ini III *1 Nonprofit Org- U.S. POSTAGE P A I D Seattle, Wash. PERMIT NO. 62 W,@,SHINGTON/ALASKA REGIONAL MEDICAL PROGRAM 50C '-'i@@'.'ERSITY GISTRICT BU[LDI'!G SEATFLE VIP@SHIIPIIGTO,'@l 981V L. PETERSON R,4PR RMPS PARKLAWN BLDG. 5600 FISHERS LANE ROCKVILLE., MD 20$@g VOL. 7, NO. 2 APRIL, 1974 ,I 'itl S E D Bli COURT Oil, DER After a year of uncertainty, contin- uation of the Regional Medical Pro- gram nationally is now assured through June, 1975, Donal R. Spark- man, M.D., director of W/ARMP, has been informed. RMP was one of 12 health agencies which the federal administration marked for termination after June, 1973. Although RMP was granted a year of grace by, the Public Health Programs Extension Act signed last June, funds which Congress had ap- propriated for the program were not made available. The National Asso- ciation of RMPS, a private organiza- tion of the agency's staff, volunteers and friends, subsequently filed suit bl;@l anJ a o Souvenirs of the year for release of the impounded money. '@,!,,jska, beach On February 7 the U.S. District c b i II 0 ri ,,s I,-, g 1 E; s I g fl,@ 9a r r a r, gd b y oil Court in Washington, D.C, ruled that $126,000,000 in impounded federal funds be released and that RMP be Two young Seattle nurses, Linda were some shocks. Even though they permitted to carry out its Congres- Morris and Pauline Werth, are back were warned, they "couldn't believe-" sional mandate. The court order also on duty at Seattle's Virginia Mason Sitka's prices, particularly apartment removed restrictions which had limit- Hospital after a year of duty in Sitka, rents. ed RMP's activities to certain areas of Alaska. They solved this by signing up for health care. They're happy to be back, and hap- an Old World War 11 coast artillery This restored to RMP its mission as piest of all to be among Mason's ther- look-out cabin, Unheated, poorly stated in 1971 with emphasis on in- apists, dietitians, housekeepers and wired and without water, it went for creasing availability of care, enhanc- other hospital helpers. In Sitka the $50 a month. With help from a new ing its quality and moderating cost. nurse is all these, and more. friend the girls re-wired the hut, built The exact amount of funds available The year's experience for Pauline a narrow loft for sleeping, added a for Washington and Alaska will de- and Linda was arranged by W/ARMP stove and settled in for a year of pend upon HEW approval of projects. to provide additional skilled nurses for carrying their water from the hospital Requests, to continue current major Sitka Community Hospital which was in jugs. projects are now being reviewed by experiencing a rapid staff turnover. Housekeeping hardships were off- HEW. Requests for proposals for new Pauline and Linda feel they bene- set by spectacular views, the sound projects have been circulated. Those fited even more than they helped dur- of surf and berries "as big as our selected for funding will be presented ing their year up north. At first there Continued on Page 2 to HEW in July for approval. 14vi:IiN I:Kutri lvir_r_io PRESS l@\1 SEATTLF- Caspar Weinberger, secretary of Health, Education and Welfare, head- lined a panel of his department's lead- ers at a full day's press seminar in Seattle February 7. This was part of the group's nationwide swing through the headquarters cities of the 10 fed- eral districts. Discussing the $111 billion HEW budget for F. Y. '75,Weinberger explained that this figure is 94 per cent uncontrol- able as that per- centage goes to- ward social secur- Weinberger ity and welfare payments. The CANCER SCREENIIJG was the topic when William Pomerance, Pil.D., (left) c; t!l secretary spoke primarily about the National Cancer Institute met with MiIL'oti Evans (center), executive vice pre3.i- proposed welfare reforms designed to dent of the American Cancer Society's Washington Division, and Jess B. Sp;ai- provide direct cash assistance and holz, Pil.D., WIARMP consultant in cancer control. encourage employment. Henry E. Simmons, M.D., deputy assistant for health, said, "Clearly we have moved beyond the point at which @l CANCER I S'T,17UTE F C 5 concerns about a shortage of physi- cians is paramount." Warning that an l@IG FOR Eil\ LY DETECTIO increase in the number of physicians will result in an increase in health care T .he National Cancer Institute is fo- Discussing ways in which W/ARMP costs, Dr. Simmons called for a man- cusing on early detection of cancer of might assist in cancer screening, he power strategy aimed at geographic the lung, colon, uterus, breast, blad- recommended use of self-adminis- maldistribution, inappropriate over- der and prostate, according to Dr. tered pap tests or a mobile unit as the supply of specialists and inadequate William Pomerance, chief of the In- best means of reaching low income attention to physician productivity. stitute's diagnosis branch, who visited women who are unlikely to be tested He recommended "defining the pro- W/ARMP during February. otherwise. per role of physician assistants and Dr. Pomerance said that 75 per cent other allied health profesionals.' , Dr. of cancer deaths are caused by malig- Simmons said he would have favored nancies originating in these areas. HEALTH MANPOWER a demonstration-type PSRO (Profes- CLEARINGHOUSE OPEN Continued from Page 1 sional Standards Review Organiza- thumbs" growing just outside the Need a doctor? tion) rather than the national program door. Perhaps you only think you do. No- authorized by Congress. Artistic Pauline painted landscapes, body is saying you aren't sick, it just took "hundreds" of photos and ex- may be that what you really need is WE@IATCFFEE HOME plored the wilderness in mushroom not a doctor but a Medex, a nurse NURSES RECEIVE hunts. Linda found it a special thrill practitioner, ei midwife or a psychia- to snowmobile and to skate on a real trist. PO TABLE ECG lake where she could look through the W/ARMP's latest project, the Health W/ARMP has loaned a portable ice and see grass below. Manpower Clearinghouse, will help ECG machine to the Home Health On the job they learned how to match health providers with commu- Services based at Central Washinq- clean and maintain their own equip- nities that need them. The Clearing- ton Deaconess Hospital, Wenatchee ment and acquired some specialized house seeks applications from towns for use in home visits to patients who nursing skills such as how to soak and neighborhoods that feel they are have artificial pacemakers or are re- devil's club thorns out of loggers' underserved. These areas will be covering from a heart attack. This will feet. Linda had her first experience helped to decide what sort of health be a pilot project similar to the one gavaging (tube f.eeding) a two-pound care best suits their needs. conducted earlier by King County 12-ounce preemie who spent his first The Clearinghouse also will recruit Visiting Nurses. two months of life in the hospital health manpower at all levels and struggling to reach discharge weight work with providers seeking to enter ULMER ELECTED TO RAB of five pounds. the field or to relocate. The two young women recommend The project will coordinate efforts Eldon Ulmer, Anchorage pharma- Alaska for those who are resourceful. already being carried on, and in some cist, has been elected to the Regional On only one point did they feel they cases duplicated, by the state medi- Advisory Board of W/ARMP as the failed. They planned to do without a cal, nursing, and hospital associa- American Cancer Society representa- car, but the perils of biking through tions, the National Health Service tive lo the group. He succeeds Elmer Sitka's rain, pursued by packs of Corps, Medex, the federal loan for- Gagnon of Anchorage who died be- Huskies, defeated them, and they sent giveness program and state and fed- fore completing his term. home for their car. eral agencies. page 2 NE-W CHICANO STAFFER NGTON TOURING WASHI Francisco Tello has joined the l@7 ARE I I OD' W/ARMP staff as community repre- functions, Robert W. Day, M.D., dean sentative to the Chicano population. of the U. W. School of Public Health He is making a and Community Medicine, favored spring tour of combining these responsibilities. The Washington, meet- present system, he said, "lacks focus" ing with Spanish with no organization responsible for speaking groups personal health care services. in Mount Vernon, He credited Hill-Burton with achiev- Bellingham, Yaki- ing improvement in building safety ma, Toppenish, and fostering development of central- Walla Walla, ized health care facilities. Both CHP Moses Lake and Wenatchee to dis- and RMP, he said, suffer from a con- Tello cuss health needs fusion of mission. and assist them in working with agen- Paul D. Ward HEALTH EDUC,@TION cies offering health care assistance. Soon to come before Congress are GROUP FOcl@j!cD He also will assist with a health ca- 'i- reers fair planned for May 5 in Wood- three similar bills all proposing some W/ARMP is funding a demonstra- sort of merger of RMP, Comprehen- tion project to provide training for bubrn Oregon. sive Health Planning (CHP) and the nurses, technicians and other staff , _ @rnin Mexico, Tello is a graduate Health Care Facilities Service (Hill people of 18 hospitals in North Central or Evergreen State College. Burton). Washington and the Columbia Basin. JANE JONES HO?qoylED The measures are: the Roy-Hast- This will include paying salaries of Jane Jones, R.N., director of the ings-Rogers Bill (HR12053); The Ken- a fulltime coordinator and part-time W/ARMP stroke nurse clinician proj- nedy Bill (S2994) and the Administra- secretary, purchasing teaching mate- ect, has been nominated for the Amer- tion's proposal (S3139). rials and bringing in experts to offer ican Nurses Association honorary At an open forum which W/ARMP classes in housekeeping, office proce- nurse practitioner award. She is spon- sponsored at the University of Wash- dure. maintenance, purchasing, medi- sored by both the Washington State ington February 21, the advantages cal records, laboratory techniques and and the King County Nurses Associa- and disadvantages of such a merger nursing skills. tions. were discussed. Participating hospitals are those in 'PLUS YEARS' IS Emphasizing that he was not dis- Brewster, Chelan, Leavenworth, cussing any specific piece of legisla- Omak, Tonasket, Wentachee, Repub- BEST SELLER tion, Paul D. Ward, executive director lic, Ephrata, Moses Lake, Odessa, "The Plus Years," W/ARMP's latest of California RMP, opposed the theory Ritzville, Soap Lake, Quincy, Othello publication for senior citizens, proved of combining planning, regulation Davenport and Grand Coulee. so popular that the first printing is and implementation under one This Central Washington Consor- now exhausted. For those who are still agency. He predicted that the debate tium for Health Education has been awaiting their free copy, a second on these measures will be "very, very organized with the aid of the state printing is in process. healthy and very, very lengthy." Hospital Association and Big Bend Also available is a bulletin explain- Ward warned that planners, imple- and Wenatchee Valley Community ing Certificate of Need laws. menters and regulators are "a differ- Colleges. W/ARMP AND BATTELLE ent mix of people" and should be STUDYING AMBULANCES separated. RURAL HOSPITALS JOIN Ambulance systems serving 11 Speaking for a merger of these TO MEET PSRO RULES Washington communities will be ana- The Health Care Review Center, lyzed in a study by W/ARMP in co- supported in part by a $19,000 grant operation with the Battelle Human Af- from W/ARMP, sponsored a March fairs Research Center. conference for rural hospitals to dis- The report is intended to give other uss cooperative arrangements for communities information on the many c complying with the Bennett Arhend- types of ambulance systems function- ment to the Social Security Act estab- ing in this state with their cost and lishing Professional Standards Review levels of personnel training. Organizations (PSRO). Tentatively selected for the study are three cities with Medic I type ve- The Center presently is helping eiqht hospitals develop programs that hicles, Seattle, Bellevue and Wenat- meet requirements of the Joint Corn- chee, and eight with ambulances op- mission on Accreditation of Hospitals erated by the community, hospitals, as well as PSRO. These hospitals are: private firms or volunteer crews. Providence and Doctors, Seattle; Van- These are Spokane, Everett, Tacoma, TIIE ALASKA AIRLINES ticket in couver Memorial; St. Luke's, Spokane; Walla Walla, Duval, Twisp, Mount Ver- Tomrny Oi)gtooguk's pocket was a gift Whidbey General; Island, Anacortes non and Sedro Woolley. from @'IIAR?-,IP. Ongtooguk, deputy di- and St. Luke's and St. Joseph's, Bell- r,@ctor of the Norton Sound Health ingham. RMP RESULTS Is published by the Corpor@ition, @,las one of 60 Alaska In addition to covering Patient Care Washington/Alaska Regional Medical Program 500 University District Building nativ-es v/17oss, transportation to fhe Appraisal, the quality control audit Seattle, Washington 98105 Decf,,,n@jr,,r Alaska Federation of Na- developed with W/ARMP aid, Health 543-8540 tivids H@,alth ,Planning Conference in Care Review also covers cost, utiliza- Donal R. Sparkman, M.D. - Director ,I Dee Jones - Editor paid by WIARMP. tion, nursing and pharmacy review. "There is no resistant high blood pressure - only resistant patients." With this premise, the Mason Clinic is teaching patients how to help moni- tor and control their own hyperten- sion. For the past three years the clinic has been referring patients to a two- day class where they learn physical details of their condition, are warned of possible complications and are ad- vised on following controlled sodium diets. Patients also learn how to take their own blood pressure readings twice daily, Dr. Richard R. Paton, director of the project, feels that the class helps the patient accept treatment and thus have better control. Around the state other physicians and institutions have introduced hypertensive patient teaching but usually on an individual basis rather than a classroom situation, Nurse Clinician Pat McDonald opens the class by issuing each pa- ]"[zTRUCTIO@] in blood press,,,rE? readings gilen E. T. Ashwort,@ tient his own stethoscope and sphyg- @ I" "' momanometer. By the time everyone Di@t) ol i@ederal ,tid John G. Fc,,,i Di@ !:)a,7ingtoi) by oat @li'cDonaid, R.Pi. has learned to pronounce these, the atmosphere is reasonably relaxed. Patients learn the possible compli- Emphasizing that salt-free foods The instructor cautions patients not to cations of hypertension. Some sound need not be bland, she recommends confuse hypertension with "tension," frightening - congestive heart failure. other flavorings. The low sodium not to hold their breath while taking Others are practical - higher insur- dieter may choose whether he wants readings as this increases pressure ance rates. And she dispels some his meal spiced with peppermint, chili, and not to be alarmed by occasional myths. Headaches, feelings of "full- horseradish, cinnamon, rosemary, "spikes" in readings. ness" and other symptoms are not re- tarragon or some 50 other spices. Systolic is the reading on the sphyg- liable signs of elevated pressure. Hard liquor is limited to two ounces momanometer when the stethoscope Some 10 per cent of all adults (22-24 daily. Four ounces of wine may be picks up the first sound of blood rush- million persons) have hypertension. substituted. Since cigarettes have not ing through the brachial (arm) artery- Only one- eighth of these are properly been proved to affect blood pressure, That is the highest reading and is writ- controlled, The condition affects more smoking is not forbidden, but also not ten "on top." Diastolic is the point at Blacks than Caucasians and frequent- condoned. Coffee is allowed in which "he last sound is heard. It is the ly is found among those Orientals fol- moderation. baselne indicating pressure exerted lowing a salty diet. Men encounter Tips on dining out include carrying on the artery wall when the heart is re- more cardiac complications, though your own salt-free bread or crackers, laxed. In a recent class patients' read- women have more strokes before age selecting a fruit dessert, avoiding ings ranged from 150/90 to 210/150. 65. Equality is reached after 65! sauces and gravy, using lemon and Miss McDonald shies from terming . Eff.ective drug therapy for hyperten- vinegar on green salads. anything "normal," but acknowledges sion is relatively new, though ancient At the close of each day's session that the old adage of normal systolic nostrums included watermelon and a physician joins the group to answer pressure readings being "100 plus cucumber seed or mistletoe. Mason questions, check BP readings and in- your age" is fairly dependable. Clinic has found that those who follow sure that patients are scheduled for a controlled sodium diet can be man- return visits. aged on lower dosages of medication. W/ARMP is interested in helping Most in the classes are on a 40 offer similar classes in other areas in mEq or 920 milligram sodium diet. Washington and Alaska. Theoretically this would allow them three-eights of a teaspoon of salt daily. Since many foods contain some sodium, they must learn to shop and cook in a different way. Prior to the class each patient receives individual diet instruction. During class the dieti- tian conducts a general discussion on food selection with emphasis on what is forbidden. She gives tips on diet foods, shows packages and advises ML on where these foods are sold or how WRAPPING the cuff demands three CONCENTRATING on the sounds was similar dishes may be prepared at hands, Matthew Chen of Seattle dis- Lawrence L. Brown of Seattle. home. covered. n,qno 4