gg Major Changes in New RMP] Legislation Present Legisla P.L, 89-259; PLL. LION Vey qt. 20-574 Legislation as passed in House and Senate Construction Authority Heart disease, Carnce and related diseases. making ay st advances i 4 nosis and treatment, Se, CaMmcecr, stroke a allable n diag- and on. cooperative arrangements for research, training and re- lated demonstrations of patient care, Limited to ‘alteration, major repair, remodeling and reno- vation of existing buildings... and replacement of obsolete built-in equipment of existing of cost. buildings," up to 90% Adds kidney aseeniia and other related diseases . Promotes medical data ex- change as well as research, training, and demonstrations of patient care; medical data exchange relates directly to kidney transplants to include data exchange betwcen tissue typing banks and, on a re- gional basis, among medical . schools, hospitals and other institutions and providers. . Adds prevention and rehabil- itation explicitly. . Gives additional emphasis to regionalization of health care resources and services in order to strengthen and improve (1) primary care and (2) the relationship between primary care and specialized care. . Concerned with increasing capacity as well as quality, and with areas with limited health services. Adds authority to include "new construction of facilities for demonstrations, research and training when necessary to carr out Regional Medical Programs." Present Fegistteion P.L. 89-239; P.L. 90-574 Legislation as Passed in House and Senate Mili 1LONs } Ons} Funding Regional Advisory Groups ~ None specified in law. Grants, with two-year availability of funds. Composition: Requirenent there must include "mracticing physicians, medical center officials, hospital ad- ministrators, representatives from appropriate medical societies, voluntary health..." and other health-related agencies...'' and members of the public...''familiar with health needs. Requires that the appropriate sojonal, metropolitan, or local areawide comprehensive health planning agency 314(b), have an opportunity to consider operational grant proposals before the RAG may recommend approval. Three-year extension PY' 71 $125 RY'72 150 rY'7S 250 Includes provision that no more than $15 million shall be available for kidney disease activities in FY'71, and also includes a $53 million discretion earmarking for new construction. Adds contract authority as well as RMP grant authority, and would permit Regions to obtain services in- -kind from Federal agencies. One-year availability of funds. Requires official health and health planning agency repre- sentation on such advisory group requires that public members include persons familiar with the financing of, as well as the need for services, and that suck public members be sufficient in number to insure adequate com- munity orientation. Also includes a representative ¢ the Veteran's administration as ex officio member, if there is é VA institution in the Region. Present Legislation P.L. 89-239; P.L. 90-574 Legislation as Passed in House and Senate 8. Council Listing. of Advanced Facilities Advisory Council responsible for RMP matters. Sixteen members - leaders in fields of fundamental sciences, medical sciences,or public affairs. At least 2 practicing physicians, one expert each for heart disease, cancer and stroke. : Lists of facilities equipped and staffed to provide the most advanced methods of diagnosis and treatment in heart disease, cancer and stroke are to be established. Provides that the Assistant Secretary for Health and Scientific Affairs of HUW shall be Chairman, replacing the Surgeon General in this positio Mekes the Chief Medical Directo of the Veterans! Administration an ex officio member of the Council. Tncreases the size of the Counc from 16-20 members. Provides for: (1) one member who is out- standing in the study or care of kidney disease; (2) leaders in the field of health care administration as well as the fundamental and medical sciences; (3) two members outstanding ir the field of prevention of heart disease, cancer, str or kidney disease; (4) four of the twenty should ‘members of the public. Adds a similar requirement for kidney disease. 4 Present Legislation P.L. 89-239; P.L. 90-574 Legislation as passed in House and Senate 10. ii. Multiprogram Section S10 General Authorities Provides for grants for services needed by, or which will be of substantial use to, any two or more regional medical programs. All authorities and de- terminations under Title IX, including the awarding of grants to Regional Medical Programs, are exercised by the Surgeon General of the Public Health Service. None specified in law Provides for both grants and contracts for a broad variety of activities including: activities of use to two or mor regional medical programs, deve opment or demonstration project collection of epidemiologic data, development of training, and conduct of cooperative clinical field trials. Also authorizes assistance in meeting the costs of special projects for improving or developing new means for the delivery of health services concerned with the diseases included in this title. Authorizes support for research studies, investigations, traini and demonstrations designed to maximize the utilization. of mar power in the delivery of healt services. Authorities and determinations exercised by Secretary rather than Surgeon General. When a single project receives grants from two or more sources within certain parts of HSMHA, the Secretary may issue regulat under which administrative functions with respect to such projects will be performed by < single administrative unit; ap- plications may be consolidated: and duplicative requirements revised Present Legislation PLL. 89-239; PL. 90-574 Legislation as passed in House and Senate 12. Joint Funding (continued) 13. Annual _ Report None specified in law. Limited to projects funded unde Sections 304 and 314 and Title of the Public Health Service Ac This includes Regional Medical Programs, Comprehensive Health Planning and Services, National Center for Health Services Research and Development. Provides for an Annual Report from the Secretary on the ac- tivities carried on by the prog covered in this legislation.* Jt will cover an evaluation of the effectiveness of the progra relationship between Federal an non-Federal financing; and reco mendations for changes in progr legislation. * Rather than a compilation of separate reports, this is desig to be an overall integrated report covering the coordinated range of activities of Regional Medical Programs, Comprehensive Health Planning and Services, National Center for Health Serv Research and Development, and t National Center for Health Statistics. ** Jn addition, the Conference Report calls for a‘separate’ stu and report on the appropriate scope of Regional Medical Progr: in relation to disease coverage whether or not the scope of the program should be expanded to cover "other major diseases and conditions."