'L o  wy ,  j


                                   1,1@Ci@Cal A

                        T
                               L



                                                 @,,cL4@cal- Educat4@on and Hospitals
                                     Medical Assc)cia@Lic,-,a
                         C-a4         Ker.-Lucky
                             @Vi -, -



                        .,ast              Yiont@o.-rery County Medical  Soc2-ety
                                                cl
                        Day"Lo-i-,,    Ohio


                            l@on'lai-i  C.   T-rover
                                   ',O-"-rccL-or,  Trover Clir,-Lc
                            '@o@   '--o,  l,',c-Litucky

                                         T
                                         ,@oo'- f ord,
                                                                          iC4
                                                         @ca-",etyy of iqcd  @ne
                        0 - i' i7, ca-- -'L Ohio



                                               and Plar--iei:s



                                     Greater Miami Valley HosDital Planiii-,i- Council



                                 E.        tether


                        If,-ustce,  Ken-@-u-@ky Hospital Assoc-La-Lion
                        @ L
                        -recriv-,-
                                   e,      Ye,-,tuc@-Y


                                    D-Lr,2c-Lo,:, Bethesda Hospital
                           ,LC 4,
                                      Ohio







                                           of Trustees,  Un@Lvcrsity of Louisville
                          u-'sville,  l@Q-.itucky

                        Dav-j'_d 0. Gamble
                        -Lrustce, Berea College







                                                                              3

            Members of the  Public  cont'd.

                 Laurence L. Davis
                 Treasurer, Christ Hospital
                 Cincinnati,  Ohio

                 George W.  Grider
                 President Elect, American Pharmaceutical Association
                 Danville, Kentucky

                 John P. Hennessey
                 Member, Executive Board, Cincinnati AFL-CIO Labor Council
                 Cincinnati,  Ohio


                 Louis F. Ison
                 President, Kentucky Farm Bureau Federation
                 Harrodsburg, Kentucky


                 Kenneth C. Kent
                 Member, Board of Directors
                 Vanderburgh County Tuberculosis Association
                 Evansville,  Indiana

                 James A.  Sutherland
                 County Judge, Nelson County
                 Bardstown,  Kentucky

            Voluntary Health Associations

                 Philip P.  Ardery
                 Chairman, Board of Directors, American Heart Association
                 Louisville,  Kentucky

                 Lucile T. (Mrs. Rexford S.) Blazer
                 Member, Board of Directors, Kentucky Heart Association
                 Ashland, Kentucky

                 Victor A.  Sholis
                 Member, Board of Directors, American Cancer Society
                 Louisville,  Kentucky

                 W. Armin Willig
                 Treasurer, American Cancer Society
                 Louisville,  Kentucky

            Public Health Officials


                 Donald W.  Giffen
                 Chairman, Louisville-Jefferson County Board of Health
                 Louisville,  Kentucky

                 Dr. Russell E. Teague
                 Commissioner of Health, Commonwealth of Kentucky
                 President-Elect, Association of State and Territorial Health Officers
                 Frankfort,   Kentucky













               Allied Health


                    Florence D. Hennessey
                    Chief, Nursing Service, Veterans Administration Hospital
                    Cincinnati,  Ohio

                    William C.  Kranz
                    President, Kentucky Society of Oral'Surgeons
                    Lexington, Kentucky



                Other


                    Carl M. Hill
                    President, Kentucky State College
                    Frankfort, Kentucky

                    Sewall 0. Milliken
                    Executive Director, Public Health Federation
                    Cincinnati,  Ohio

                    Russell E.  White
                    Vice President for Business Affairs
                    Transylvania College
                    Lexington, Kentucky









                       SUMKARIES OF TENNESSEE MID-SOUTH OPERATIONAL PROJECTS




       1.  Continuing Medical Education--Meharry

           Meharry Medical College proposes to inform Negro physicians in  the
           region about more effective techniques for treating heart  disease,
           cancer, and stroke.  One of this plan's interesting provisions is
           sending a senior resident from Meharry to care for  the  physicians
           practice while he is attending the course.

       2.  Continuing Education--Vanderbilt

           In contrast to Meharry's approach of bringing the physicians to the Center,
           Vanderbilt proposes to establish continuing education centers at
           community hospitals linked to a proposed Department of Continuing
           Education at Vanderbilt.

       3*  Hopkinsville Education Center and Chattanooga Education Center

       4.  These are the first of the local continuing education centers specified
           in the Vanderbilt plan.  At each hospital, a full-time Director with an
           appointment at Vanderbilt and an assistant director will supervise resident
           and physician education in their area.  Their services will be available
           to physicians at smaller community hospitals in each area, as will the
           enlarged hospital library facilities.

       5.  Special Training for Practicing Physitians--Vanderbilt
           This plan focuses on developing practicing radiologists' skills  in
           vascular radiology, but might later be broadened to include all aspects of
           diagnostic   and therapeutic radiology.

       6.  Cardiac Nurse Training Program--Mid-State Baptist Hospital-Nashville_

           The key factor in reducing mortality from cardiac arrest is the immediate
           availability of a knowledgeable person to initiate resuscitation.  Mid-
           South Baptist proposes to instruct cardiac nurses in new resuscitation
           techniques by holding three four-week courses.

       7.  School of X-Ray Technology--Meharry

           Meharry plans to establish a two-year program for training at least 10
           X-ray technologists per year.

       8.  Radiology Technologist Training Program-Vanderbilt

           Vanderbilt proposes to increase the number of X-ray technologists, improve
           the quality of their training, and increase their opportunities for
           continuing education.  Three small hospital training programs in the








                                        -2-

          area will be discontinued as separate entities and subsumed by a
          new school of X-ray technology at Vanderbilt.

       9. Nuclear Medicine Training Program--Vanderbilt

          A new series of courses taught by paramedical and medical personnel
          will be made available to physicians and technologists to increase
          their skill in nuclear medical techniques.

       10.  Expansion of School of Medical Technology--Baroness Erlanger Hospital--
          Chattanooga

          To augment medical technology capabilities in the area, this plan makes
          two proposals: (1) Expand the Baroness Erlanger program for medical
          technologists; and (2) Establish a school for certified lab assistants
          who could free technologists from more routine work for more complex
          procedures.

       11.  Vanderbilt Coronary Care Unit

          This project's purpose is to establish a network of coronary care
          units with adequate equipment, staffed by well trained personnel.
          Vanderbilt will be the training and information center for the regional
            demonstration unit and will provide a focal point for continuing
          education.

       12.  Franklin Coronary_Ca@e Unit--Williamson County H6spital--Franklin

          This is one of the subsidiary units mentioned in the Vanderbilt proposal
          above.  This is primarily a pilot project to study the feasibility an
          usefulness of establishing & coronary unit in a small community hospital.
          Other units will be established at:

               1.  Jennie Stuart Memorial Hospital--Hopkinsville, Kentucky
               2*  Clarksville, Clarksville Memorial Hospital
               3.  Nashville, Nashville Metropolitan General Hospita
               4.  Meharry Medical College Coronary Care Unit
               5.  Murray, Calloway (Kentucky) County Hospital
               6.  Chattanooga, Baroness Erlanger Hospital
               7.  Nashville, Mid-State Baptist Hospital
               8.  Crossville, Uplands Cumberland Medical Center
               9.  Tullahoma, Harton Memorial Hospital

       13.  Meharry Super-voltage Therapy Program

          This project is aimed specifically at improving cancer therapy for a
          large indigent population. Meharry will use its funds to obtain a cobalt
          60 High Energy Source for therapy and a computer hook-up with Vanderbilt.









                                            -3-

       14.  Proposal to Improve Patient Care in a Remote Mountain Community b@
           Recruiting and Training Health Aides for a New Extended Care Facili@
           Scott County Hospital--Oneida, Tennessee

           Manpower shortage in this isolated mountain hospital is critical.
           Personnel to man an extended care facility now under construction will be
           obtained by two methods: (1) In-service training for hospital personnel.
           (2) An educational director (an RN) to serve as a lisison to the  high
           schools to encourage young people to enter the medical field and  come
           back to practice.

       15. Health Evaluation Studies on a Defined  Population  Group--Multiphasic
           Screening--M6harry Medical College

           Meharry will determine the effectiveness of a comprehensive  health
           program and multiphasic screening examinations in early diagnosis of
           heart disease, cancer, stroke and their precursors.  To run t is
           experiment, a neighborhood medical center supported by Office of Economic
           Opportunity will serve a selected population of 10,000.  The test
           population and a control population will be evaluated with reference
           to morbidity, changes in health attitudes and utilization patterns,
           effectiveness of the screening procedures and the cost per patient diagnosed
           or treated.

       16,  Experiment to Test and Implement a Model of Patient Care-- Vanderbilt
           University Hospital

           This is an attempt to define a new structure for patient care.   New
           personnel called stewardesses will be trained to take over  nursesi
           non-clinical duties.  Nurses would then be free to spend more time with
           the patient and to keep up their specialized skills4 After  the  model
           is refined at Vanderbilt, it will be tested in community  hospitals
           specifically Baptist and St. Thomas.

       17.  A Medical Surgical Nurse Specialist Graduate Program to Improve Nursina
           Care of Patients with Heart Disease, Cancer, and Stroke--Vanderbilt
           University School of Medicine

           Vanderbilt is developing a program to train medical surgical  nurse
           specialists to improve nursing card of heart, cancer and stroke patients.