0 0 SUBCOMMITTEE ON LABOR AND HEALTH, EDUCATION, AND WELFARE, AND RELATED AGENCIES COMMITTEE ON APPROPRIATIONS 92ND CONGRESS U.S. SENATE DEMOCRATS Warren G. Magnuson, Washington, Chairman John C. Stennis, Mississippi Alan Bible, Nevada Robert C. Byrd, West Virginia William W. Proxmire, Wisconsin Joseph M. Montoya, New Mexico Ernest F. Hollings, South Carolina REPUBLICANS Norris Cotton, New Hampshire Clifford P. Case, New Jersey Hiram L. Fong, Hawaii James C. Boggs, Delaware Edward W. Brooke, Massachusetts Ted Stevens, Alaska Ex oj'f-icio members: Allen J. Ellender, Louisiana Milton R. Young, North Dakota Harley M. Dirks, Professional Staff ',.'ember W. Proctor Jo-Lies, Professional Staff @lember Robert Clark, Professional Staff Mem'oer LABOR @iD HEALTH, EDUCATII:)"", AND WELFAIUT SUBCO@IMITTEE OF THE SENATE liPPRO-@2RIATIO'@NS COi"@'IITTEE 92ND CO'@CIIESS ,I Warren G. '.ia@,nuson (Democrat) of Seattle, Washington. Born in 1,@innesota, 1905. Entered University of law school in 1929; Washington, graduating from the served as special prosecuting attorney of King County, 1.931; elected to the Washington State LeRislature, ed ia the regular and special sessions of 1933; serv chairman of the Judiciary Committee; assistant United States district attorney, 1934; elected prosecuting attorney of King County, November 1934; member of American Legion and Ve'terans of Foreign Wars; served as lieutenant commander i n U.S.N.R. in Pacific Fleet; married Mrs. Je-rmaine Elliott Peralta on October 4, 1964; elected to the 75th through the 78th Congresses; elected to the Senate November, 1944 and re-elected Warrc@ G. of Seattle, Washi?-,gt;on for all subsequent terms. Chairman of Committee on Democrat--Dec. 14, 1944 Commerce. Member of Committee on Aeronautical and Space Sciences. John Cornelius Stennis (Democrat) of De Kalb, Mississippi. Born in Kemper County, Mississippi, August,3, 1901. Married, two children; attended the county schools and graduated from Kemper County Agricultural High School, Scooba, 1919; B.S. degree, Mississippi State College, 1923; LL.B. degree, University of Virginia Law School, 1928, member of Phi Beta Kappa, Phi Alpha Delta (legal), and Alpha Chi Rho Fraternities; Presbyterian, Mason, Lion, member of Farm Bureau, Mississippi, and American Bar Associations; past president, State 4-H Club Advisory Council; elected Mississippi House of Representatives from Kemper County, 1928-32; elected district prosecuting attorney, 16th Judicial District, 1931 and 1935; appointed circuit jud?,e, 16th Judicial elected 1938, 1942, 1946; elected District, 1937, and L, United States Senator November 4, 1947, to fill unexpired in November 17, 1947; . . . term of the late T.G. Bilbo; sworn of De Yalb, DemucraL-Nov. 5, 1947 re-elected 195?; 1958, 1964, and 1970. Chairman of Armed Services Committee. Member of Aeronautical and Space Sciences Committee. 2 Alan Bible (Democrat) of Reno, Ilevada; born in ov@el-@@@, @@@evada, Yovember-20, 1909; married Loucile Jacks; children--one diug,iter and three sons; A.B. University of Nevada, 1930; LL.B, Georgetown University School of Law, 1934; admitted to the Nevada State Bar, 1935; asso- ciate la@.7 partner of late United States Senator Pat NlcCarran, Reno, 1935--38; appointed then elected district attorney of Storey County (Virginia City), 1935; appointed deputy attorney aeneral of Nevada in 1933; elected attorney c-ene ral of Nevada in 1942 at age of 32 years, becoming youngest attorney general in tTnited States; reelected attorney general in 1946 iTithout opposition; served as president and vice president of National Association of Attorneys General, private practice of law under S6-,n.' @3i ib' Le firm name of Bible & I-IcDonald, Reno, from January 1951; of Rero, lievada member of American Bar Associatio-n, chairman_of Democrat--Dec. 2, 1954 State delegation of Committee on Improvement of Judicial Administration, National.Safety Council, Nevada State Bar Association, University of Nevada Alumni Association, Lambda Chi Alpha social fraternity, Reasons, and Eagles; elected to the United States Senate November 2, 1954, to fill the unexpired term, of late Senator Pat McCarran; re-el6cted for all subsequent terms. Member of Committees on Interior and Insular Affairs and Committee on District of Columbia. Robert C. Byrd (Democrat) of Sophia, West Virginia; born in North Wilkesboro, North Carolina, January 15, 1918;-student - Beckley College; Concord College; Morris Harvey College, 1950-51; Niarshall College, -52; LL.B 1951 . cum laude, American University; married Eri@.,a Ora James, May 29, 1937, two daughters; elected to the West Virginia House of Delegates in 1946 and re-elected in 1948; elected to the West Virginia Senate in 1950 and elected to the U.S. House of Representatives in 1952, 1954 and 1956; elected to the U.S. Senate in 1958; re-elected to the U.S. Senate in 1964 and 1970 by the greatest vote ever accorded a I-lest Virginia candidate. He was elected secretary of the Senate Democratic cted by Con.Lerence in January 1967 and reele Sen. Robert C. Byrd unanimous vote in January 1969; elected Senate of Sophia, West Yirginia Democratic @fajority INThip in January 1971. Democrat--Jan. 3, 1959 Member of Committees on Judiciary and Rules and Administration. 3 William W. ProxT,@@1re (Democrat) of, Wisconsin; born in Lake Forest, Illinois, November 11, 1915. Ile earned his undergraduate degree from Yale and two graduate degrees from Harvard University; taught government at Harvard, worked for J.P. Morgan and Co-,P.Dany on Wall Street, n ne months before Pearl Harbor, lie enlisted as a private in the U.S. Army to serve in the counter- intelligence corps, leaving active duty in 1946 as a first lieutenant; he has been in politics since 1950, when he was elected to the Wisconsin State Assembly. He was elected to the United States Senate in 1957 to fill the seat left vacant by the death of Senator Joe McCarthy. He was re-elected the following year to a full 6 year term and again re-elected in 1964 and 1970. Sen. WitZi= W. Prv.,7,my,e He is married to Ellen-flodges Si\,iall. Mr. Proxmire is oj@ Y.2dison, Wiscons@n Chairman of the Joint Economic Committee; ranking Demcrai--August, 1957 Democrat on the Banking, Housing and Urban Affairs Co=nittee.' and member of the Joint Committee on Defense Production. Joseph M. i4o@a (Democrat) of Santa Fe, New Mexico; born in Sandoval County, New Mexico, September 24, 1915; attended Regis College in Denver, Colorado, and Georgetown University Law School in Washington, D.C.., receiving LL.B. in 1938; a lawyer by profession; actively engaged in various business enterprises; elected to.1,7ew Mexico House of Representatives in 1936 at age 21 while still in college; reelected in 1938 and named majority floor leader; elected as youngest member of State senate in 1940 and named .ajority whip; reelected to State senate in 1944 and named chairman, Senate Judiciary Committee; was elected Lieutenant Governor in i946 and reelected in 1948; in 1952 again was elected to the State senate; in 1954 was returned to the office of Lieutenant Governor, and re-elected in 1956; married Della Romero and they have three cliildren--Joseph II, Patrick, and Lynda; delegate, ilexico-United States Interparliamentary Sen. Joseph m. wntoga Conference, 1961-65; official United States observer, of @.ta Fe, He's @,zleo Latin American Parliamentary Conference, Lima ' Peru, Democrat--Nov. 3, 1964 1965; elected to the 85th Congress in special election n I n C -7 r-. 1 1tl- ily the death l@ ?, .2 , I, to -%Taca,-,c-y c -,@ -1 Apr" @ -L @ic a,,,c. of Antonio M. Fernandez; re,@etted to the 8Gth, and 88tli Congresses; elected to the - Torks and U-ni:ted- States Senate in 1.964 'and 1970. Member of Committee on Public Select Committee on Small Business. 4 Ernest F. (Democrat) of Charleston, S.C.; born in Charleston, S.C., January 1, 19.12-, son of Willielmine Meyer and Adolph G. Hollings; attended public schools, Charleston, S.C.: graduate, The Citadel, B.A., 1942; the University of South Carolina, LL.B., 1947; LLD. conferred by The Citadel, June 1959; married Patricia Salley of Col--,z,,ibia, S.C., -1",arch 30, 1-946; four children; ember of Charleston County, South Carolina, and m America-,i Bar Associations; admitted to practice before South Carolina Supreme Court, 'U.S. District Court; U.S. Circuit Court of Appeals; U.S. Tax Court, U.S. Customs Court and U.S. Supreme Court; Armed Forces, 1942-45, served overseas from Africa to Austria; elected to South Carolina General i@ Assembly from Charleston Countv, 1948, 1950, and 1952; chairman, Charleston County Legislative delegation; speaker pro tempore, South Carolina House of Representatives; elected twice by unanimous Sen. Ernest F. BotTi@ige vote 1951, 1953; elected Lieutenant Governor, of Charleston, South CaroZira November 2, 1954; elected Governor, November 4 1958; 9 Democrat-Nuv. 8, 1966 served as Governor, 1959-63; appointed to Hoover CoTmaission May 15, 1955; appointed by President Eisenhower to Advisory Commission on Intergoverranental Relations, December 1959; re-appointed by President Kennedy February 1962; chairman, Regional Advisory Council on Nuclear Energy; elected November 8, 1966, to complete the unexpired term of the late Senator Ol.in 1). John-,ton- rp.-c,.Iected to full 6-year term November 5, 1968. Chairman of Appropriations Subcommittee on Lec,3.slative Branch; member of Subcommittees on District of Columbia-, Military Construction; State, Justice, and Commerce, the Judiciary, and Related Agencies. i@lorris Cotton (Republican) of Lebanon, New Hampshire; born Warren, New Hampshire, May 11, 1900. Educated Tilton School, Phillips Exeter Academy, Wesleyan University, George Washington University Law School; lawyer, firm of Cotton, Tesreau & Stebbins, Lebanon, New Hampshire. Married. Secretary of United States Senator George Moses, 199@4-28; prosecuting attorney, from Grafton County, 1933-39; justice, municipal Court of Lebanon, 1939-43; majority leader a-,id later speaker New Hampshire House of Representatives; elected to the 80th Congress on November 5, 1946; re-elected to the 81st, 82nd, and 83rd Congresses; Sen. no@8 cot@, elected to the United States Senate November 2, 1954; @ @L.,anon, !ie-o Hs7vali@, to copplete the term of the I-ate Senator Charles W. Republican--@ov. S. 1954 Tobey ending January 3, 1957; re-elected to all subsequent terms. Member of Committee on Commerce and Joint Coripittee on Atomic Energy. 5 Cliffor& 0. Case (Reptiblican) of Rahway, N.J.; born in Franklin 'ark, N. J., April 16, 1904. @iarried with three children. Attended public schools in Poughkeepsie, i@.Y., and was graduated from Rutgers University with A.B. degree in 1925, and from Columbia University with LL.B. degree in 1928; received honorary LL.D. from Rutgers University, Middlebury College, Rollins Co lege, Rider College, Bloomfield College, Princeto-,i University, and Columbia University; was admitted to the New York bar in 1928 and practiced in New York City from 1928 to 1953; member of the Rahway Common Council, 1938-42 and of the New Jersey House of Assembly, 1943-194'-t; served as a Member of the House of Representatives, 1945-53; trustee of Rutgers University from 1945 to 1959; trustee of New Jersey Society for Crippled Children and Adults; director, N.J. Chapter, Arthritis and Rheumatism Foundation; director, American Institute for Retarded Children; trustee, Rahway (N.J.) Sen. Cliffoiq P. Case Chapter, American Red Cross; member of various civic of RahwV, New -Je2,sey and fraternal organizations; Presbyterian; elected to Republican--Jan. 3, 1955 the United States Senate on November 2, 1954; was re- elected for all subsequent terms. Member of Committee on Foreign Relations. Hiram ecn@ Fon@, (Republican) of Honolulu, Hawaii; born in Honolulu, October 1, 1907 ; attorney and businessman; corporation president of several business. firms; operates banana farm in Honolulu; attended Kal.iliiwaena Grammar School, i@lcl',inley HiRh School and St. Louis. Co-Ilp-ize- University of Hawaii, B.A., LL.D. (Ilonorgr@); member Phi Beta Kappa; Harvard Law School, LL.B.; Tufts UT-tivers4. 1,L.D. (Honorary); Lafayette College, LL.D. (Honorary), Director, Hall of Fame for Great Americans; 14 years in Legislature of the Territory of Hawaii; 6 years as speaker and 4 years as vice speaker; delep-ate to the Repu'olican National Conventions 1952, @956, 19.60, 1964 and 1968; vice president of Territorial Constitutional Convention, 1950; judge advocate of i the Seventh Fighter Command of the Seventh Air Force with rank of major in World War II; presently colonel, U.S. Air Force Reserve; married to Ellyn Lo; 4 children; Sen. Eirwn L. Fong, of HonoZulu Ha-@ii elected to the United States Senate July 28, 1959, for Republican--Aug. 21, 1959 the term beginning August 21, 1959; re-elected 1964 and 1970. Member of Committees on Judiciary and Post Office and Civil Service. 6 James Cnleb Bo,-,s (Republican) of Wilmin@-'.p,.-,, I)ela-ware; born Kc@nt County, Delaware, May 15, 1909; educated in the pul)14@c scliools,of Delaware; A.B. degree, University -are State College, of LL.B. decree, Dela.i., married Elizabeth Muir; two children; member of the bar of the State of Delaware and the United States Supreme Court; former judgc, of the Family Court of New Castle County, Delaware; elected as U.S. Representative at Large from Delaware to the 80th, 81.st, and 82d Congresses; elected Governor of the State of Delaware for two '+-year terms, 1.952 and 1956; chairman of the National Governors Conference, 1959; president of the Council of State Governments, 1960; enlisted as private in Delaware National Guard, 1926; colonel USAR, ret.; brigadier general, ret., Delaware National Guard; five campaigns in the European Theater of Operations during World War II; Legion of Merit, Bronze Star with cluster, French Croix de Guerre with Palm; elected to the United States J. Caleb Bogga Senate November 8, 1960, for the term ending of Wi@rgton, De@-zre January 3, 1972. Member of Committees on Public Works Republican--Jan. 3. 1961 and Post Office and Civil Service. Edward W. Brooke (Republican) of Newton Centre, Mass.; born in Washington, D.C,, October 26, 1919; attended public schools of Washington, D.C.; B.S. degree, Hi@ ard University, 19,'!; master of laws, Boston University Liw School, 1950 (editor of Law Rev-Lc@w, 1946-48); honorary degrees: Doctor of Jurisprudence, Portia Law School Boston, 1963; Doctor of Public Administration, Northeastern University, Boston, 1964; Doctor of SciLr,.ce, Worcester Polytechnic Institute, 1965; Doctor of '@--2rican International College, Springfield, 1965; Doctor of Laws, Emerson College, Boston, 1965; Captain, U.S. Army, Infantry; 5 years' active service, EuropeL@il theater of operations; recipient of Bronze Star and Combat Infantry--an's badge; served with "Partisans" in Italy; chairman of Finance Co-,imission, citv of Boston, April 1961 to September 1962; member of President Johnson's Commission for Civil Rights under law; the Republican Club of Massachusetts; National Association of Attornevs General;, National Association of District Attorneys; Sen. E,@ W. B--ogk-- American Massachusetts, and Boston Bar "-qsoz,'-ations; of C-,ntze@ Uyssach-asetts married Remigia Ferrari Scacco, two children; elected Attorney General of the Cc--:nonwealt',,i of Massachusetts, 1962; re-elected 1964; electe-4 to the U.S. genate Novc-T-@iber 8, 1966. Member of Appropriations Subcommittees on Forei@n Operations; Legislative B-rcticli, llj@,'@li-f--arv Constr--Tcti---n; @-d State, Justice, a.-'d Conirerce, the j-,idic-,.ary, and Related Agencies. 7 Republican, of Anchorage, Alaska; born in TED STEVENS, Indianapolis, Ind., November 18, 1923; graduated from high school, Redondo Beach, Calif.; attended Oregon State College, Montana State College; graduated from U.C.L.A., 1947, Harvard Law School, 1950; served in the Air Force in World War II in China, 1943-46, first Lieutenant (pilot) 14th Air Force; awarded two Distinguished Flying Crosses, two Air Medals, and the Yuan Hai Medal (by Chinese Nationalist Government); practiced law in office of Northcutt Ely, Washington, D.C4, 1950-52; member, law firm of Collins & Clasby, Fairbanks, Alaska, 1953@; appointed U.S. Attorney, Fairbanks, Alaska, September 1953; transferred to Department of the Interior, Washington, D.C., as legislative counsel, 1956; appointed assistant to the Sen. Theodo2v F. Ste?)ens Secretary of the Interior (Fred Seaton), 1958; appointed of Anchoraqe-, AZaska solicitor of the Department of the Interior by President Eisenhower, 1960; returned to Alaska, 1961, Republican -Dec. 24, 1960 opened law office in Anchorage; president Anchorage Republican Club, 1962-63; elected to the State House of Representatives, 1964, reelected 1966, served as p-ro t= and leader; member Americnn, Federnl, Cplifornia, Alaska, OP i -1 and District of Columbia Bar Associations; admitted to practice before the United States Supreme Court, 1954; member, Rotary, American Legion, Veterans of Foreign Wars; Republican Club, Petroleum Club, Anchorage Press Club, and Alaska Press Club, married Ann Mary Cherrington, of Denver, Colo., 1952; five children: Susan, Beth ' Walter, Ted, Jr., and Ben; appointed December 23, 1968, by Governor Walter J. Hickel to fill the U.S. Senate vacancy created by the death of Senator E.L. Bartlett; reelected November 3, 1970, for the term ending January 3, 1973. Allen JoseDh Ellender (Democrat) of Houma, La.; born in Montegut, Terrebonne Parish, La., September 24, 1890; lawyer and farmer; graduate of St. Aloysius College, New Orlean s, La., and Tulane University of Louisiana, at New Orleans, with degrees of M.A. and LL.B.; married to Miss Helen Calhoun Donnelly (died September 30, 1949); one son, Allen J., Jr.; served in World War I; city attorney of Houma, 1913-15; district attorney, Terrebonne Parish, 1915-16; delegate to Constitutional Convention of Louisiana in 1921; member of the house of representatives of Louisiana, 1924-36; floor leader, 1928-32, during administration of the late Huey P. Long, Governor; speaker of the house of representatives, 1932-36; Democratic nominee for United States Senator from Louisiana, and elected without opposition in the general election held on November 3, 1936, for the term ending January 3, 1943; reelected November 3, 1942, in the general election, without opposition,for the term ending January 3, 1949; reelected without opposition in the general election held on November 2-, 1948, for the term ending January 3, 1955; again re-elected without opposition in the general election held on November 2, 1954, for the term ending January 3, 1961; re-elected November 8, 1960, for the term ending January 3, 1967; re-elected November 8, 1966, Sen, AlZen J. Ellender for the term ending January 3, 1973; Democratic of Ilour=, Louioiz-,a national committeeman from Louisiana, 1939-40. Chairman of Committee on Appropriations. Member of Committee on and Fcrestr-; a,-,--, Joint Committee on Nonessential Federal Expenditures. Milton R. Young (Republican) of LaMoure, Tor-th Dakota; born December 6, 1897 in Berlin, North Dakota; attended the LaMoure County public schools and was graduated from LaMoure High School in 1915; attended North Dakota State Agricultural College and Graceland College at Lamoni, Iowa. Married Malinda Vi Benson of LaMoure, N. Dak., July 7, 1919; three sons. Member of school, township, and county AAA boards; elected to House of Representatives of',North Dakota State Legislature in 1932; elected to State Senate of North Dakota in 1934 and served continuously until his resignation March 14, 1945; elected president pro tempQre 1941; majority floor leader 1943. Was actively engaged in the operation of his farm near Berlin, N. Dak., until his appointment to the U.S. Senate. Appointed to the U.S Senate Ma ch 12, 1945; elected at special' r election June 25, 1946 for term ending January 3, 1951; re-elected to successive Sen. Witon R. yomg terms; served as secretary to the Senate Republican Conference Committee since 1948. of La.Afouiv, -Iorth Dakota Member of Committee on Agriculture and Republican--March 12, 1945 For6stry and ranking Republican on the Appropriations Committde. 9 LABOR-WELFARE SUBCOMMITTEE OF THE HOUSE APPROPRIATITt4S COMMITTEE 92ND CONGRESS DANIEL J. FLOOD (Democrat) Of Wilke-,-Barre Pennsylvania. B.orn in Hazleton, Pennsylvania, Novon@ber 26, 1903. Received early education in public schools of Wilkes-Barre, Pennsylvania, and St. Augustine, Florida. Graduate of Syra-tise University, A.B. and M.A. degrees, and ater attended Harvard Law School and Dickinson School of Law, Carlisle, Pensylvania, graduating in 1929 with L.L.B. degree. Admitted to the bar of various State and Federal Courts in i930. Attorney -,r liome Owners' Loan Corpor- ation 1934-35, Deputy Attorney General for Pennsjlvania and Counsel for Pennsylvania Liquor Control -,ard, 1935-39; Director, Bureau of Public Assistarice Disbursements, State Treasury, and Executive Assistant to State Treasurer, Pe..nsylvania, 1941-44; married Catherine H. Daniel J. F16od Swank on September 24, 1949; member of many of Wflkes-Ra-re (lith Dist.) local civic, fraternal, beneficial, and social Democrat - 12th tem societies. Elected to 79th, 81st, 82nd, 84th Congress and re-elected to succeeding Congres@ . Former Vice Chairman of Special Committee to investigate Katyn Massacre (murder of Polish officers by Russians). Also member of Sbcom- mittee c,.i Defense, Committee on Appropriations. 2 WILLIAM @lA@fC Lla (Democrat) of Bowling Green, Warren County, Kentucky; born in Bowlin@ GreEnp Kentucky, educated in the public schools of Bowling Green, Kentucky, and high school at Ogden Preparatory Department; A.B. degree, Western Kentucky State College, Bowling Green, Kentucky; L.L.B. degree, Ohio State University, Columbus, Ohio; married to Miss Virginia Reardon, of Bowl-i.ng Green, Kentucky, on June 17, 1937; two daughters: Celeste White, 26, and Louise Lewter, 22; practicing attorney, Bo wl.ing Green, Kentucky, since March 18, 1934; Federal concili- at ion commissioner 1936-37 for Western District of Kentucky; elected county attorney of Warren County i 1937 and served three l'our-year terms, n William II. Natcher elected Commonwealth attorney of the 8th Judicial Bowli?7g Green (2d Dist.) District, composed of Allen and Warren Countries, Democ-pat - 10th term in 1951 and served unti.1 August 15, 1953, having been elected to Congress; Baptist; member of Kiwanis club, Odd Fellows, Ameri.cal Leg on Post 23, and 40 and 8 Mammoth Cave Voiture 1146; past president of the Bowling Green Bar Association; past president of the Youn- Democratic Clubs of Kentucky, 1941-46; during World War 11 served in the United States Navy from October 1942 to December 1945; elected to the 83d and succeeding Congresses. Also member of Subcommittee on Agriculture, and Subcommittee on District of Columbia (Chairman), Committee on Appropriations. NEAL SMITH (Democrat) of Altoona, Iowa., born March 23, 1920 at Hedrick, Iowa; married Beatrix Havens, two children, Douglas and Sharon; farmer and lives on farm near Altoona, Iowa; engaged in the practice of law in Des Moines, Iowa; graduated Drake University Law School; attended 14iss,ouri University College of ersity Liberal Arts and Syracuse Univ Schools of Public and Business Adminis- tration- 4-H Club member and leader for ten years, farm o rator since 1937 .pe except for time and armed services and some of the time in college; spent four years in World War II, citations include Neal Smith nine battle stars, Air Medal, 4 Oak Leaf of Altoona (5th Dist.) Clusters, and Order of the Purple Heart; Democrat -7t@t tem elected National President Young Demo- cratic Clubs of America 1953--served usual two-year term 1953 to 1955; former chairman, Polk County Board of Social Welfare (a nonpaying civic board which distributed several million dollars per year to needy families and elder citizens)- former assistant county attorney for Polk County, Iowa; member of Disabled American Veterans, Masonic Order, and various farm, school, and service organizations; elected to 86th and succeed- ing Congresses. Also member of Subcommittee on State, Justice, Commerce, and the Judiciary, Committee on Appropriations; and Select Committee on Small Business. 3 W.R. HULL, JR. (Democrat) of Weston, Missouri; born in Weston, Platte County, Missouri, April 17, 1906; widower; children, Mrs. Susan Hudson and W. R. Hull 3d; elected to the 84th Congress and succeeding Congresses. Also member of Subcommittee on Agriculture, Coui-. mittee on App:ropriations. W. R. Hull, Jr. of Weston (6th Dist@) Democrat - 9th term ROBERT (BOB)RANDOLPH CASEY (Democrat) of Houston, Texas; born in Joplin, Missouri, July 27, 1915, moved to Houston, Texas, in 1930, and graduated from San Jacinto High School;,attended the University of Houston end the South Texas School of l,aw all night, was admitted to the State bar of Texas in 1940; opended law office in Alvin, Texas, and served as city attornev and also a member of the -school board; assista t district n Attorney in Harris County, in charge of the civil department; in 1948 was elected to the State house of representatives and served in the regular and special sessions of the 51st Legislature; elected county judge of Bob Casey Harris County in 1950 for a two-year of Houston (22d Dist.) term; re-elected in 1952 and again 'in Democrat 7th term 1954 for a four-year term; member, First Christian Church; married Hazel Marian Brann on August 13, 1935, and have ten children; elected from the newly created 22d district to the 86th Congress and succeeding Congresses. Also member of Subcommittee on Legislation, Committee on Appropriations. EDWARD JAMES PATTEN (Democra't),bf Perth Amboy, Nj., iTrn@in Perth Amboy, August 22, 1905; graduated from Newark State College, Rutgers Law School, L.L.B., and Rutgers Un-Lversity, B.S. ED.; member of Eagles, Moose, Elks, Kiwanis, Knights of Columbus, tion 1 Conference of Chri tians and Jews, Na a s Chamber of Commerce, and NAACP; lawyer, 1927; teacher public schools, 1927-34; mayor of the city of Perth Amboy, 1934-40; county clerk of Middlesex County 1940-54; campaign manager for Robert B. Meyner, 1953 and 1957- secretary of state of the State of New Jersey, 1954-62; president, Salvation Army Board; past president of the Middlesex Bar Association; chairman of the Middlesex County Democratic Colmnittee, 1934-36; member of the Democratic State Committee and member of American Judicature Society; recipient of "Outstanding Citizenship" award from American Hp-ritage Foundation and Edward J. Patten Btnai Blrith',-, "Brotherhood" award; married of Perth @boy (15th Dist.) Democrat 5th teym February 22, 1936, to Anna Quigg of South Amboy, N.J.; one daughter, Catherine M.; elected to the 88th Congress November 6, 1962; reelected to the 89th, and succeeding Congresses. Also member of Subcommittee on Military .Construction 5 ROBERT H. MICHEL (Republican) of Peoria, Illinois. Born March 2, 1923, in Peoria, Illinois. Graduate of Peoria Public Schools and Bradley 'University, B.S. 1948, business administration. Served in the enlisted ranks during World War II; arded the Bronze Star, Purple Heart, and aw four battle stars, Married, four children. Elected to the 85tli and succeeding Congresses. Also member of Subcon ittee on Agriculture, Committee on Appropriations. Robert B. Michel of Peoria (18th Dist.) Republican 8th team GAPD,TER E. SHRIVER (Republican) of Wichita, Kansas. Born July 6, 1912, in Towanda, Kansas; married in 1.941, three children. Attended public schools of Towanda and Wichita; graduate of University of. Wichita in 1934 (post-graduate study at University of Southern California in 1936) and Washburn La-v7 School, L.L.B. degree. in 1940. trgaged in law practice since 1940; served for three years in the U.S. Navy as an enlisted man and officer during World War II; State representative 1947-51 and State Sena -60; member of American, tor 1953 Kansas and Wichita bar associations, Veterans of Foreign Wars, American Legion, Garner E. Shriver National Sojourners, Albert Pike Masonic of Wichita (4th Dist.) Lodge, Wichita C6nsistai-y, De Molay Legion Republican 6th term of Honor, and College Hill Methodist Church; elected to the 87th Congress November 8, 1960 and succeeding Congresses. Also member of Subcommittee on Foreign Operations, Committee on Appropriations. 6 SILVIO 0. CONTE (Republican) of Pittsfield, Mass.; born in Pittsfield November 9, 1921, son of Mr. and Mrs. Ottavio Conte; attended public schools in Pittsfield and the Pittsfield Vocational High School, graduating in 1940; machinist at General Electric Co. in Pittsfield before joining the Seabees in World War II; served in Southwest Pacific; attended Boston Colleae and Boston Colleae Law School, graduating in 1949; admitted to the bar same year; in November 1950 elected tb the Massachusetts State Senate; served as Senator from Berkshire District 1951-58; Massachusetts Bar Association, Federal Bar Association.; married to the former Corinne Duval, four children, elected to the 86th and succeeding Congresses; silvio o. Conte delegate to Republican National Convention; .of Pittsfield (lst Dist.) 1968, member of Platform Committee; member of Republican ?th term Appropriations Committee; Subcommittees on 1--asury-Post Office; Foreign Operations and Transportation; Select Committee on Small Business; Joint Conmiission on the Coinage; Migratory Bird Conservation Commission. J. KENTNETH ROBINSON (Renublican) of Winchester, Va.; born in Frederick County, Va. on May 14, 1916; attended public schoo s in Winchester; received B.S. in Horticulture from Virginia Polytechnic Institute, Blacksburg, Va., in 1937; entered family fruit growing and packing business; served four years in U.S. Infantry, retiring as Major, married Kathryn Rankin of Richmond, Va., ane. they have seven children; member aid officer of nwerous local civic, fraternal, social and business organizations, lifelong member of ds; elected to Virginia the Society of Frien Stzte Senate for 21st Senatorial District in 1965, was re-elected in 1967, and resigned upon election to Congress; committee s, Agriculture and assignments: General Law Mining, Welfare, Enrolled Bills, and Nominations and Confirmations; served as chairman of Ret)ublicin Delep,,ation to 1968 and 1969 General Assemblies; J. Kenneth Robinson was elected to the 92nd Congress November,3, 1970. Also member of Subcommittee on Foreign Operations, Committee on J. Kenneth Robinson of ;;inchester (7t;,Dist.) Appropria:tioris. I?epublican - lot tem 7 SUBCOM4ITTEE ON LABOR AND HEALTH, EDUCATION AND WELFARE, AND RELATED AGENCIES COMMITTEE ON APPROPRIATIONS 92ND CONGRESS Democrats Daniel J. Flood (Pennsylvania) - Chairman William H. Natcher (Kentucky) Ne al Smi th. (I ow-a) W.R. Hull, Jr. (Missouri) Robert (Bob) Randolph Casey (Texas) EdTiard J. Patten (New Jersey) L,epublicans Robert H. mi chel (Illinois) Garner E. Shriver (Kansas) Silvio 0. Conte (Massachusetts) J. Kenneth Robinson (.Virginia) Robert M. Moyer, Professional Staff Assistant Henry A. Neil, Professional Staff Assistant 0 0 IVASI-IINGTON'/AL-NSK-@: Ted Stevens (R. -.,Alaska) 1. B.ACKGIZOUi\'D A. Grantee or Sponsor: UniNTersitv of l@,ishiiicyton Scl-iool' of Medicine B. Coordinator: Donal R. Sparl@iiian, M.D. C. Boundaries': cotenninous x%,itli those of the tivo states D. History 1. Initial planning grant: Septenber 1966 2. Operational status: February 1968 II. FUi\DII\'G A. Support throuah FY71: $6,999,000 B. FY72 aiiard: 1,868,000 C. Total support to date: --s@867,000 III. ORCANIZATION A. Regional Advisory Group 1. Chairman: C. Robert Ogden, Presidei-it, Nort]-i Coast Life Insurance Conpany 2. Composition (43 rombers) a. Practicing physicians 11 b. Medical center officials 3 C. ll'O,---,,,ital aciiiris@l-rators 5 d. Voluntary heal 'I agency representatives 2 e. Other health ivorkers 5 f. Public health officials 3 g @lembers of the public 12 h. Other 2 TOTAL 4S @B. Program staff: 33.8 Full-time equivalents IV. PROGRAM PRIORITIES A. Improve the availability of care B. Improve the accessibility of care C. Improve the acceptability of care D. Maintain and improie the quality of care E. Assist in the contaiment of costs.of care V. OPMATIO,\TAL ACTIVITIES 7ne -recion currently sl-,,,-orts 20 a,@4,,4+,CS a4- a okro 0 .1 't, I I"@ @ LI -L V J- LI.L LIL 1,003,000. These incl.ude an emphasis on the coordination of health services and manpim@r develolinent and training. Kidney disease is given eq)hasis ivith five components funded at a level of $125.000. 2 VI. SELECTED IT-GIO.@U Cfl!aA=-RISTICS A Popu@altion: 3.7 million -- 59% urban, 8% minority B. fieal@li resources 1. I)niversity of l@asliinaton School of @ledicine 2. 121 short-term., non-Fed-@ral hospitals with 11,863 beds. ,(Alaska 13 hospitals, Washington - 108 hospitals). 3.' Alaska 183 physicians (,\ID's and DO's) IVashington 4,208 physicians (@ID's and DO's) 4. Alaska - 590 active registered nurses Wasliinc,,ton ll,.361 active registered nurses VII. ILLUSTRATIO.,\'S OF ACTIVITY One illustration of IN'ashi@aton/Alaska R%Tls efforts to improve health services coordination is the development of an unusual cooperative arrangement betiveen the 39-bed IVillapa Harbor Hospital, located in a remote lumbering community m the lVest coast of IVasliingtoia, and the 300-bed Virginia Mason medical center in Seattle.,. In 1969 the small community was serviced by one physician nearing retirement and a failin- hospital for a population of 9,000 people. Two years later, through the aid of I%lashincton/Alaska P,',[Pls Com- C> munity Health Services P-roaram, the toi%n iia,,; has ti@o resident physicians, an elected 'liealtJi board, a Comprehensive Health Planr,4Lncl,- agency, an emergency military helicopter service i ic:.,l lies patients to a specialized service center, as well as a cooperative arrange- ment beti.;eeii the two hospitals. The latter has produced a "hot- line" for consultation between the hospitals, air and land transpor- tation, arrangements for continuity of patient care, a druc, inventory and formulary (resulting in a savinas of $S,000 in one ),ea-r), as well as continuing staff education for the smaller hospital. The success of this program has prompted Virginia @lason to request IVashington/Aldska R\IP to help in identifying other communities for similar arrangements. GREATER DELAIVARE VALLEY RMP*: James C. Boggs (R.-Delaware) I. BACKGROUND A. Grantee or Sponsor: University City Science Center, Philadelphia B. Coordinator: Martin Wol , M.D. C. Boundaries: Region encompasses the State of Delaware and a number of counties in eastern Pennsylvania and southern New Jersey (Delaware River basin area). D. History 1. Initial planning grant: April 1967 2. Operational status achieved: April 1969 II. FUNDING A. Support through FY71: $81838,000 B. FY72 award (projected): 2,433,000 C. Total support to date: $11-,271,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Leonard Wolf., Ph.D.;.Vice President for Planning, University of Scranton, Scranton, Pennsylvania 2. Composition (61 members) a. Practicing physicians 14 b. Medical cen-tler offit-Lals 10 c. Hospital administrators 8 d. Voluntary health agency representatives 5 e. Other health workers 2 f. Public health officials 9 g. Members of the public 11 h. Others 2 TOTAL 61 B. Program Staff: 46.08 Full-time equivalents IV. PROGRAM PRIORITIES Improving the quality, quantity, and accessibility of health care. V. OPERATIONAL ACFIVITIES The Region currently has 16 ongoing operational- activities with a total funding level of $796,667. Approximately 19% of funds are related to training of nurses for coronary care unit operations. The lar e majority of remaining funds are devoted to man-omier deve-lon7.@.nt, 9 including continuing education and training. Activities are beinc, reoriented in line with changing priorities, and include recruitment and reactivation of health care personnel, special training for -respiratory disease care, etc. 2 VI. SELECFED REGIONAL CI"CRERISTICS A. Population: 6,200,000 -- 72% urban, 97% white B. Health resources 1. 6 medical schools 2. 165 short-term, non-Federal hospitals with 40,000 beds 3. 13,300 practicing physicians M's and DO's 28,500 registered nurses VII. ILLUSTRATIONS OF ACTIVITY Ten participating hospitals have joined in a 3 phase program of roving patient care through a deliberately planned process of pinpointing patient care deficiencies, determining the causes, and then developing training processes which will overcome those deficiencies in the future. This is a group approach to self- evaluation by physicians. Current year funding is supporting development and adoption of care criteria for at least three conditions. As that progresses other conditions will be assimi- lated into the process. *NOTE: As of May 1, 1972, the Greater Delaware Valle@ RNT will become two separate RN@lPs, with the splitting off of the state of Delaware. The new Delaware P.%!P will attain planning status as of @ 1, with an initial funding of $200,000 for the first yea . Details of organizational structure and staffijig-for the new Tegion Ea-ve not yet been completed. HAIVAII RMP: Hiram L. Fong (R.) I. BACKGROUTO A. Grantee or sponsor: Research Corporation of the University of Hawaii B. Coordinator: @lasato M. Hasegawa, M.D. C. Regional boundaries: The entire state of Hawaii, including American Samoa, Guam and the Trust Territory of the Pacific Islands (Micronesia). D. History: 1. Initial planning grant: July 1966 2. Operational status achieved: October 1968 II. FLJNDING A. Support through FY71: $2,963,000 B. FY72 award: - 937,000 C. Total support to date: $3,900,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Eucene Helbush,, Member Public Health Committee of Chamber of Comerce - Hawaii 2. Composition (32 members) a. Practicing physicians 10 b. Medical center officials 3 C. Hospital administrators 5 d. Other health workers I e. Public health officials 2 f. Members of the public 9 g. Voluntary health agency representatives 0 h. Other 2 TOTAL @2 B. Program Staff: 17 Full-time equivalents IV. PROGRAM PRIORITIES A. Assist in improvement of-health care delivery system by improving equity of access; quality of care and influence cost reduction B. Improve organization patterns, develop cooperation, arrangements and serve in catalytic role C. Improve quality controls in health services. V. OPERATIONAT-.AC7D!ITIES The Hawaii RW currently has 6 ongoing activities funded at a level of $393.,828. Fifty-three percent of their money is aimed at projects for improving health manpower recrutiment. The Ynaior shift in 2 emphasis is directed toward improved and expanded services by existing physicians, nurses and other allied health personnel; increased utilization of new types of allied health personnel; new and specific mechanisffr@that provides quality control and improved standards and-decreased costs of care in hospitals. VI. SELECTED REGIONAL CHARACTERISTICS A. Population: 1.0 million -- 81% urban, 62% minority B. Health Resources 1. @dical School - University of Hawaii School of @ledicine 2. Hospital and beds - 22 short-term, non-Federal hospitals with 2,453 beds; 86% involved with R4P 3. Physicians and nurses - 949 physicians (MD's and DO's), 2,334 nurses VII. ILLUSTRATIONS OF ACTIVITY The Hawaii Regional Medical Program is assisting in improvement of the health care system of Hawaii by improving equity of access; iWroving quality of care; and influencing constraints in health care costs. In general the heart program satisfied basic needs in Hawaii by establishing coronary care units throughout the Islands and training ample @ers of physicians and nurses to staff units. 'Ihe Hawaii RMP is currently working toward improving the overall health care delivery system in general, rather than specific cate- gorical diseases. TRI-STATE Ri'v[P: Edward W. Brooke (R.,Massacliusetts) I. BACKGROUI\TD A. Grantee or Sponsor: Medical Care and Education Foundation, Inc., Boston B. Coordinator: Leona Baumaartner, M.D. C. Boundaries: States of Massachusetts, New Hampshire, and Rhode Island (some western counties of Massachusetts are also served by the Albany RMP) . D. History 1. Initial planning grant: December 1967 2. Operational status achieved: February 1969 II. FUNDING A. Support through FY71: $5,3361000 B. FY72 award: 2,461,000 C. Total support to date: $7,797,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman- Louis A. Leone, M.D., Director, Department of Oncology, Rhode Island Hospital, Providence 2. Composition (,62 members a. Practicing physicians 27 b. Medical center officials 3 c. Hospital administrators 4 d. Volmtary health agency representatives e. Public health officials 4 f. Other health workers 5 g. Members of the Public 10 h. Others 4 TOTAL 62 B. Program staff: 43.0 Full-time equivalents IV. PROGRAM PRIORITIES A. Supply distribution and-education of health/manpower B. InstitLitional cooperation and reuionalization C. Geographic gap filling D. Medical care financing V. OPERATIONAL ACTIVITIES Tri-State PM currently has 6 ongoing operational components with a funding level of $613,500. About 60% of that.sm supports activities in the area of intensive coronary care. Better manpower utilization is the iia 4or --F--@as of programs are.sup-@orted by approximately 2 half of the available funds, the remainder supporting various types of patient care demonstrations. Approximately S9% of funds ($365 000) go to activities directed against health problems of the black popu- lation in@the three state area. VI. SELECFED REGIONAL CHARACFERISTICS A. Population: 7,374,000 -- 89% urban, 5% minority B. Health resources 1. 5 medical schools; 1 @,o-year medical sciences school 2. 188 short-term,@non-Federal hospitals with 33,07S beds, 20% of these a-re participating in R4P planning bodies and operational activities 3. 11,200 active physicians; 35,800 active nurses VII. ILLUSTRATIONS OF ACFIVIIY The major thrust of the Tri-State R4P is undergoing change in accord with changing emphasis of the national program. Greater emphasis is being placed on actions which affect the delivery of health care services, and chanaing the system, while attacks on individual disease problems are being de-cm ed. Existing disease control activities ,phasiz a-re being reoriented as the transition process indicates. There has also been an increased emphasis on awarding of contracts to meet specific needs of the program, while awarding of grants for marginally related activities has been de-emphasized. The end point ha s been a greater reliance on program expertise in meeting the Region's needs through priority programming. During the past year the Tri-State Region instituted a $300,000 program "To assure that no patient with end-stage kidney disease will die from lack of necessary services." I\Teiv England states other than those of the Tri-State Region are involved. The short-yan2e objective is to develop a method of procuring donor organs and to identify problem of funding. The long-range objective is to furnish an adequate supply of cadaver organs to satisfy patients needs in various transplant units. MISSISSIPPI: John C. Stennis (D.) I. BACKGROUT A. Grantee or sponsor: University of Mississippi Medical Center, Jackson B. Coordinator: Theodore D. Lampton, M.D. C. Boundaries: Coterminous iNTith State (a few northern counties are. also,served by Memphis RN@IP). D. History 1. Initial planning grant: January 1967 2. Operational status: July 1969 II. FUNDING A. Support through FY71: $4,S99,000 B. FY72 award: 1,053,000 C. Total support to date: 52,000 III. ORGANIZATIOIN A. Regional Advisory Group 1. Chairman: Lewis Nobles, Ph.Di, President, Mississippi College 2. Composition: (30 members) a. Practicing physicians 4 b. Medical center officials I c. Hospital administrators s d. Other health workers 4 e. Public health officials 2 f. Members of the public 4 g. Voluntary health agency representatives 9 h. Others 1 TOTAL 30 B. Program staff: 22 Full-time equivalents IV. PRO@L PRIORITIES A. Remolding the program structure to respond to nei-z initiatives and expanded opportunities-in planning for the statels health needs B. Improving both quality and quantity of health manpower by up- grading abilities-in the field and attracting new personnel to the field V. OPERATIONM ACTIVITIES The region is currently supporting nine operational components at a funding level of $920,000. The major emphasis is on improved health manp(x,ier training and utilization. 2 VI. SELE= @GIONAL @CRERISTICS A. Population: 2.2 million -- 17% urban, 37% minority B. Health resources 1. One medical school 2. 97 short-term, non-Federal hospitals with 8,698 beds 3. -1,610 physicians (@ID's and DO's; 3,670 active registered nurses VII. ILLUSTRATIONS OF ACFIVITY A stroke intensive care unit serves as a learning center to upgrade skills of physicians, nurses and allied health professionals. Additionally, it serves the poor who are obtaining care where none was previously available. The skills of the following groups have been upgraded by assignment to, or rotation through the unit: 89 medical students 18 nursin students 9 33 practical nurses 2 nurses aides 8 house staff phys cians. MOUIWAIN STATES R,,T Alan Bible (D. - Nevada) I. BACKGROUNI) A. Grantee or Sponsor: WIcliE-9 P.0'Drawer "P",, Boulder,, Colorado B. Coordinator: John W.Gerdes, Ph.D. C. Boundaries: Including the States of Idaho, Montana, Nevada, and Wyoming D. History 1. 'Initial planning grant: November 1966 2. Operational status achieved: March 1968 II. FUNDII\'G A. Support through FY71: $7,676,000 B. FY72 award (projected): 13,764@000 C. Total support to date: $9 440,000 III. ORGANIZATION A. Regional Advisory Group Chairman: Arthur R. Abbey,, Executive Director Wyomina Hospital 1. Medical Service 2. Composition (26 members) a. Practicing physicians 4 b. Medical center officials 2 C. Hospital administrators A d. Other health i%Drkers 4 e. Public health officials 0 f. Members of the public 8 9. Voluntary health agency repre- sentatives 2 h. Others 2 TOTAL TC B. Program staff.t 27 Full-time equivalents IV. PR@l PRIORITIES A. Assist in subregional centers for continuing education B. Improve health centers for rural residents C. Stimulate health manpower development and utilization D. Provide specialized centers development V. OPERATIONAL ACTIVITIES The Mountain States RT currently has 11 ongoing activities funded at a level of $784,200. At present a great deal of money (56 per cent) goes to continuing education and trainina Most projects are aimed at provider groups. New and expanded roles C, ior existing health professionals who will serve the disadvantaged rural and poor are being explored throughout the Region. IlVhile stimulating the improvement of existing 0-r- resources, P@.IP ivorks cooperatively to create greater awareness health manpower opportunities. VI. SELE= REGIO,@ CHARACTERISTICS A. Population: 2.2 million 30% urban and 5% minority B. Health Resources 1. Medical schools - none 2. Hospitals and beds a. Mountain States - 131 short-term, non-Federal hospitals with 8,517 beds; 29% involved with @IP b. Nevada - 17 short-term, non-Federal hospitals with 1,967 beds 3. Physicians and nurses a. @lountain States - 1,536 physicians (MD's and DO's) 5,646 nurses b. Nevada - 463 physicians (NID's and DO's) 1,060 nurses VII. ILWSTRATIONS OF ACTIVITY The Mountain States Regional @ledical Program as a whole is faced with the problems of providing quality health care in sparsely populated areas. The Region can never get enough physicians to cover the vast rural areas or to serve the populace in every small community, therefore, emphasis is placed on assisting subregional centers for continuing edu- cation to seek solutions so that health practitioners will be better trained to help meet the needs in their surrounding communities. In summary, throuah continuing education offerings and such outreach programs as the Comunity Teams in Nevada and off-campus nursing work- shops a new rapport has become manifest among,the urban and rural health workers. 2 TRI -STATE @LP: I\Tor-ris Cotton (R. -,\Teii Ham ,pshire) I. BACKGROtiND A. Grantee or Sponsor: Medical Care and Education Foundation, Inc., Boston B. Coordinator: Leona Baumgartner, M.D. C. Boundaries: Statesof Massachusetts, New Hampshire, and Rhode Island (some western counties of Massachusetts are also served by the Albany RMP). D. History 1. Initial planning grant: December 1967 2. Operational status achieved: February 1969 II. FUNDING A. Support through FY71: $S.*3363,000 B. FY72 award: 2,461,000 C. Total support to date- $7,797,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Louis A. Leone, M.D., Director, Department of Oncology, Rhode Island Hospital, Providence 2. r-oT.Posil+-ion (61& -,,e,-,bers' a. Practicing physicians 27 b. Medical center officials 3 c. Hospital administrators 4 d. Voluntary health acency C> representatives 5 e. Public health officials 4 f. Other health workers 5 g. Members of the public 10 h. Others 4 TOTAL B. Program staff: 43.0 Full-time equivalents IV. PROGRAM PRIORITIES A. Supply distribution and-- education of health/manpower B. Institutional cooperation and regionalization C. Geographic gap filling D. Medical care financing V. OPERATIONAL ACFIVITIES Tri-State RV currently has 6 ongoing operational components with a funding level of $613,500. About 60% of that sum supports activities in the area of intensive coronary care. Better manpower utilization is the major focus of programs which are supported by approximately 2 half of the available funds, the remainder supporting various types. of patient care demonstrations. Approximately S9% of funds ($36S,000) go to activities directed against health problems of the black popu- lation in the three state area. VI. SELECFED REGIONAL CHARACRERISTICS A. Population: 7,374,000 -- 89% urban, S% minority B. Health resources 1. 5 medical schools; 1 t-io-year medical sciences school 2. 188 short-term, non-Federal hospitals with 33.,07S beds, 20% of these are participating in RV planning bodies and operational activities 3. 11,200 active physicians, 35.,800 active nurses VII. ILLUSTRATIONS OF ACRIVITY The major thrust of the Tri-State RNP is undergoing change in accord with changing emphasis of the national program. Greater emphasis is being placed on actions which affect the delivery of health care services, and changing the system, while attacks on individual disease problems are being de-emphasized. Existing disease control activities are being reoriented as the transition process indicates. There has a]-so been an increased emphasis on awarding of contracts to meet specific needs of the program, while awarding of grants for marginally related activities has.been de-empl-iasized. The end point has been a greater reliance on program expertise in meeting the Region's needs through priority programming. Du-ring the past year the Tri-State Region instituted a $300,000 program "TO assure that no patient with end-stage kidney disease will die from lack of necessary services." iNew England states other than those of the Tri-State Region are involved. The short-range objective is to develop a method of procuring donor organs and to identify problems of funding. The long-range objective is to furnish an adequate supply of cadaver organs to s@tisfy patients needs in various transplant units. NBV JERSEY @IP: Clifford P. Case (R.) I. BACKGROLINID A. Grantee or Sponsor: New Jersey Joint Committee for Implementation of P.L. 89-239. B. Coordinator: Alvin A. Florin M.D. C. History 1. Initial planning grant: July 1967 2. Operational status: April 1969 II. FUNDI NTG A. Support through FY71: $416841000 B. FY72 award (projected): 1,400,000 C. Total support to date: $6,084,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Richard J. Cross, M.D., Professor of Medicine, Rutgers Medical School 2. Composition (27 members) a. Practicing physicians 6 b. Medical center officials 3 c. Hospital administrators 5 d. Voluntary health agency representatives e. Public health officials 3 f. Other health ivorkers 2 g. members of the public .6 TOTAL 27 B. Program staff: 20.5 Full-time equivalents IV. PWGRAM PRIORITIES A. improvement of services to urban poor B. Health manp(xier education C. Regionalization of Health service resources V. OPERATIONAL ACTIVITIES The region currently has t%,elve ongoing-operational activities with direct cost funding of $814,000. Approximately one half of the projects are directed toi@ards categorical diseases (heart, cancer and stroke) and the other half are nulti-cateuorical disease programs. In terms of prina-r,, focus, +.",-- NTc,,v lo-rsey J'rog-raii-i is U'irecceu' ratlier evenly in three areas -- continuing education, patient care delivery and coordin- ation of health services. Close to half of the NJW's operational monies support inner city programs for blacks and spanish surname populations. 2 VI. SELECTED REGIONAL CHARACFERISTICS A. Population: 7.2 million -- 89% urban,, 18% minority B. Health resources 1. 2 medical schools 2. 107 short-term, non-Federal hospitals with 25,247 beds; 58% (62) of these hospitals are involved in RMP planning and activities 3. 9,176 physicians (',,ID's and DO's); 24,900 active nurses (42,400 total) VII. ILLUSTRATIOINS OF ACTIVITY With more than 85% of New Jersey cancer patients being treated in co ity or general hospitals of 500 beds or less, it is the aim of the New Jersey @IP - Tumor Conference Boards to bring the most up-to- date medical information to the practicing physician responsible for cancer patient care. Thus, four agreements of affiliation have been executed with eighteen hospitals and negotiations are currently under- way with six additional hospitals. More than 10,000 patients have been brought under team -review of the status of their disease, treat- ment jmdes, and rehabilitation plan. By March 1972, it is anticipated that 43 hospitals will be totaling an estimated 15,000 annual admissions for cancer. An objective of the project is to establish joint tumor conference boards for two or more hospitals. In Middlesex County, a demonstration of a joint conference board is planned for St. Peter's General Hospital (ongoing) and @lidcllesex Hospital. The encouraging factor in support of a joint program for these two institutions is thb recent program amal- gamation of radiation therapy services in St. Peter's Hospital to serve both hospitals. New Jersey @ has provided staff and technical assistance to six Federally- designated Model Cities Program through the assignment of full-time Urban Health Coordinators. In each city the Urban Health Coordinator helps plan and organize,facilities and manpower resources to increase the effectiveness of local health care delivery system . This project, now in its second year of operation, serves a population of 200,000 dis- advantaged residents and has secured or applied for more than five million dollars from sources outside the RMP for funding health program in these cities. Plans call for expanding the project to include 367,000 residents of the 14 newly approved State Co ity Development cities. A project has been developedtd organize providers of services and health care facilities into a comprehensive care program especially directed at serving the disadvantaged and others without regular sources of medical'care. The project, at Middlesex General Hospital, is designed to serve a patient population of 4,000 persons with a program of pre- ventive medicine and treatment -,"-il.izing a full-tiire family healt]-i care team The project includes multiple funding from Medicaid, Medicare, hospital resources, and the @IP. NOV @ICO: Joseph M. Montoya (D.) I. BACKGROUN'P A. Grantee or sponsor:@ The University of New Mexico B. Coordinator: James R. Gay, M.D. C. Boundaries: Covers the entire State of New Mexico D. History 1. Initial Planning grant: October 1966 2. Operational status: July 1968 II. FLJNDING A. Support through FY71: $4,331,000 B. FY72 award: 1,033,000 C. Total support to date: $5@364,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Hugh B. Wooclvard, M.D., Medical,Director, Mountain Bell Telephone Company 2. Composition (41 members) a. Practicing -physicians 13 b. Medical c;@t'e'r officials 2 c. Hospital administrators 4 d. Voluntary health agency representatives 2 e. Public health officials 4 f. Other health workers I 9. Members of the public 13 h. Other 2 TOTAL B. Program staff: 15 Full-time equivalents IV. PRO@ PRIORITIES A. Manpoi%,er B. Prevention/health maintenance C. Availability of care .D. Quality of care V. OPERATIONAL ACTIVITIES The region is currently supporting 12 operational activities in the amount of $461,317. Monies are divided among the following disease categories: heart 11%, cancer 7%, stroke 24%, and multicatezorical 58%. Over 60% of the funds support training existing health personnel in new skills. 2 VI. SELECFED REGIOINM CHAP,,%CTERISTICS A. Population: 1.0 million -- 29% urban 52% white B. Health resources 1. I medical school 2. 39 short-term general, non-Federal hospitals with 3,351 beds. 47% of hospitals participating in RMP 3. 969 physicians (,\fl)ls and DO's); 2,511 active registered nurses VII. ILLUSTRATIO@NS OF ACTIVITY "Coronary Care Nurses Training Project" - the project emphasizes the relationship between training of personnel in cardiovascular care and their functions in the Central monitoring units and remote stations. It will continue the four-week course to prepare nurses to work in a Central @nitoring Unit, and accelerate the teaching of personnel who will be working in the Remote Stations (one-week courses). The Remote Monitoring Project will establish eight Central Monitoring Units and 23 Remote Units to provide quality care to myocardial infarction victims in local facilities. The plan encompasses ap- proximately one-half of the small hospitals in New Mexico. -i%,o licensed practical Forty-seven registered nurses and t nurses Completed a training program ",N'arsina in the Coroi-iaiy fare U.-lit.,, Three continuing education programs for CCU nurses have been planned. In conjunction with the remote monitoring project, approximately 30 nurses and other paramedical Personnel received a one-week training program. This program will provide the nurses in smaller hospitals (remote units) with the knowledge and skills necessary for the nursing management of patients with coronary heart disease. SOUIH CAROLINA: Ernest F. Holli@cys (D.) I. BACKGROUND A. Grantee or sponsor: Medical University of South Carolina, Charleston B. Coordinator: Vincent Moseley, M.D. C ' Boundaries: Coterminous with State D. History 1. Initial planning grant: January 1967 2. Initial operational period: August 1968 II. FUNDING A. Support through FY71: $4,184,000 B. FY72 award: 1,341,000 C. Total support to date: $5,525,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: James W. Colbert, M.D., Vice President, Academic Affairs, @l.U.S.C. 2. Composition (70 members) a. Practicing physicians 37 b. Medical center officials 2 c. Hospital administrators 6 d. Voluntary health agency representatives 6 e. Public health officials 3 f. Other health workers 3 g. Menbers of the public 10 h. Other 3 TOTAL 70 B. Program staff: 30 Full-tijne equivalents IV. PROGRAM PRIORITIES A. Redirection of program efforts to identify with emerging Federal and State initiatives in planning and delivery of health services. B. Continue to upgrade patient care by upgrading skills and abilities of health practitioners. V. OPERATIONAL ACTIVITIES South Carolina RW currently ha--- 13 operational activities at a cost of $724,000. The major emphasis of these activities are health manpower training and utilization and improved coordination of health services. VI. SELECTED REGIONAL CHARACRERISTICS A. Population: 2.6 million -- 38% urban, 31% minority 2 B. Health resources 1. one medical school 2. 70 short-tem., non-Federal hospitals with 9,213 beds. Sixty percent of hospitals participate with the South '%IP Carolina R 3. 1,955 physicians (ND's and DO's); 5,62S active registered nurses VII. ILLUSTRATIOINS OF ACFIVITY Noteivorthy among continuing projects is one which is designed to improve and expand existing continuing education opportunities in the health sciences at the community level. It's efforts are directed to professional, technical, and allied health personnel. A kidney disease education and service program is aimed at expanding facilities to provide additional patient-training and provide equipment and professional support for home dialysis of the renal patient. IVASHINGTOiN/ALASKA: l@larren G. @la,@on. (D. -Washington) I. BACKGROUND A. Grantee or Sponsor: University of Washington School of @ledicine B. Coordinator: Donal R. Sparkman, @I.D. C. Boundaries: coterminous with those of the two states D. History 1. Initial planning grant: September 1966 2. Operational status: February 1968 II. FLJNDING A. Support through FY71: $6,999,000 B. FY72 award: 1,868)000 C. Total support to date: 8@867,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: C. Robert Ogden, President, North Coast Life Insurance Company 2. Composition (43 members) a. Practicing physicians 11 b. @ledical center officials 3 c. Hospital a@,P-is+..-,-+o-s s d. Voluntary health agency representatives 2 e. Other health workers 5 f. Public health officials 3 g. Members of the public '12 h. Other 2 TOTAL .B. Program staff: 33.8 Full-time equivalents IV. PROGRAM PRIORITIES A. Improve the availability of care B. Improve the accessibility of care C. Improve the acceptability of care D. Maintain and improve the quality of care E. Assist in the containment of costs of care V. OPERATIONM ACFMTIES The region currently supports 20 operational activities at a level o 1,003,000. These include an emphasis on the coordination of health services and manpower development and training. Kidney disease is given emphasis with five components funded at a level of $125,000. 2 VI. SELE=- RE-GIONA:L CHARACFERISTICS A. Population: 3.7 million -- 59% urban, 8% minority B. Health resources 1. University of Washington School of Medicine 2. 121 short-term., non-Federal hospitals with 11,863 beds. (Alaska 13 hospitals, Washington - 108 hospitals). 3. Alaska 183 physicians GID's and DO's) Washington 4,208 physicians (MD's and DO's) 4. Alaska - 590 active registered nurses Washington 11, 361 active registered nurses C. VII. ILLUSTRATIONS OF ACI'IVITY One illustration of Washington/Alaska RMP's efforts to improve health services coordination is the development of an unusual cooperative arrangement between the 39-bed Willapa Harbor Hospital, located in a remote lumbering community on the West coast of Washington, and the 300-bed Virginia Reason medical center in Seattle. In 1969 the small co ty was serviced by one physician nearing retirement and a failing hospital for a population of 9,000 people. Two years later, through the aid of Washington/Alaska @,IP's Com- munity Health Services Program, the town now has tivo resident physicals, art elected health i)oard, d Comprehensive Health Planning agency, an emergency military elicopter service which flies patients to a specialized service center, as well as a cooperative arrange- ment between the two hospitals. The latter has produced a "hot- line" for consultation between the hospitals, air and land transpor- tation, arrangements for continuity of patient care, a drug inventory and formulary (resulting in a savings of $5,000 in one year), as well as continuing staff education for the smaller hospital. The success of this program has prompted Virginia Mason to request Wa-shington/Alaska RMP to help in identifying other co ties for similar arrangements. Job WEST VIRGINIA R4P: Robert C. Byrd (D.) I. BACKGROUND A. Grantee: West Virginia University Med ical Center B. Coordinator: Charles D. Holland C. Boundaries: Coterminous with state D. History 1. Initial planning grant: January 1967 2. Operational status achieved: January 1970 II. FUNDING A. Support through FY71: $1,716,000 B. FY72 award: 609,000 C. Total support to date: $2@325,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Charles E. Andrews, M.D., Provost, WVU Medical Center 2. Composition (36 members) a. Practicing physicians 9 b. Medical center officials 3 c. Hospital administrators 6 d. Voluntary health agency representatives 7 e. Public health officials 2 f. Other health workers 3 g. Members of the public 5 h. Other 1 TOTAL T6- B. Program staff: 19.25 Full-time equivalents IV. PROGRAM PRIORITIES A. Rural health care B. Delivery of primary health care services C. Preventive Services V. OPERATIONAL ACTIVITIES West Virginia @IP currently supports 5 operational activities in the amount of nearly $190,000. Only one of these programs is directed toward the control of a specific disease entity (i.e., stroke); the remainder a-re for the.most part broadly based in the areas of cooper- ative delivery of health care services, conmnication networks, emergency medical system , and general continuing education. Over half of the Region's operational funds ($100,000) go for the conduct AL 2 of continuing education program for physicians, primarily in the form of one project aimed at improving care through the use of physicianiself-audit -review. Another noteworthy effort (20% of funds) isi,directed toward improving primary care delivery to children in rural and remote areas of the State. VI. SELEC7ED REGIONAL CHARACRERISTIC A. Population: 1.8 million -- 95% white, 62% rural B. Health resources 1. 1 medical school; 11 schools of nursing; 7 schools of medical technology 2. 74 short-term, non-Federal hospitals with 9,286 beds. 3o 1,500 active @ID's, 111 active DO's; 5,001 active RN's. VII. ILLUSTRATIONS OF ACRIVITY A. Rural School Health Program: This activity has been underway in West Virginia @IP since July 1971 and has as its major objectives the identification implementation and evaluation of a prototype school health program which can be replicated in rural areas throughout the Nation. Program emphasis is on the prevention of health problem , particu- of py4 larly chronic diseases, and tqe more efficient use Lmaiy health care services. Having c leted preliminary planning OMP activities (e.g., collection of baseline data, rando sampling of health status of elementary school children, modification of school health record form), the program this year will begin the development of a new type of health manpower, the "school health assistant;" test the feasibility of employing various types of health personnel, including pediatric nurse practitioners and physicians' assistants; and initiate screening and referral services for children as well as educational programs for their parents. WISCONSIN: William Proxmire (D.) I. BACKGRDUND A. Grantee or sponsor: Wisconsin Regional Medical Program, Inc. B. Coordinator: John S. Hirschboeck M.D. C. Boundaries: coterminous with state D. History 1. Initial plannina grant: September 1966 2. Operational status: September 1967 II. FLJNDING A. Support through FY71: $5,115,000 B. FY72 award: 1,764,000 C. TotIal support to date: TU 879,000 III. ORGANIZATION A. Regional Advisory Group 1. Chairman: Rodney Lee Young, J.D., County Judge Lady Smith, Wisconsin 2. Composition (45 meffbers) a. Practicing physicians 9 b. Medical center officials 4 c. Hospital administrators 8 d. Voluntary health agency representatives 2 e. Other health workers 6 f. Public health officials 2 g. Members of the public 11 h. Other 3 TOTAL @5 B. Program staff: 24.0 Full-time equivalents IV. OPERATIONAL ACRIVITIES The region is currently supporting nine (9) operational activities in the amount of approximately $450,000. A majority of the funds are expended in the area of training existing health personnel in new skills, although significant portions of their budget are also directed towards patient care delivery and coordination of health services. The projects being carried out in the region are under the aegis of a variety of institutions. For example, two smaller projects are directed from the medical school, two from hospitals, one from a voluntary health agency, another from a public health agency, etc. V. SFLECRED REGIOINAL crERISTICS A. Population: 4.4 million -- 49% urban, 95'0 white B. Health resources 1. two (2) medical schools 2 2. l@4 short-term, non-Federal hospitals with 22,385 beds 3. 4 605 physicians @,ID's and DO's); 14,084 active registered nurses VI. ILLUSTRATIONS OF ACFIVITY A project recently funded by the Wisconsin RV proposes to demonstra'te the capability of the nurse associate in performing some tasks which are now performed by physicians. The project will ultimately prepare 68 physician-registered nurse team . The initial focus will be on child health care because of the amount of work already done in this area. Because of the rural nature of Wisconsin, the project will then move into the area of family health or general practice, followed by the application of the concept to geriatrics practice. These te@ will practice in various settings (single office, group practice, health center and outpatient department-coimunity setting). Perfor- mance, role acceptance and cost effectiveness will be continually evaluated in order to anticipate problems and suggest modifications. Another activity recently funded -- "North Central Wisconsin Outreach"-- will hopefully serve as a prototype to be replicated elsewhere in the state. Addressing the problem of "no doctor towns," in which there is little likelihood of recruiting a physician,, this project hopes to develop Satellite Clinics. The clinics would be staffed only 2 and one half days per week by a physician; the remainder of the time by a trained physician assistant. GREATER DELAWARE VALLF.V @',IP: Daniel Flood (D) llilkes-Barre, Peniisylvi.nia (District 11) 1. BACKGROUND A.. Grantee or Sponsor: University City Science Center, Philadelphia B. Coordinator: @lartin Ilollmann, M.D. C. Boundaries: Region encompasses a number of counties in 'eastern Pennsylvania and southern New Jersey, and the state of Delaware. In general it covers the Delaware River basin area. D. History: 1. Initial planning grant: April 1967 2. Operational status achieved: April 1969 II. FUNDING A. Support through FY71: $ 8 837 753 B. FY72 award (projected): 2,433 217 C. Total support to date: $11,270,970 III. ORMIZATION A. Regional Advisory Group i.. Chairman: Leonard Wolf, Ph.D.; Vice President for Planhi.ng, University of Scranton, Scranton, Pennsylvania 2. Composition (61 members) a. Practicing physicians 14 b. Medical center or'ficials 10 c. Hospital administrators 8 d. Voluntary health agency representatives 5 e. Other health workers 2 f. Public health officials 9 g. Members of tfie public 11 "'h. Others, .... 2 TOTAL 61 B. Core staff: 46.08 full-time equivalents IV. PROGRAM PRIORITIES: Improving the quality, quantity, and accessi- bility of health care. V. OPERATIONAL ACTIVITIES: The Region currently has 16 ongoing operational activities with a total funding level of $796,667. Approximately 19% of funds are related to training of nurses for coronary care Unit , operations. The large majority of remaining funds are devoted to man- power development, including continuing education and training. -Activities are being reoriented in line with changing priorities, and include recruitment and reactivation of health care personnel, special training for respiratory diseqse care, etc. 2 VI. SELECTED REGIONAL CHARACTERISTICS. A-.. Population: 6,200,000 -- 72@-. urban, 97% white B.-licali@ Resources I 6 medical schools with 40,000 beds 2. 165 short-term, noii-Fed- al hospitals or 3. 13,300 practicing physicians (@ID's and DO's) 28.,500 registered nurses VII ILLUSTRATIONS OF ACTIVITY Ten participating hospitals have joined in a '3 phase program of improving patient care through a deliberately planned process of pinpointing patient care deficiencies, determining the causes, and then developing training processes.wliich will overcome those deficiencies in the future. This is'a group approach to self-' evaluation by physicians. Current ),ear funding is supporting development and adoption of care criteria for at least throe conditions. As that progresses other conditions wil'l be assiini- lated into,the process. IOII.A R,\IP: Nleal. t.'Smitli (D); Altoona (Fifth District) 1. BACKGROU,\TD University of Ioiqa, College A. Grantee or sponsor: of Medicine -Ir. Cliarles Calch@ell (Acting) B. Coordinator: C. Regional boun @ies: coterminous with state D. History: 1. Initial planning groAt:. Dece@er'1966 2. Operational status achieved: July 1968 II. FUNDING A Support through FY71: $2 876,860 B. FY72 mvard 889,998 C. Total support to date: T3,-766,858 III. ORGANIZATIO-N A. Regional Advisory Group I.. Chairman: Georue Hegstrom, M.D.; practicing physician, McFarland Clinic, Ames 2. Composition: (40 members) a. Practicing physicians 8 b. Medical center officials 2 c. Hospital administrators d. Other health i@orkers 6 e. Public health officials 3 f. Members of the public 10 g. Voluntary health agency res ntatives 1 rep e h. Others 4 TOTAL 40 B. Core staff: 17 full-time equivalents IV. PROG@L P.AIORITIES -A. Assist in the development and testing of new and voluntary ways to deliver comprehensive quality care. B. Foster improved manpower utilization and distribution. C. Foster cooperative relationships, appropriate training and adequate data collection. V. OPERATIOI@ ACTIVITIES: The-I@IP currently has 7 ongoing activities funded at a level of $352,76Q. Last year a large majority of that sum was devoted to continuing education and training. Planning for FY72 hoivever., alters that picture and indicates a spending level of about $210,000 for purposes. The current application requests funds for planning of a renal care program, an emergency medical services program, and a neonatal care program. 2 YI. SELECTED IZE-C-IO.NAL CTIARACTERISTICS A. Population: 2,825,000 57% Urban, 09% white B. IJealth resources 1. Universi@, of Iowa College of Medicine 2. Colleae of Osteopathic Medicine and Surgery 3. 133 short-term, noii-Federal hospitals with 15,333 beds; 62% involved with RN,@ 4. 5,900 practicing physicians 17,000 active registered nurses Z> VII. ILLUSTRATIO'i\'S OF ACFIVITY In the Mason City area, emergency ambulance services are being of f-eyed to -rural residents with acute Myocardial Inf-a-rction. Upon bein@,,.o ,i.l alerted, the emergency vehicle will pick up trained personnel, administer care enroute to the hospital where intensive care is available. An ancillary purpose is to reduce tlie.i-ioed for a full -range of emergency cardiac care services in isolated rural hospitals. Less emphasis is being given to operational component activities. Skills of core staff are bein(y increased with a view toward assisting in development of Health Maintenance Organizations, increasing cuality of care, cost reduction etc. In brief, project activities a-re cTivinc, wa)r to planning and evaluation in regard to total program priorities and to related national priorities. ILLII\'OIS: Robert Michel (R), Peoria (District 18) NOTE: Representative @lichel's district falls into both the Illinois and the Bi-State RNIP'S. 1. BACK6ROLJ,\'D A. Grantee or sponsor: Illinois Reaional Medical Proarim, Inc. B. Coordinator: Morton C. Creditor, @I.D. C. Boundaries: in general, cote-aiinous with state; some overlap with Bi-State RN,]P in southern Illinois. D. History 1. Initial plannina grant: July 1967 2. Operational status: February 1970 II. FUINDINIG -rough FY71: A. Support th $4,942,754 B. =FY72 award: - 2,000,000 C. -Total support to date: $6)942,7@ III. ORGALNIZ-ATIO-N A. Regional Advisory Group 1. Chairman: Dexter Nelson, M.D., practicing physician, - Princeton, Illinois .2. Composition (55 m@mbers) a. Practicina physicians 9 b. Medical center officials 12 c.. hospital administrators 12 d. Voluntary health agency representatives 3 e. Other-health workers 4 f. Public health officials 3 g.- members of the public 12 TOTAL 55 Core staff -- 22.5 full-time equivalents IV. OPr-,RATIO.@ ACTIVITIES: The region is currently supporting 9 operational activities in the amount of approximately 758 000 direct costs. Monies are fa'irly evenly divided among heart, cancer, and stroke activities. Interestinaly, no activities have continuing education and training as a major emphasis, while patient care demonstrations and coordination of healt]-i services account for almost 3/4 of available funds. Over 50% of the funds support activities sponsored by voluntary health agencies. V. SELECFED REGIONAL CHARACTERISTICS A. Population: ll'I million 83% urban, 87% white B. Health resources 1. 5 medical schools; I college of osteopa 2. 256 short-term, non-Federal hospitals with 51,267 beds; 6% (161 of these are involved in T'@,!P f)'Iai-u-iii-ig and activities. 13,100 physicians @ID's and '])Ols) 35,500 active registered liui,ses. 2 VI. ILLUSTRATION-S OF ACTIVITY fielpina to solve the manpower problem is a key prourain of the Bi- Statd Re@ion.' In this connection, the Bi-State @IP (i@lissouri and 11 nois) obtained a waiver from the \Iissouri Council on Higher Education so as to make it possible for non-hic,]-i scJiool gradu@tes to enter junior colleaes for training as aide-level health workers. C, This is a part of Bi-State's larger effort of getting all neighbor- hood health personnel in the IZegion to work together in assessing their manpower needs and taking steps to meet them. In terms of direct patient care, the Bi-State @IP has established an intensive care facility at St. Louis City Hospital to serve an estimated 400 medically indigent stroke victims from the inner city each year. There has also been established, as an integral partof the project, a much-needed trainina unit for the purpose of instructing approximately 100 nurses from the Bi-State Region in the critical early management of acute stroke. In'addition, this project has C> created cooperative arrangements amona existina lona-term care centers C, C, Z> Z> for stroke and set up a practical teachina program for therapists 0 concerned i.;ith rehabilitation and., when necessary, custodial care of stroke victim throughout the Bi-State area. The Illinois RNIP is supporting a demonstration project in Chicaao in C> a lo-w income community area to-test the usefulness of an automated medical history system in a Community Health Clinic. If the system is successful it will be incorporated into the re lar funding schedule gu for the Valley Clinic. KANS.,kS: Garner E. Shrii,er (R), l@7ichita (First District) I. B.,kCKGI-,',OIAID A. Grantee or Sponsor: Uiiversity of Kansas @ledical Center- il '%I. D. B. Coordinator: Robert Broi,,,ii i C. Boundaries: coterminous with state D . History 1. Initial planning arant: July 1966 2. Operational status: June 1967 II. FUNIDING A. Support through FY71,: $51961,663 B. FY72 miard: 1,603,419 C. Total support to date: 7, 65,082 III. ORGAI\IIZATIOIN A.- Reuional Advisory Group 1. Chairman: Robert Polson, @I.D., practicing physician, Great Bend, Kansas 2. Composition (19 meffbers) a. Practicing physicians 7 b.' Medical tenter officials 3 c. Hospital administrators 3 d. Voluntary health agency represen a ives 1 Other health workers 1 f. Public health official 1 g.' @ffbe-rs of the Public 3 TOTAL -19 B. Core staff: 60.0 full-time equivalents IV. OPERATIO,@AL ACFIVITIES: Kansas R%,]P currently has 9 funded operational activities. The level of support for these in direct costs is about $520,000 -- 85% of which supports activities in continuing education and manp@@er utilization and over 10% in the coordination of health services. Most of the program do not support specific disease-Toldt-ed activities but progr@ of a more general -nature, such as a medical library-system, various training program (includina one designed to recruit health professionals from a Model Cities neighborhood). V. SELEC7ED REGIOI\'AL (RAMCTERISTICS A. Population: 2,250,000 66% urban, 95% white B. Health resources 1. 1 medical school 2. 146 8hort-tem, non-Federal hospitals with 11,80S total beds; 14% (21) are involved with R\T planning and activities., .3. 2 333 active physicians (@ff)ls and DO's) 6.,895 active registered nurses (10,532 total) 2 ILLUSTRATIO,\'S OF ACRIVITY A unique attempt to alleviate the gliortage of health manpower is being carried out by the Kansas Regional ',Iedical Program. '@lany registered -\IP nurses for one reason or another were not ijorkina and the KR established a program to promote the re-entry of registered nurses into the ]Zegioii's health care system. For the past tivo years, the Kansas proaram has offered six three-week training courses. hundred and thirty-three nurses have been trained and are employed in the 17 hospitals in Kansas City. Over 100 of the 133 nurses are employed on a full-time basis-and 33 of this number hold supervisory positions. 'nie Kansas Prouram is also supporting a project desianed to provide and promote employment in the health fields and entry into the healtji pro essiorls for model neighborhood residents. The methodology @lo),ed in this project will center around the development of the health aide as a category of health personnel. The general purpose of this@project is to raise the level of knowledge and understanding among indigent residents about good health practices @d to provide a means of entry of these citizens into health care professions. KFI\TRUCKY (01-110 VULEY R\IP) l@lilli,-an Natclior (D) .b@o-@@ling @ecii (Second District) I. BACKGPOU,\TD A. Qrantee or Sponsor: University ofkentucky ResearcJi Foundation, Lexington B. Coordinator: IVi lliam @IcBeath M.D. , M.P.H. C. Boundaries: Reaion encoir.passes the State of Kentticiw, and parts' of southern Indiana and soatliivesteni Ohio D. History 1. Initial planning grant: January 1967 2. Operational status achieved: January 1969 II. RJNDING A. Support through n@71 $3,594 092 B. FY72 support (projected) 1,505,902 C. Total support to date $5,099,994 (projected)- III. ORGANIZATIOIN -A. Regional Advisory Group 1. Chairman: Donald I. Loi@,ry, B.S., Technical Staff Director, Proctor and Gamble, Cincinnati, Ohio 2. Composition (41 members) -a. Practi'cina physicians 9 b. Medical center officials 7 c. Hospital administrators 5 d. Otlier health i@orkers 3 e. Public health officials 2 f.- @lembe-rs of the public g. Volmt@ry health acency C, representatives 2 h. Others 2 TOTAL 41' B. Cote Staff: 18.12 full-time equivalents IV. PRO@L PRIORITIES A. Development of health manpower B. Improved delivery of ambulatory care -ITIF,S: OVP-,@IP currently has seven funded activities V. OPERATION,'L ACTI@,7 in the amount of $76S,000. Slialitly less than half that sum ($3Sl,OOO) supports patient care demonstration activities. A somei%,hat smaller amount ($330,000) is devoted to continuing education and training type activities. Two components dealing with multiphasic screening-a'nd home health care are oriented toivard control in the indigent population. 2 VI. SETECFED REGIO.@U CL-L@CFERISTICS A. Population: 5,300,000 52%,urban, 90% white B. Health Resources 1. 3 medical schools 2. 157 short-term, non-Federal hospitals with 22,679 bods; 12% of these are involved with RNIP activities 3. 5i9OO physicians (,@ID's and DO's) 17,188 registered nurses. VII. ILLUSTRATIOIN,,S OF ACFIVITY Witliiii the past year, the major thrust of the program has been delineated as "manpower development." To that end, a project has been proposed for initiation in 1972 which will train a new type health professional, the clinical associate. He will function under the general auspices of a physician and will perform specific activities designed to free the physician from routine duties, so he can concentrate oii more critical needs. The training inclu es a preceptorship so the trainee can move into various semnents of the medical care spectrum in accord with his abilities and desires. till, Jr. MISSOTJRI (,\Io.R',IP): IV. R. 11 D) , IVeston, Missouri (District 6) 1. BA@KGROUIND A. Grantee or Sponsor: CuratQrs of the University (if Missouti, Columbia B. Coordinator: Arthur Pi.lli, M.D. C. Boundaries: cotendnous ivith-state but excluding @e,St. Louis area D. History 1. Initial planning grant: July 1966 2. Operational status achieved: Al)ril 1967 II. FUJ\TDING A. Support throuah FY71: $20,916,311 FY72 award (projected)' 2.282,096 B. Total $23;198,407 III. ORGANIZATIO'I\T A. Regional Advisory Group 1. Chairman: Robert E. Fr@', Hospital Administrator 2. Composition (12 members) a. Practicing physicians 6 b. Hospital 'administrators 1 c Members of the public 4 d. Others 1 TOTAL 12- B. Core staff: 48457 full-time equivalents Act IV. PROGRJOI PRIORITIES: ivities which relate to the prouram's mission, i.e., to serve as a "catalyst for ch anaes which will provide the best health for residents of the region." V. OPERATIONAL ACRIVITIES 'The region currently has underway 24 operational activities with a fundina level of $l'i231,641. i\learly half the funds support activities related to continuing education and/or patient services. Strong emphasis is placed on coordination-botiveen health care service providers. Last year 40% of funds were expended for activities of that nature. Under R%,IP leadership, for example, 12 hospitals in the Green Hills area of imissouri'have banded together to discuss and act on mutual problems, including administrative practices, personnel needs and practices, etc. VI. SELECTED RE-GIO,\TAJ, CHARACFERISTICS A. Population: 4,677,400 -- 45% urban, 63% white B. Health resources: 1. 2 medical schools; 2 schoolsof osteopathy 2. 121 short-term non-Federal hospitals with 21,480 beds; 67% of these are involved with RNIP. 2 .3. 5,900 physicians (@ID's and DO's) 11,20o active registered nuzses VII. 'ILLUSTRATIO;'\TS OF ACTIVITY Sikeston Intensive Care A seven bed Intensive Care lJnit has been established and become operational since initial ftu)dii-i- in mid-1970. Through June 1971, 218 patients had been admitted, half of i%,Iioiii i,:ere categorized as cardiacs. During that period tijelve pacemakers ijere installed and 36 def-ribrillations perfoiTied. The unit is currently operating at 75% capacity. Hiah praise for the procram and its training coiTonent has been received from participatiiia institutions. NBV JERSEY: Ediqard J. Patt strict l@5) 1. BACKGPOU,\'D A.@. Grantee or Sponsor: I\Tcii Jerse@ Joint Comittee for @iplenientation B. Coordinator: Alvin A. Florin, M.D. of P.L. 89-239. 'C. Boundaries:. cote@nous with state D. History 1. Initial plannina grant: July 1967 2. Operational status: April 1969 II. FUNIDII\'G A. S out through FY71: $4,684,186 UPI) B. FY72 x%lard (projected): I.,400,000 C. Total support to date: $6,o84,186 11 OR@'RIZATION A. Regional Advisory Group 1. Chairman: Richard J. Cross, M.D., Professor of Medicine, Rutgers Medical School 2. Coniposition (27 members) a. practicing physicians 6 b. medical center officials 3 c. hospital administrators 5 d. voluntary health aaency representatives 2 C, e. public health officials 3 f. other health workers 2 g. members of the public 6 TOTAL 27 B.. Core staff: 20.5 Full-time equivalents IV. OPFRATIO.VT@ ACTIVITIES: The -re,,lon currently has tiNTelve ongoing -operational activities with direct cost funding of $814,000. Ap- proximately one half of the projects-are directed towards categorical diseases (heart, cancer and stroke) and the other half are multi- categorical disease progr@ . In tei@ of p-rimar),, focus, the Neii Jersey Program is directed rather evenly in three areas -- coiitinuin- education, patient care delivery and coordination of health services. Close to half of the NJR-W s operational monies support inner city programs for blacks and spanish surname populations. V. SELECFED PEGIO@,KL CHARACTERI@TICS A. Population: 7.2 million 89% urban, 89% white B. Health resources 1. 2 medical schools 2. 107 short-term,- non-Federal hospitals with 25,247 beds; 58% (62) of these hospitals are,involved in @ffl plannin .9 and activities. 3. 9,176 physicians (@ff)ls and DO's) active nurses (42,400 total) 2 VI. ILLUSTP,-kTIO.\!S OF ACRIVII'Y With more than 8S% of New Jersey cancer patients being treated in conmunity or general hospitals of 500 beds or less, it is the aim of .the New Jersey RNIP - Tumor Conference Boar& to bring the most up-to- date medical information to'the practicing physician responsible for cancer patient care. lliu's, four aoreements,of affiliation have been executed with eigliteen'liospitals and negotiations are currently under- way w.ith six additional hospitals..' More than 10,000 patients @ave been brought under team review of the status of their disease, treatment niodes, and rehabilitation plan. By March 1972, it is anticipated that 43 hospitals will be totalin(Y an estimated 15,000 annual admissions for cancer. An ob ective of the project is to establish joint tumor conf-ereiar-e boards for tqb or more hospitals. In Middlesex County, a demonstration of a joint conference board is planned for St. Peter's General Hospital (ongoi ) and @,Liddlesex Hospital. The encouraging factor in support nccll of a oint program for these two institutions is the recent procram amalgamation of radiation therapy services in St. Peter's Hospital to serve both hospitals. New Jersey RN-IP has-provided staff and technical assistance to six Federally-designated iNbdel Cities Programs through the assign- ment of full-time Urban Health Coordinators. In each city the Urban Health Coordinator helps plan and organize facilities and manpoi,;er resources to increase the effectiveness of local health care delivery ject, now in its second year of operation, serves s,ystems. This pro lation of 200,000 disadvantaged residents and has secured or a popu C, Eipplied for more than five million dollars from sources outside the RNP for funding health proor@ in these cities. Plans call for expanding the project to include 367,000 residents of the 14'neii;ly approved State Community Development cities. A project has been developed to organize providers of service and health care facilities into a comprehensive care program especially directed at serving the disadvantaged and others without regular Z> sources of medical care. The project, at Middlesex General Hospita is designed to serve a patient population of 4,000 persons with a program of preventive medicine and treatment utilizing a full-time family health care team. The project includes multiple funding from Medicaid, Medicare, hospital resources, and the l@IP. TEXAS: Robert R. Casey (D), I-lous ton, (District 22) 1 I. BACKGROU.\D -University of Texas System A. Grantee or Sponsor: B. Coordinator: Charles McCall, II.D. C. Boundaries:. coterminous i,.,ith state D. History 1. Initial planning grant: Januarv 1966 2. (4)erational status: July 1968 II. FL iND I I\'G A. support through FY71 $ 8,190,302 B. FY72 aivard: 1,650,386 C. -Total support to date: $ 9 840,688 Ill. ORGAIN I 7-,kT I OiN A. Regional AdiTisory Group -1. Chairman: N. C. Hightoiier, M.D., Scott and IVIiite Hospital and Clinic, Temple 2. Composition (50 members) a. practicing physicians 12 b. medical center officials 13 c. hospital administrators 9 d. voluntary health agency representatives 3 -e. other health ivorkers 2 f. public health officials 3 g. members of the public 8 ,TOTAL so B. Core staff: 24.0 Full-time equivalents IV. OPERATIO,@IU ACTIVITIES: The reaion is currently conducting 19 operational activities ivith $945,000 in direct costs. Approximately 60% of the TR,\ffl activities are in tJie area of general continuiiia education and 30% of th'eir monies are directed toivards patient care delivery problems. Categorically speaking, (36%) of their projects are.for-strbke-related diseases and (26%) are in the area of cancer. Texas is supporting tivo projects directed tm@,ards blacks and chicanos (one of iiliich is coordinated with.rlodel Cities). V. SELE-MED REGIOI%'AL CL-@CTERISTICS A. Population: 11.2 million 80% urban, 87% ivhite B. Health resources 1. 4 medical schools 2. 492 short-tem, nm-Federal hospitals Avith 46,149 total beds; 14% (67) of these are involved in the RNIP 3. 11,700 physicians (@U)ls and DO's) 20,000 active registered nurses.@(30,000 total) 2 VI. ITIUSTRkTio:\Ts OF ACFIVITY One of the more significant projects in the Texas region has been the implementation of a proaram aj-jpod at the prevention of morbidity and mortality from cervical cancer. Application of exf-oliative cytology screening ider the aegis is tal,-inc, place at 109 satellite clinics w of the Sout]-ii,;esten-1 i%ledical School at San Antonio. Approximately 3,700 smears are being performed each month ivith 40,000 ivoinen tested each year. Preliminary findings indicate that the program is findinc, more and earlier lesions with more favorable outlook than expected.. -STATE R.\IP: Silvio Conte (R) Pittsfield Massachusetts (Distric t 1) ]\IOTE-:.@Representative Conte's district Includes territory served by both he Albaiiy@ Regional Medical Programs. ,'tlic Tri-State and t I. BACKGROUI\'D A. Grantee or Sponsor: Medical Care and Education Foundation) Inc., Boston B. Coordinator: Leona Baumgartner, M.D. C. Boundaries: States of Massachusetts, New Hampshire, and Rhode' Island (some western counties of Massachusetts are also served by the Albany R\IP). D. History 1. Initial planning grant: December 1967 2. Operational status achieved: February 1969 II. FLMING A. Support through FY71: $5,459,941, B. FY72 asvard- 2,461,425 C. Total support to date 7,921,366 III. ORGANIZATIO.'Q A. Regional Advisory Group Chairman: Louis A. Leone, @I.D., Director, Department of Oncolo(,,y., Miode Island Hospital, Providence 2. Composition (62 me@ers) a. Practicing physicians 27' 3 b. Medical center officials c. Hospital administrators 4 d: Voluntary health acency representatives e. Public health officials 4 f. Other health worl,-ers 5 g ' Members of the public 10 h. Others 4 TOTAL 62 B. Core Staff: 43.0 Full time equivalents IV. OPERATIOi'iAL ACTIVITIES 'Tri-State R@iP currently has 6 ongoina operational components with a fundina level of $613,500. About 60'- of that sum supports activities 0 in the area of intensive coronary care. Better manpower utilization is the major focus of rogr@ AIiicli are supported by approximately p half of the available funds, the remainder supporting various types of patient care demonstrations. Approximately 59% of funds ($365,000) go to activities directed against health problems of the black POPU- -lation in the three state area. 2 V. SI:LECM REGIONU CIIU,@CRMSTICS A. Population: 7,374,000 82% urban, 97% i@hite B. Health resources 1. 5 medical schools; 1 ti@o-year medical sciences school 2. 188 short-term, non'Fede'Tal hospitals i@ith 33, 075 beds 20% of these are participating in l@ND3 planning bodies and operational activities 3. 11,200 active physicians; 35,800 active nurses VI. ILIUSTRATIOI\TS OF ACTIVITY The major thrust of the Tri-State R\IP is undergoing change in accord -ranging emphasis of the national proaram. Greater emphas' witli cJ is is beingplaced on actions i@Iiicl-i affect the delivery of healtJ-i care services, and cha'ngina the system, i@hile attacks oii individual disease problem are being de-empliasized. Ex-isting disease control activities a-re being reoriented as the transition process indicates. The-re has also been an increased emphasis on'mqarding of contracts to meet specific needs of the program, i@,hile mvardina of grants for C, marginally related activities has been de-einpliasized. The end point as been a greater reliance on proaram expertise in mee h ting the Regions' needs through priority programming. An intensive coronary care demonstration project of the Albany RNIP is. located at Bershire Medical Center in Pittsfield, Massachusetts.. To @date it has trained 190 Purses from 29 hospitals. These hospitals account for 68% of g&neral-hospital admissions in the Albany Region. During the past year the Tri-State Region instituted a program "to assure that no patient ijith end-stage kidney disease ivill die from 'lack of necessary services." New England states other than those of the Tri-State Region are involved. .nic short--ranae objective is to develop a method of procuring donor organs and to identify problems of funding. 'Die long-range objective is to f-ui-nish an adequate supply of cadaver organs to-satisf-y patients needs in various transplant units. VIRGINIA RNRI: J. Kenneth Robiii@oii (R) Wil@ ITO]Ith District) ,I'. BACKGROUND A. @Grantee or Sponsor: Virginia Regional Medical Prograin, Inc. B. Coordinator: Euaene R. Perez, @I.D. C. Boundaries: coteminous.ivitli state D. -History 1. Initial plannina ary 1967 grant: Jai-iu Z. Operational status achieved: January 1970 II. FLMING A. Support through FY71: $2,445,7SS B. FY72 support: 789,488 C. Total support to date: $3,235,243 III. ORG/\NIZATIO',\' A. Regional Advisory Group 1. Chairman: Mack I. Shwffioltz, M.D., Commissioner of State Health Department 2. Composition (36 members) a. Practicing physicians 11 b. Medical center officials 2 c. Hospital administrators 7 Voluntary health auency 4 e. Public health officials 2 f. Other health workers 3 g. @lembers of the public 7 TOTAL 36 B. Core staff: 20.3 full-time equivalents IV. 0:PBRATIONAL ACTIVITIES: MIP currently has 7 funded operational activities. The level of support for.tliese in direct costs. is about $372,000, 85% of which supports activities in continuing education for health professionals. Approximately 40% of the funds are.beiii(y expended in the area of heart disease, over 10% for @troke-related activities and about S% in the area of cancer. V@- SELECTED REGIONAL CHARACTERISTICS A. Population: 4,648,000 ---63% urban, 81% white B. Health resources 1. 2 medical schools 2. 102 short-term iion-Federal hospitals with 16,,385 be(L; 15% of these are involved in JINIP activities 3. 4,631 physicians (,NID's and DO's) 11,500 active registered nurses VI. ILLUSTRATIO,'\'S OF ACRIVITY The VRNIP is supporting a program to (1) educate and train nurses and physicians in the treatment of patients with myocardial'infarction 2 (2)'.provide consultative assistance. to coronary care units. Over C, -ils, have been trained 50 healtli professionals, representiiiu 19 hospit, to date, and the project director has provided consultation to six hospitals either planning or operatiiia CCU'S. 'hie @ledical Colieoe of Virginia, under the sponsorship of the MIP, hasundertaken a project to demonstrate that the case of stroke patients in rural communities can be improved by up-grading the knowledge and skills of physicians mid other health perso el throuch a relationship with a medical center. I'he incidence and management of stroke is beina studied in five small rural communities (6)- general practitioners, (105) nurses and nursing.assistaiats and a number of family members are participating in educational programs related to care and rehabilitation of stroke patients. 0 0 0 Regional Medical Programs J. Budget Summary 1971 1972 1973 Estimate Estimate Estimate Activity or Subactivity Pos. Amount Pos. Amount Pos. Amount Regional Medical Programs Grants and contracts .... 56 1/ 74,735 56 1/ 139,300 56 125,10C Direct operations ....... 178 4,025 169 4,602 194 5,051 Program direction and management services ..... 67 1,394 68 1,117 68 1,13C 245 80,154 237 145,019 262 131,287 II. 1973 Prograr S@a= FY'72 ADD OR SUBTRACT FY'73- 56 RMP's 98.-' 0 98.3 CONTRACTS 4.3 0 4.3 CANCER CONSTRIJCTTON 5.0' -5.0 0 HMOS 16.2 -16.2 0 EMERGENCY MEDICAL - - SERVICE 8.0 +7.0 15.0 AHEC 7.5 0 7.5 139.3* -14.2 125.1 Grants & Contractc 5.1 Direct Ops. Direction & Management *Smoking and Health Contracts 131.3 taken out, print shows 140,656 @l Represents regions. Regional Medical Programs Budget Summary (Dollars in thousands) 1971 1972 1973 Estimate Estimate Estimate Activity or Subactivity Po S. Amount Pos. Amount Pos. Amount Regional Medical Programs: Grants and contracts .... 56 I/ 74,735 56 1/ 139,300 56 1/ 125,100 Direct operations ....... 178 4,025 169 4,602 194 5,051 1973 Program Summary Funds will be needed for programs to enable existing health manpower to provide more and better care and training and more effective utilization of new kinds of health manpower. New funds will be used to plan and develop Area Health Education Cent@rs, which will be major sources of manpower for Health Maintenance Organizations, Experimental Health Service Delivery Systems and other comprehensive health care systems. Activities qimed at improvii - the accessibility, efficiency, and quality of health care will provide opportunities to increase the rate of implementa- tion of systems, innovations and new technology. Rural health care systems will be developed that are comparable with needs of rural areas. Development o emergency healLn dare systems will bring together better transportation - rvices, communication which would tie hospitals, transportation facilities and other emergency organizations into rapid response systems, and emergency medicAl centers with specially train(' doctors and nurses. The provider- initiatea activities leadilLg to a gr@ater sharing of health facilities, manpower,, and other resources will provide the opportunity to show how scarce resources can be linked together efficiently. -Further Regional Medical Prugrams wil=l be strengthened so it will be possible for all to accomplish their objectives and goals. Regional Medical Programs particularly the weaker ones, will be provided the strong leadership required by the expansion and redirection of Regional 'L .4edical Program activities. The rapid expansion of Regional Medical Program activity and the movement into new areas of emphasis will require additional development of policy guidance and criteria for project development. Increased technical assistance will. be needed for new projects in areas involving new techniques and innovative delivery patterns, mote effective use of new kiildg of health manpower, and th2 quality of care guidelines. 1/ Represents regions. Regional Medical Programs J. Budget Summary (Dollars in thousands) 1971 1972 1973 Estimate Estimate Estimate Activity or Subactivity Pos. Am ount Pos. Amount Pos. Amount Program direction and management services .... 67 1,394 68 1,117 68 1,136 IIi 1973 Program Summary This activity provides for a central staff@needed in planning, directing, and evaluating the broad scope f program activities in the RMPS; maintains effective COUUILLinications and information links with the 56 local regional medical programs and the general public, and provides Administrative management qervices. 0 0 0 DEPlir,,T',%i'!,,",@T OF EDUCATIO',, AIND I]EALTII Sl,-Il@%?ICES Al\'D I,IE!iTi'd, IIEALTIL AD'@',Ili\'T.STIU@TIO'i Regional 1.1cdic,-Il Progranis /uDouiits Available for 01)1.j. j-on J-972 1973 Appropriation ....................... $102,771,000 $131,287,000 Real transfer to: "Operating expenses, Public Buildings Service," General Services Administration ......... 1,000 Comparative transfers to: "Departmental iianageinent," OS ...... 27,000 "Prevc@ntive health ser-,,.,ces ......... 2,189,, O@O Sul)total, budget authority .......... 100,554,000 131,287,000 u I balance, start of year.. 44,500,000 u gated balance, larsing ........ -35,000 Total, obligations ................. $145,019,000 $131,287,000 ol-)].i-@ations bv Activity 1972 1 9 7 3 Inctease or crc,@isc, Page Es t i-pll t e Esti.mite he Ref. Pos. Ai,,Iouiit Pos. A,@Tioulit Pos. Aipo all t Regional medical programs: (a) Grants and contracts... --- $139,,ob,ooo --- $125,100,000 --- -@14,200,000 y (b) Direct @V, @ zn-C operations.. 169 4 602,,OOO .194 5 GOO +25 + 0 0 0 Program direction and m@,n,--eitient services ......... '68 1,117,000 68 I'@ '000 @,-ooo Total obligations.. 237 $145,019,000 262 $131,287,000 +25 -$13,732,000 I)%, Object 1972 1.973 Increase or I'stimate E f-, t -i. 1-.li a t e. I)ecrease TotTl number of per@-qzineiit positions .................. 237 262 + 25 Full-time (,(Ii.ii.v@ilent of all other p,o,@l'-L-i-oi)s ............ 51 51 Average niiiibc2r of all oil loyec!s .................. 260 277 4- 17 p Personnel coTql)ensation'. Permanent positions ........ $3,465,000 .$3,788,000 + $323,000 Positions other than ........... 309,000 B09,000 permanent ..... Other personnel compeii- sation ................... 57,000 57-,OOO Subtotal., personnel compensation ......... 3,831,000 4,154,000 + 323,000 p nol benefits ........... 378,000 412,000 + 34,000 ee Travel and transportation of persons ..................... 289,000 314,000 + 25,000 Transportation of things ..... 35,000 35,000 Rent, coiTh-ouni.cati.bns and utilities ................. 367-5000 368,000 + .1,000 "ri,nting and reproduction .... 87,000 87,000 )ther servi ,ces ............... 634,000 716,000 + 82,000 -,itracts ......... . Project co. 4,300,000 4,300,000 supplies and materials ....... 59,000 62 000 + 3,000 Equipment .................... 39,000 39,000 .Iraiits, subsidies and contributions ........... 135,000,000 120,800,000 3.4,200,000 al obligations by ect,bject .................. $145,019,000 $1-3-1,287,000 -$13,732,000 0 loestipiated obligations .......................................... $145,011@9,000 1973 estimated obligations ......................................... 131,287,000 lqet change ... ....................................... -13,732,000 Base Change from Base Pos. AT--Oullt Pos. AntoLint Iiicreaseg: A.' Built-i.n: 1. lqorking capital fund t$58,000 charges .................... 2. I-.Iithiii'@grade pay increas(,..., @133,000 3 . I-lil-itai-y Pay Bill (P@L. 92-129) + 9,000 B. @o r.,- m 1. Up,.qard mobility .............. + 28,000 @2. Emergency medical services ... +25 +356@.000 Total, increases ...... -i-25 +578,000 De6reases: A. Built-in: 1. Tiqo-da7ys less pay ........... -27,000 B. Program: 1. Savings realized from cuts in positions in 1972 and reductiop.iip.,iyc-,rage grade -83,000 2. Grants and contract* .................... 139,300,000 -14,200,000 Total, decreases ....... -14,310,000 Total, net change ................. +25 13 7@3Z,000 Sili,@@l"l,)ry Of CIII]13'c@s 19 Udget authority ............................................ $1-00,554',OOO 3.973 budget authority ........................... ............ . 3@31-i287,000 Net change ............................................... @+30,733,OOQ Base ClianRe from Base Pos. Amount Pos. l@l-Li o u II t Increases: A,. Biiilt-in-. 1. I%Iorki-n- capital f uiid charges ............... +$58,000 2. Within-grade pay increase .............. .+133,000 3. Ifilitary Pay Bill (!'.L. 92-129) + 9,000 B -o r@m 1. Upl..,,ard liability ........ + 28,000. 2. Einerpency medical services. +25 +350,000 3. Grants and contracts .... 94,800,000 +30,300,000 Total, increases ..... +25 +3.0,878,000 Decreases: A. Built-in: 1. 'Aio-days less pay ........ 27,000 b 1. Savinps realized from cuts in positions in 1972 and reduction in aver 0 Total,-decr&ases ...... '145,000 Total, net change ........ +2 +30,.733, 0 Exp']..ql)zltio,,i of Cl a@,,@s increases: Bui]-t7i.n: ng capital fund cliar-es. increase of $58,000 is included for i-7orki -i(le pay. increases. $133,000 is included for i@7i.thiii-gr, iii-itary Piy bill increase. (P.L. 92-129) $9,000 is included for i, B. $28,000 is included for Upward nobility. 25 positions and $350,000 are i.ncl-u-iod for the new Emergency I-ledic,-.l Services Prograri. These resources will be used to provide planning and evaluation, profc,-ss--nal and technic ' issistance, staidard setting, project review, projec.t grants and contracts niiiaFcment, data systems development, and program direction and management services. se-. A. Built-in- $27,000 is excluded for two days less pay. B. P ro r@am $83,000 is excluded because of savings realized from cuts in Positions in 1972 and reduction in average grade. The decrease of $14,200,000 in 1-973 ref'Lects adjustments for tN,7o non- recx,-riiig items in 1.972 of $21,200,000 and an increase of $7,000,000 fDr a n s for i,.,,,,,ei-gc,,nc-y medical services. These ex-7 program o@ grants and contract funds-i-iill t used to support 5 projects in addition to the 5 funded in 1972. Exl)],qnati.oii of Traiisfc,).s 1972 Pti)-I)c)se Real transfer to: Operating expenses, Public Buildings Servicc@," General -$1,000 Transfer to GSA for Sc-rvd-ccs Administration rental of space. Comparative transfers to: t'Departr.ental management" -27,000 Transfer of Public Affairs function to Office of the Secretary. "PreventiNye health services -2,189,000 Traiisfer of National Clearinghouse for Smoking and )Iealtli. 0 0 S i. 11 i- f i C,! i-I '.I' t. c@ '3 )-I t e I tie Action oi- I-.o I)c@ ]()7). ilousc, it di.r(@(-tc@Ct that the Ei@!lit Pdcliqtri-c- Pul-i-.,)oniry I)roj-, be coi-i- e Pediatric cts x-7e,-e fL'T!Ciad at a $1,000, @@O ti.i@ued.i.n 19i2 at not Ic@ss tiiin the level, in .1.97).. It i.s -tiiticipa.teci 1971 level. (pa-e 16 of Llie re@)c)rL) . tlic@. 1.@172 ai-i@ 197') levels @-.7ill be tlic.,.saiiie. -1972 Senlq! Report Research and Oer,,onst).-ati.o@,) -@ra,,its 1. COIYLmi.ttee expres,,;c@cl l@f--en 1. Pccc,,nt studies liavc@ bep.Lin to interest in a I.ong-r@kiic,e. @lari to develc)-i) plans for co@'L)at-. L:, develop pro- LnF, eii(I-st@i-c, l@idnc--.y dicc-,ise. There gra,ii,3 ai,@@-ed at proviei-1-1,@i,,, therapy will- be l@,Licl,. F,)--oatc-.r eml)liisis on for the 8,000 to 10,01JO A7!-,,cricii-is pl..ici-ii-I I)ro.-'Iect in the coiitcxt i.7)io fell vi.ctir-i to kicli-@ev disease of I)c)tl,@ and nitioii---il- oa)-ly. (page 25 of the renert). In e@;raiicled I)I.anF,, fundF, invested i-ii tlics(, activities i,7j-ll increase from @14,t..00,000 in 1971 to an e.-;ti,,.Iated $8,500,000 in 1972. Up to $1.6,200,000 be used 2. CoTrnittee directed that a 2.i portion of IZ'@'LP increases be used to to fund the plaiinin,- and development prove out programs. (page 25 of llil-10's in 1972. of the report). iimittee -o2ects ongoin 3. Co coiictir3.-cd x.?itli the 3. All pi- g in 1971 Ilouse and further directed that all x-7hi-cl) have been included in their pediatric pulmonary projects ongoing applications by the 11,MP's affected in 1971 x.,crc-. to be. funded in 1972. have approved for 1.972. At the (page 26 of the report). same t.iiiia, final fundi.ng decisions have been left to the iiidi-,,i.(itial reFions their oi.@n systems of pr@.Crities. -t,,Ll Sci)atc@ Sil',I-li,f joint ft (CC)Iitld) be ii or t (co,it' d) specific cr-@- and /4 over the I)a!,t Y(,,]. 4. Cof,,-uiiittec@ directed -And policy have been (le-vc@].OPc-'l the Na'tioi-ii]. Advisor@, Coiii(,,il to teria u @s tliciii-,clves to questions and issued to the ]@'@1)'s. There has ii(ldrcl L surrouiidiric, Llic fl@il)j-]-ity and been i 1-aqrl@ecl increase in efforts o"' staff to iiiec,.t with IZOE oiial Advisory individuality. allowed P., coul-d.iiipair their effectiveness. Grotip@,,. In Jantiiryl 3.972, a I\Iatibnal p a'g'c, 2 5 o fthe report). Coordinators Confel-ence was held. 'L t brought togetlic-,i- il.1- coordinators, G 'Lroni every region and Council rer@,bers to discuss with staff issues, policy, etc. Covr,nittee directed that 5 A new survey of cardiovascular Increased funds be targeted to a surgery facii.ities-iii the District 'review of the availabll--'-ty of and of Colu,-@il)j.a is currently in progress access to special surgical tOa-,-IS 3-n @uiider the auspices of the \!('trOI)Ol@l-, ta l@Tisliii-,c,ton A report will open-heart -qn.d coronary artery n , surgery, especially in r_l@ District be available before 6/30/72. In of Col.ur i-a. (page 25 of the report). addition, regional I.-Icdi-.cal PrograTns Service, in order to carry out Sec. 907 of the Ptibl-ic Ilealth Service Act, L.-)ntracted with the Joint Co.-.il@i-,sio-,i 3i-i Accreditation of hospitals to develop the Secretary I--, T,ists-. One of the cri.teri.a which will be used in identifying eligible institutions for those lists will be. their par-- atioii in a regional plan for ticip the optimal development and utilj.za- tion of specialized facilities and services. Conference Report !Re.searc.11 ind demonstration c-,rants Comniittee agreed that no exist- Al.1 r@"PIs will, where consis- ing regional- riedical program is to tent with l@ational Advisory Council i r amount in l,Y 1972 ap loved funding levels, be funded !receive a lesse P' tiian'-it received in 1971i (page 6 at or above the l@'Y 1971 le.-,,el.. of the report). 0 0 197") AI)propriat4-on lzition Autl)orj.zed re (I II 0 s t c,@ (I.- Public Ilealtli Service Act Title IX ll'('.ucat:ioii, Research, Trainii-ii,, and Der.-.onstrzit-i-ons in the Fields of ]!cart Disease, Cancer, Strolc@, !,-LCiney Disease, and other F,,elated Diseases ..... $250,000,000 $1.20,800,000 PUBLIC IIE,@LTH S)7-RVICE ACT 'flIie Public llc-@alth Service Act, Title IX, Education, Research, Training And Demonstrations in tl-,c Fields of Ileart Disease, Cancer, Stroi@e, Kidney D2sease, and other Pelated Diseases. "Sec. c@100. The purposes of this title are-- ii(a) tlirou-h grants and contracts, to enco@rage and assist in the establish- ment of regional cooperative arrangements among medical schools, research -'@nsti- C, tutioiis, and hospitals for research and training (including continuing education), for medical data exchanger and for demonstrations of patient care in the fields of heart disease, cancer, strole, and kidney disease, and other related diseases; @ll(b) to afford to the medical profession and the medical institutions of-the n through such cooperative arraneemen.ts, the opportunity of making available to their patients the latest advances in the prevention, diagnosis, and treatment and rehabilitation of persons suffering from these 64,-'-C@ise-s; if (c) to promote and foster reg-Lc)nal liii@'@ages ar!.iong health care institutions and providers so as to strengthen and improve primary care and the relationship between specialized and primary care; and 11(d) by these means, to improve generally the quality and eiiliancc- the capacity of the health manpower and facilities available to the Nation and to improve health services for persons residing in areas earth limited health services, and to accomplish these ends without interfering with the patterns, or the methods of financing, of patient-'care or p7-.-ofcssional practice, or with the adn@iiiistration'of hospitals, and in cooperation with practicing physicians, medical center officials, hospital administrators, and representatives from appropriate voluntary health agencies." See 901-(a)' There are authorized to be appropriated $50,000,000 for the fiscal y;ar ending June 30, 3.966, $90,000,000 for the fiscal vear ending June 30, 1967, $200,000,000 for the fiscal year ending June 30, 1968, @65,000,C)OO for the fiscal year ending June 30- 1969 'I-20,000,000 for the nc,,-.-t fiscal ),car, $125,000,000 for the fiscal vear ending June 30, 1.9.71, $150,000,000 for the I year ending June 30, 1972, and $250,000,000 for the fiscal year ending -')O, 1973, for Lo zi,D-s!-E;t pu,@lic or nonprofit private universities, -il schools, research institutions, ind otlif@r public or nonprofit private institutions and agencies 4j-ii planning, in conducting feasibility studies, and in oi)er,itini- i)i3.ot 1)roie0ts for the establishment of i-(,i,,ional medical programs of and demonstration for c8ri7yjilg out the purposes of ,research, training ctivi.ties this title and for contracts to cii-Y), out the ptirposes-of this title. Of the sums appropriated under this section for the fiscal year c@ii(Ii.iiF, June 30,' 1971, 11 re than $159000,000 slial.1 be. for @ictivi-tiies i.n the fiel-d of l@ disease Of the siipis a.I)propri-,ited under this section for qny fiscal -year c after-Jiine 30, 1970, not more t--Iian $5,000,000 may be mide available in ants for new construction. For any fiscal car eiidiii,-, any such fiscal- year for gr, y t@ after June 30, lc,'69, such portions of the appropriations pursuant to tliis. section as the Secretary may determine, but not exceeding 1 per ceiitu,.,i tl)c--i-cof,.' sliall be available to the Secretary for evaluation (directly or by grants oF t6nt'racts) of the program authorized by this title--." "ViULTIPROr.R@A@l SEI,',VICES "Sec. 910. (a)To facilitate interregional cooperation, and develop improved national capability for deli.very of health services, the Secretary is authorized to utilize funds appropriated under this title @o make ,,r@-@nts to public or noii- profit private agencies or institutions or combinations thereof and to contract .for-- "(1) programs, service@, and activities of substantial use to two or.nore -regional medical programs; (2) development, trial., or demonstration of methods for control of heart disease, cancer,,stroke, lidney diseasii, or other related diseases; 11(3) the collection and study of epideriiologic data related to any of the diseases referred to in paragraph (2); 11(4) development of trai-ning specifically related to the prevention, os-'Ls, or treatment of any of the diseases referred to in paragraph (2), or to the rehabilitation of persons suffering from any of such diseases; and for continiiin of sucn training @.7here liortage of trained personnel wo.uld g programs s otherwise limit application of knowledge and skills important to the control of any of such diseases; and (5) the conduct of cooperative clinical field trials. 11(b) The Secretary is authorized to assist in meeting the costs of special projects for iir, rovina or developing new neaT)S for the delivery of health p 0 services concerned with the diseases with which this title i.s concerned. of (c) The Secretary is authorized ti; -support research, studies, investigations, training, and demonstrations designed to maximize the utilization of manpower in the delivery of health services." 0 Pub-lic Law 91-515 glst Confress, 11. R. 17570 October 30, 1970 To ijuciid title, iii ,Iii(i ix of tiie riii)iie ii(,ititli @'c-rviee Act f,.o I.,; to revise,, traiiiii).-, Lij(l deiiioiistratioiis tutlioi-iz(@0, tljercuiiiler, iiiid for oflier I)ui,l@es. I,,c it ell(Icle @ (191@l llo-,Itqe 0 d by the @'eiz,,it of the Vizite(I States (,f itz Cully).,3,ss PubliG Ifea,ltl-x S,ervioe Act, Tl'rllr@, I-A'-NIENI).@tENTS TO TI'PIE IX OF TIIIE l.'UBLIC a eiidrents. SEPI'ICI@', ACT Slc. 1.01. This title, ii@iay be cited i,; the "IIeirt. I)is@ise., Ciiieer, Citation of Stroke, and ]@id)iv3@ Disease -,k-iiieiidiiiei)ts of 1970". title. Si.,(,. 102. @Sc,-ction DOO of the Pliblic lle,,iltli Act. i@ aiiiei)ded 79 Stat. 926. to read ,is folloivs: 42 USC 299. ((SLC. 900. TI)e ])iirl)ose-, of this title, ,ire 1-ii-oii('Ii @)-i@aiits ,,.,id to ciicotti@ll t I , ,i)i(I ,issist in tile e.@,tiiijisl@3I)ellt of ).(",iol),Il cool)eritivc,, tiiiong ixiediezil selools, iiistiti)tioiis, and liosl.)iti-@li for and trp@iiiiii,@ eoiii iiiiiiiig c(li,,citioi)), foi- in(,(Iic,.il deal @t excli,iii,@re, tii(I for (leiiioiistr,,itic)iis of 1),ttic@iit c;, I-(,, in tile iicl(ls of lie,irt d cancer, sti-oke, tii(I l@idiiey tt)id otlier reliied diseases; 84 STAT. 121@)7 "(b) to til'oi-d to the III .(]Rival) ))rof(@,ssioll ',Ill(l I )Glen( jet] jilst@i- 84 STAT. 1298 tiitiolis of tl)c \'at,;oii, tlil-oii@li ,,,ilcli cooper,,itiN-e the ol)i-)orttiiiit3, Of to their tile, ]@it(@st ndN-,til@- Ili the I)revejiti0ii, (li@1,111114DSiS) Liid ti-c@zttiiiciit tnd bilititioiiof o P-j- liyik:ifes ,tiiioiig health (c) to )1'01)lot@ Ilid f ,t . n 't -P -.iojis - -idei-s so as to sti-eii(-,tiicit tiid in rove C, I , iiistittit t)id ])roA Ili I,-riiii,i.i-y care ,@,iid the i-elatioii,,Ii;.p between qiid pri- iiiarv cit re; and (d) by t)iese, means. to iiiii)roi-e g(@nerilly the quality and enhance the capacity of the )ie:iltl), i)lalij-)oNver and fi@iitic.3 to tli() Natioii and to iiiil)i-ove I)eiltli serN,ices for pei@,,(jn,-, recording in it,li Iiiiait-e(l lie@,tltli services, and to w accomplish c@iids Nvitiloii,6 iiiterferiiiz Nvitli tile patterns, or tll(@, iiiet)lo(ls of financing, of I)zLti(-Il'k, care or I)ra(,.ssionil - 'tli the ]practice, or vi , "t(ifflillistr,,itioli of liosl itils, 'Ilia ill coo]-)Pr- atioii with I)i-acticiiig I)Iiysici,,tiis, medical @eiiter' officials, I)o.@pi- tal administrators, ilid representatives ' froiii appropriate voluntary health tge))cies." SEc. 103. (11 1) 'Fli@ first se)it(@,nce of section 001.(a) of such Appropria:bions. @A-ct is qmellded by stril@iii_7 out iDiiii(,di,-Itel.N- 30, 82 Stqt. 1005. 1969,", iiid ))Y 'ill-el-tilli iiiiiiie(liatelv before. for gr@iiitS" 42 USC 299a. tle folio-%Vijl(,: $12;-),Ooo,ooo for the fic;@l year ending JuTe ",O, 1971, $150,f)00,000 for the fiscal A.e-,ir ciidinL, June 30, 1.972, and $250,000,000 for tile fisei I i-e@ir ending Jule -o, 19 7i, (2) c;iiclifii-stsciitc-iic(,@isfut-tlierainciideclbysti,il(ingoiittliepc@riod lifter "titl(@," .ind iiiFzc!rtiii@, in lieu. thereof "'and for contracts to carry out the I)iirposes of this Jules!) (3) Such st!cti(.)!i 901 (a) is tiyientled by out the second @,nds, limi- .@iitL@iiee and in lieti thereof tile, - fol"oyjil@l": "of tit(@, suits te-tion. ,tl)i)ror)i-iated uii(lei-tliis section fortl)c@, fis(-,,il,),car eiidinrr June @O, 1971, ]load iii-oi-e than $15,1)00,OW sliall be for ICtivit,ies in tile field V-or7 o Pub. Law 91-515 1970 Of )@idii(,-y dis(@:ise. Of tl'L' suilis lil)])rol)riite(I till(it@l' this sectioil for ,illy fiscal v@r cii(Iiiig )itiie I()l 194-0, )lot illo)-c thin $5,000,000 inay icil fiscal 3!(,@ir ft)i- t,r@iiits fol- 'ICNV ;Illy SI a-. f .Ilcll is fiii,tl)er ,ti))eiid(-cl I)y adding It the 79 StP-t 926; (1)) Sectioii 1)01 o . i,11(r oil: 82 Stet: 1006. end t)iL@,r(,of the folloNv . :I)lt, lill(ic,.r this title, the 42 USC 299a. -'I (P-) At the-, reclukest of ally of @l 91 of ,iyin@i,ts to stic-it - cil)iei)t niay I e )-)y the fair iiizlrl@et re a Ul)l)lies, 01- fiij@iii-@110(i 1).N, tilp to SU(@ll the qiiioliiit@ of i I i(, I)iiy, alloxvziiiec, tri-LN-eliii,, L@xi)Cllses, sts in connection Nvitll the (letitil of all oflicer or ein- a ol-.C).Illllc@)lt to the, recipient -ivllen stieli ftii-)lisliiiig or 84 STAT. 1298 s lie (,.a,,,e, iii,,iy lie, is for t.ie collN.el)ieiice. of iiid at the 84 AT. 1299 r i-c@cil)ieiit and for the, I)iirl)ose of oitt the @l al 111(@(licill I)i-ogrtiin to NN-Iiieli tlic,, gr@iiit iiii(Ic-r this title is 42 USC 299b. 101. Sect@oii '1)02(a) of such Act is 't)y stril@ing otit ,iii(I ti-ct,,Itlnellt i-clatiiig to heart, disease, cancer, or strolm, All(i It the OI)tlojl of reltted disease or diseases" and iiisertii)(,@ in li(!u I-lic@reof '@t Y.,"Lil)illg, I)i-evt@iitioii, diiipiic)si,;, ti-e-,itiiieiit, find rc-Iiiibilitqtioii i,@l,'Itiiig to heart disease, cancer, stroke, or kidney di@is(" "I)Itl) it the option of the aj)plie4ii)t, otliel, related dise.t.w,s,@. (b) Section 902(f) is ,iiiieilcl(@(I I)y strikiii,,,@ olit ;'includes" Iiid iii.@(-,i@ing in liell t)ic@reof "i)ieiiis new (,oi)stj,iictiol) of f@icilities for denioiisfr,,itiojis, research, -,lead training -,wheat necessary to Carry Olit regional treasurer] pro-rtins'. 42 USC 299o.- SFC. 105. Section (4-) of sti(,li Act is ainciidecl- (1) 1))y -@trikiiigoitt"voltiliti,)-y)i(i@ilili igeiicies, ,tiid" ,iiid insert- in - in li(!ii tl)er(@f '@vollillt"lry Or Offi(-iftl lie@litli ac,elicies, Health 9 (2) of it first tll,e,l,eill, the foll'onviiig: ;'(iiicliidiiia as ,iii ex I-icio inciiil)ei- if there is located ill .;iicli religion ol)(@ ()I- i@@oi-e hospitals or other lie5altli facilities of the Adiiiiiiisti-atio n, the indi- i,iduil I oiri tl-te Adiiiiiiistr-,itor of @'et A IV I crtiiis @ki'-.,iirs sliill designated to serve oil sti(-Ii advi,@,ory gi,oiii) its the of the or other health ciii@c facilities of SI.icli Adiniii- istratioii NY'lijel) locited in -catch ,iiid (3) by St-i-ikiiig oiit "held for the, 1)roN-ided leader the pro-rani" ,tiid iii,,ertiiia in lieii thereof "need foi- iii(I fii)"Illcil)r-r of tjie@services i))-ovicl(-,d ,iiildcr the and Nyllieli advi@ory group sliall 1)'c, siifl'lcieiit in niiinber to iiisui-c I(le(filite coliiiiiiiiiity orici;tation (,is detei-iriiiie(I bv the Seeretii-v SFc.. 106. That part of the, second Eciit(@iiee of section 1)04(b) of ,iicli 42 USC 299d, Act precediiic_r 1)ai,aLri--,ipli is ,tiiieii(le(I I)v striking oiit @section 903(i)) (4) q-nd airport leof " the. '-Section 90,3(b) (4), if ol)l)ortiiiiitV de(l, 1)rior to -,iieli i-ecoi-n- rneiid,,tt.ioii, for coii-;iderqti( t tioll I;v ea(-Ii 1)iiblic or iloii- profit private i(_rejiev or or cli ]la,.; (leN-(!Iol)ed a coiiii)i,e- lieiisive r(@gioiial, iii@ti-ol)oliLiii re or o liei@ local area i)l,,iii r(tfei.red to in s tioll 14 (1)) coveriii .1 Iiieli the l@egion@il )liL,(Iical (-r 'II v I.erL ill -,v proL-,r,,tin for which tll(. ql)])Iiciti'oii is Yil-,ide Nvill be. located, iild if the Rj)li]iC',Itioii". National Ad- SFC,. 1,07. (-,I) Section 90.@)(it) of siieli A(-t. is viiieiided to read R-, visory Council follows: on Regional IISFC. 905. (,,t) The Seerctii-y inty -,II)T)Oillt, without rezal-d to the 14edioal Pro. civil service, laws, 11 @N,,,itioiial -kdi-is@)ry'Coillicil oil 1,e(rionitl '-Nfedical granis I 0 1'rograins. ']'lie ('oillicil Shia]) coil,,-iFt of tli(, Assistant Secretary of 42 USC 299e. October 30, 1970 - 3 Pub. Law 91-515 84 S'I't@T. 1300 I)L, tll('. Cllftil'l))ZLII, ill(rc-iliL@f T)ii-c@ctoi- Of tl)L', Adiiiiiiist),;itioii wlio sli@tll l@c., ,tii ex t)flieio ;iii(I tiN-e))ty i)lejii- t--iiited ))el".,;, I)Ot ill tile ciiII)loy of tll(@ ;II-e, ill tll(@, of 111(@ the lic,,,Itli r)]. @kt, ]('@tst, tN%-o of ill(', sliii)] I)c oii(@ (;Iiall I)e, otitcit@liitlll.@L, ill tl)(, @@ill(ly (,I- I)e:iltll of' fi-oill di.@i,:;@, oiie ,Iitil 1)(@ Olit@titil(lilig ill tll(@, Sill(]V (I]- ll('@litli @ire, of 1)(@rsolis fi-oill olie Slizill 1)(! olit.-,Itlll(lillo' ill t)@(@ ','t 11(13r ol- of l'i-oiii sti.-()k(@, ojie, sli;ill I)c oiiist@kii(]- z iii tli(-- stiidN@ ()I- li(@iiltli of 1) fi,oll) iNvo sliall lie, iii tile of i,liti(ill ol' ise disease,, sti,o)@, oi@ dise;i-@e. foiii- sli;tll 1)(@ 0 the '(],)) Of tli(, 1)(,i-soiis fir,,t, :il)l)oiiii(@ 'd @,(,(@tioll of filc@ Tenn of I' ililic Act to sc@IIN'(, Its trick ()Ill. I(I(Iitioll"ll of the N,,itioiiil ('Oiill(,il oil .e ize(I 1)13' tile I)IICII(Iiijci:it ij-itde li stil)@ etioii (it) of iliis sc@ctioii-- ()I)e sil,,Ill foil- t(-)-IYI of ol)(@ Oil(- sell]] fol. tel,i-fi of ti@-o Ollf-' still] 1;(@l-ve fol- ,I tel-iii of iiid (4) oiii-@ s])@ill l'o)- it t(!i@i)i of folli, .IS desigii:it(,(] I)v the of 11(@tiltli, aii(I 11'eli'iii-e it tile, til)]C of oil ro., aiii,; (o',Iiei- tli@iii tli(,@ @iii- eoll Geliei-:@l ) ill Oil Ill(' (I;tte of eilactiiickiit ol.' this Act .-,Iiall coi-itillll(,' ill ol'ill('i! ill tei-iii of oili(,e foi, they were I:ist :tlil)oitit(,d to the SF,C. 108. @@ectif)ii !)07 of Act is al))Cll(l(,(l l)-v olit @'@Or 79 St@it. 930. Ill(] ill ;SI:).oke, ol- 42 USC 299g. oil t)O( 42 USC 299i, Src. 109. se(,ti )(,i) ol' sii@li Act i,, ))y iii@(@i-tiii "o, (,Oiitr,tet"' -,ift(,r "gi-aiit" it tlici-eiii. SFC. 110. (,-,) Sceiioii 910 of sll(-Il @k.ct is to I-eil(I @'S folioNvS: 82 Sta.t. 1006. 42 USC 299J. il)li)i,oved ii:ltioil@il cal):il)ility for (if )Milli t:it,yis,itit'i-ioi,iv(,dto 1-itiliz(@ to )airline, @'ji,ilits to I)III)Iic ol- iloill)l-ofit ol, ilis@ittitiolis 01' COIII- I)i)i,ttioiis tli(@,t@(-@of ziii(I to cotitj,:tct for- prog 'Liid activities of stibst,,iiiti-,il iise to r;lllls, sej,%,)(,e", , two oi- illoi@e I-egioll.11 I]lC(l i(-,l I PI-o(-,I.Ztlll",; "(2) ol. (](@illolisti.litioii of iiictl)ocls foi.- Coll- .'trol of lie;trt sti-oiie, l@idiiev dise:ise, oi- ol,lici, i@(-@l;lted d iie@, i.@ s 11(3) ilie @iii(I ,ttt(lv Of (-I)ideniiolo,,@ic (Izita related to aiiy 6f t)ie disel@ises ilclfei@-i-ed to iii -"(4) de%-elol)iiteiit of ti-,iiiiiii,, SI)eeifi,,,-:Illy to fl)(@ I)]'C- ventioii, di;tgiiosis, or ti-ezttjiieiit of iii3, of tile (liseits(@s )-ofeiired to ill ol- to tl)e ),-el),Lbilitit ioii of I)ersoii-, f-roiii @-es; ;iiid foi- coiiiiiitiiiig 1)1.0(,rl.llllls of siicii tr-,iiii g(@, of traiii(-,d NN-oitid otliei-Nvise limit NN-le "re lilid siiills iiiil)ol-t-,iiit to tile coiitrol of Ill aiid It (,t of coolieriitive cli)iieil lie](] trials. "(b) Tile @cei-t@ttti-y is iiitlioi-iz-,d to ts@ist. iii tile costs of s eci,,tl projects foi- iiiil)roviiig or dcvclol)iii,_, iiew Ilicillis l'or the (leliv- p @.ry of fl(@altit @er%,j(,es (,f)iicei,iic@(I witli tile- (li'seas(ks Nvitli iN-Iiieli this title Pub. LaV91-515 4 October 30, 1970 64 STAT. 1301 dies, 11(c) 'ilic Seci-c-tai-y i.,;.,tiitlioi.-izecl to SuP])Ol't research, ,II ti-ztiniiig, (1@@lioll@trittio]ISI -to iliaxiiiiiz(@ the titilizatioii of air tjie doliN7c@i- y of health 111. (,i) 'riie to title ]-\, Of silc@ll @%ct is @iiiiei)de(l by stril,ii@L, out AN]) tiid iiisert- D OT] IER 42 IJSC 299b- 904:(])), 905(b), -VOU 906, 90-t, iiid ()09(,t) of sii(.-Ii Act I)y the I)i-occ@diiig 299g, 299i. I)t-oN-isioii,; 'of t)@i@s Act) ii-e further 1)3, striking out tirgeoji e,.icl) it. al)l)c@ii-s therein Lil.d ilisortill(r iii li(@,u tliereof ITIE II-A!iIEXD@lE@NTS TO 'FI'FI,E III OF TI-IF, PU lll,,'.N-LTII SEIZVICE ACT H IZT A-R)r-Sl@:A)-,Cll ANI) II!-,),ATING TO 1, li'Acil,ITILS A-.\I) Sl;ilvi@cils - . (,q) (1) Sectioii 304 (,,t) of tli(,, Ptil)l@le, Ifealt@li 9'ervice Act 81 Stat. 534. 42 IISC 242b. (!d- lliiiiic,.(Iilt(!Il, after 301. (a)"; (A) ,tiid (B Laid ig claii-,(,.s (A), (11), (C) as cl,,Illses (2) Act is aiiitiid(@,d- (A ri ii,- out (b) " iiid iiisci-tiii(/iii lieu, thereof 11 (9,) by St all(I (B) b@? str @i.ii- tliereiii fLDd ii) thereof ';I@li;s sii])F;O"ctioii". Secti-ii 3c)-l. (c) of.\siieli Act is :i)iie3iiied-- ii (, out "4t Iiis section"' lilice, it, al)l) (r 11 (A) b), striiiiil(,y ot@ (c alid i@i@erLiii i lieu tl)ereof '1(3)"; all(I (13) ])Y,Stl-@]@i@g OIILI J)IlC(', it ip],)etrs theraiii aiid ii iicii the) c@Qlf slil-)Sectioii@'. (b) Sectioll 36-1 of such Act ftirtl,.cr I-ly i(lliiig :tfter the Oi,i@;ioji tlicrc@of (6) by siib-ectioii (3) (A) of tl is scct;oii the fo "I"I-Illl- neiv siil),(@ctioli: "Systclii,3 Aiialysis, of \"tti\oll,,Il J-fc-,,tltli Care, Plalis (b) (I) (A) The S(!C@etirv sliall (i@elo , through utilization of i t, .., ' p the systeinc s ii)o'liod, plaiis for livtltli care s),steiiis designed lideq@t,.itely to meet t,'.(,, health iiec,,(Is of Aiiic@rica)l i)eoi)le,. For pur@oses of tl)e 1)rccedi)ig seiitejice, the qyFteins i-nc-thod means the ,iilill),tie'lil method I)y Nvliicli vario@IQ iiie,tjis of obtiiiiiii EL desired result or @o:il is issociated with benefits invoIN-ed. "(B) The Se@@tii-y sli,,ill complete the (leN,el i)l)iiieiit of the plaiis r(-.f@rr@d to iii (A), witlii)i -much ,is i)i,.iy be ii(,ce-s- Report to to enable Iiiiii to S11I)nlit t6 the COII,(@res.; ilot tllaii sel)tem- Congress. her 30, 19TI, a report tliercon ivliieli sliall dose so eveloi)ed i@ terms of- the iiiiiiil)er of r, ol)le -%,who Nvoiild be the the Iii)id Iii(I type of lie,-tltli care -,vliiel red lie 1)1,111; the, cost in%-olN-(!d iii carrying out the cli ould be financed; 0 0 0 Regional I-ledical Programs Bud-et LI Esti.niatc,, liou@@e Senate Yc@ar to Congres s Al.l.o@.7,ince Alloiqance ApprQi-)ri.,ition 1966 $25,000,000 N.C. I/ $.25,000,000 $25$000,000 1967 45,024,000 $45$004,000 45,004,000 45,004,000 1968 64,314,000 54,314,000 64,31-4 000 58,814,000 1969 68,922,000 N.C. 1/ 68,922,000 61,907,000 1970 2/ 1 .00,000,000 76,000,000 1.00,000,000 100,000,000 1 2/ 96,502sOOO 96,502,000 115,000,000 116,99OsOOO 72 2/ 52,771,000 82,771,000 122,77lsOOO 102,771,000 1973 2/ 131,287,000 1/ Not considered., 2/ Includ viously supported under the appropriation "ChTonic es programs pre diseases," for comparability. February 28, 1972 Budget History - Grants (In Thousands) FY 1966 FY 1967 FY 1968 FY 1969 FY 1970 FY 1971 FY 1972 FY 1973 Authorization ............ $50,000 $90,000 $200,000 $65,000 $120,000 $125,000 $150,000 $250,000 Appropriation ............ 24,000 43,000 53,900 56,200 73,500 99,500 90,500 120,800 Add: Balance brought forward from previous year ..... --- 21,934 b/ 25,900 36,165 20,000 15,298 44,500 Less: Amounts helif in reserve by BOB ......... 21,000 30,900 20,000 15,000 44,500 --- Amount available for obligation ......... 24,000 43,934 48,900 72,365 78,500 70,298 135,000 120,800 Less,. Amount obligated.... 2,066 27,052 43,635 72,365 78,202 70,298 135,000 120,800 Lapse .................... --- 11,982 c/ --- --- --- --- --- Balance carried forward.. 21,.934 4,900 5,265 298 --- a/ Appropriation request. b/ Available through December 31, 1966. c/ These funds were appropriated for fiscal year 1966, available for obligation until December.31, 1966. They lapsed on that date. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE h Administration Health Services and Mental Healt History of 1973 Estimate Department OMB reduction Estimate Depar@ment reduction from 1972 to Estimate Presidentis frcm agency Department Appropriation Department to OMB Budget request Submission Posi- Exi)lanation ons Amount Appropriation egional Medical Programs $100,554,000 $152,815,000 $140,616,000 $131,287,000 $12,199,000 $9,329,000 Department Reductions: Grants: Construction --- $5,000 000 Regional medical' 5,813,000 programs, Direct operations: Technical assistance and disease control 48 656,000 Program direction and nagement services 62 730 000 ma Total, Department Reduction ............ 110 12 199 000 OMB Reduction: Grants: Health maintenance organizations --- 16,200,000 Emergency medical services +7,000,000 Direct operations: Employment reduction 8 129 000 8 9 329-000 Total, OMB,reduction -