qe
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
PUBLIC HEALTH SERVICE
| $000 ROCKVILLE PIKE
BETHESDA, MD. 20014

 

REFER TO:

July 24, 1968

Dear Mr. Ruppe:

This is in reply to your letter of July 3, 1968 to Mr. Karl Yordy
requesting additional information regarding the relationships
between P,L. 89-749, Comprehensive Health Planning and P.L. 89-239,
Regional Medical Programs.

These two programs are authorized by separate pieces of legislation.
While it is quite true that their long-range objectives are neces-
sarily the same-~better health care for all Americans, their short-
range objectives and their mechanisms are frequently quite different.
For example, the Congress has required that the Regional Medical
Programs specifically focus on the three principal "killer diseases"+~
Heart Disease, Cancer, and Stroke. Comprehensive Health Planning,

by definition, is noncategorical, Its legislative history is replete
with the Congress’ desire to decategorize and consolidate the several

_ categorical grant programs which had previously been funded under
Section 314 of the Public Health Service Act. Both programs, therefore,

'- have attempted to increase the flexibility of regions, states,

.» localities, and individuals in applying for Federal funds to implement
-. programs which qualify for support. Frequently then there is program

planning which is carried out under both programs. So long as these

" efforts are dovetailed at each level, these mutual efforts cannot

a help but enhance each other. This kind of interrelationship at the

 

“gtate and local level will reduce the possibility of unnecessary

duplication to an absolute minimum. At. the Federal level, the comple-

-.' mentary relationship between the two programs has just recently been
» veinforced, In its report to accompany’ H. R. 15758, the extension of
"= Regional Medical Programs, the House Interstate and Foreign Commerce —

(~  Gommictee stated:

 

“The: committee notes that ‘there ‘are obvious relationships
a between the activities being deve Loped by the regional
medical programs and the comprehensive health planning
lyse activities now beginning under the partnership for healta
cio? .-program, The committee recognizes that both programs are
; dust. getting aeented but. ‘the coumi ttee believes that these

 
~2-

‘programs should have a complementary relationship.
“It expects that the administration of both programs
will be carried out with effective cooperation and
interaction at the Federal level in order to avoid
duplication of activities and potential conflict :
between regional medical programs and the comprchensive :
health planning agency in the field."

A region under P.L. 89-239 nay include several states, 4 single state,
or a portion of a state such as a metropolitan area. There are
numerous examples and all of these alternatives, although és Mr. Yordy
oe indicated to you in his letter, the Michigan Region under P.L. 69-239
cee is coterminous with the state's boundaries. There are, however,
instances where there are indirect yelationships to another region,
such as those of the Upper Peninsula with Wisconsin. From our
perspective these kinds of relationships are beneficial to the
_. development of both programs as well as being in the spirit of the
... flexibility with which this program is being administered.

 

State government is actively involved in the development of both
PLL. 89+239 and P.L. 89-749, although this involvement differs in

_ both kind and degree depending upon che particular circumstances.
-For example, Federal funds under Section D of P.L. 89-749 arc grants
to state agencies awarded on a formula basis. Regional Medical
Program grant funds on the other hand ace made available to Regions

 

rE on the basis of projects to be carried out by the Region, State
moe involvement in these project grant programs is essential albeit :
different from its role in the formula gvant programs. was

oy) 2%.% am hopeful that this information in concert with that contained in
“MY. Yordy's letter will be helpful. “Mx. Yordy, by the way, has just
“become the Director, of the Office of Program Planning and Evaluation
o£ the Health Services and Mental Health Administration. This newly
»- ereated Administration is responsible for both Regional Medical
- Prograns and Comprehensive’ Health Planning at the Federal level, a
eo further means for coordinating these. efforts.

   

     
   
 

 

 

 

 

If ther ave other ways in waich an be helpful, please let me know. fone

   
 
  
  
   
     
  

 

i arely yours,

 

 

set arr m ae i.

ep A AE a gis bs

rs “uy Wee Ls, veh : rue wat
:

“Donald R. Caddwick, M.D.
Acting Director . ae
Division of Regional Medical Prograns -

 

i

Honorable Philip E. Rupp
House of Representatives
Washington, .D.C..'- 20515