we 1é manana Se ALABAMA REGIONAL MEDICAL PROGRAM RM 00028 MAY/.TUNE 1974 REVIEW Request: $2,648,439 Committee Recommendation: $2,028,389 Overall Assessment by Individual Reviewers: Above Average Critique: The present Director has had extensive experience with the Alabama Regional Medical Prograin, vacancies that have occurred on the staff have been filled very promptly with qualified people and in spite of the threatened national phase-out of RMP, both the Review Committee and the Regional Advisory Group have remained active. The membership of the RAG is adequately represented by providers and consumers from each of the region's 10 CiIP 'b' agencies, Also, the Director of the "al! agency is a RAG member. The region has been very successful in attracting local support for the continuation of its programs. ''The program presented, both proposed and ongoing, are timely relevant, and appear to be viable." The reviewers believed Alabama has achieved a viable outreach program and has prioritized its cbjectives. Although it is not unique to this region, the Alabama Regional Medical Program is continuing to attempt to equalize its minority representation on program staff, project staff and its committee memberships. The reviewers arrived at the reduction in the recommended funding level (from $2,648,439 requested to the recommended $2,028,389) by considering some of the programs, both continuing and new, to be of a low priority in a one year time-frame. For example, the Trophoblastic Disease request, the requests for Cervical Cancer Screening and the Immunoflourescence for Renal. Biopsies were considered of low priority. At this stage of RMP development, the reviewers believed the project request for Audio-Visual Assistance in Educating Hypertensives should not be funded and that the Tequest of $151,000 for PSRO should be reduced by $100,000. JULY / AUGUST REVIEW Estimated Request as of May 1974: 1.1m DRMP /DOD SCOB/6-5-74 MAY REVIEW STAFF SUMMARY Prepared by: Joe Jewell ALABAMA REGIONAL MEDICAL PROGRAM 1108 South 20th Street Birmingham, Alabama Margaret Klapper, M.D., Coordinator On duty since 7/1/73 Full-time Professional Staff: 8 ~-~-------------- Total Proposed: 1] Part-time Professional Staff: 0 Full-time Other 200 3 penne ere Total Proposed: 9 Part~time Other : =O FUNDS REQUESTED: Total Costs - $2,648,439 Program Staff - ($600,494) Target Figure $1,891,872 (7/1/74- Continuation - ($565,005) 6/30/75) New - ($1,482,940) Estimated July Request - 1.1m Period of Time Requested: Currently all activities are to terminate 6/30/75, or before. However, if permitted, several activities EMS PROJECT: may benefit by being extended (lag time etc.), in time only, via a contract route. No new EMS proposals. There are requests for continuation of five currently funded programs: #42, #43, #53, #54, & #55. None of these exceed by 15% the annualized previous budget. PSRO: #103 is an information and training program for persons who will be required to supply data etc. for PSRO purposes. KIDNEY: No renal activity currently supported. #100,although entitled renal, is aimed primarily at cancer. CHP COMMENTS: The top of Alabama Health Planning Agency (page 77) endorsed a proposal from the Alabama Health Systems Foundation (North Alabama Health Information and Education Program). The proposal was disapproved by the RAC as not a high priority as it relates to the region's current objectives. The district IV "b" agency in Gadsden, Alabama endorsed five proposals which RAG approved. A sixth proposal, (Health Resource Planning), was endorsed by the planning agency but failed to pass RAC who preceived it as being a basic CHP function. Page 2 Alabama May Review Staff Summary The CHP "A" agency director's review, appears on page 84. He is a member of RAC. He noted some of the projects sent to him for review "Do not conform with the current RMP mission; however, that decision is the business of RAC." Staff notes that the current submission did not include all of the 35 projects referred to and since Mr. Blanks sits as a member of RAC, we believe his objection was overcome by the actions taken by the members of RAC. DRMP / DOD SCOB:5/15/74 REGUESTED @.... - 974 COMPONENTS BY REGION ck 06/74 COUNCIL ALABAMA PROG YR_ 05 TH CENTRAL COMP COMPONENT TITLE a NO LL COCO PROGRAM STAFF . C010. MULTI MEDIA LEARNING SKILLS LI@RARY "042 EMS DEMO BIPMINGHAM 043 ALAEAMA E MS P 053 E CENTRAL ALA EM S ~ "054 WALA EM S$ SYS 055 NE ALA EMS 059 NOSP BASED CARDIAC OUTREACH 064 PEDIATRIC PUL 066 STRENGTHENING LOCAL PLAN O71 HLTH EXTENSION LEARNING 7 072 DISTRICT 12 E MS COUNCIL ORGAN O73 CONT ED DETECT HYET O77 ALA TOMBIGKEE AREAWIOS CH P : 079 SURVEY DEV HYPT 15 COUNTIES CH2 A Vv ASSIST EDUC HYPT OB5 AUTURN UNIV BASED HYPT ED . O&8 | STRENGTHENING LOCAL PLNG DIST 12 ANNISTON C9€ (Cubbman CNTY DENT HLTH a07 TELe COMM SYS HLTH PROF COR -TRNG NSONATAL INT CARE FORMATION STATEWIDE ADSRY COCR COUNCIL HYPT DIRECT REQUEST 4662984 604500 734355 44,600 559397 37,9130 254390 159420 399779 227764 249396 249144 499934 56375 5,000 6991 24,607 184963 145550 249760 379280 274323 INDIRECT REQUEST 1335510 0 7-726 762 7,96T “725 99450 1,332 OSM-PW TOTAL REQUEST 6002494 60,500 81,081 44,600 559397 379130 254390 154420 39,5779 222764 329366 249144 669269 56,375 59000 Ty, 753 329574 18963 14,550 299485 465730 28,655 ~23 , MAY T4 ; - REQUESTED ,@.... COMPONENTS BY REGION 06/74 COUNCIL LASAMA . PROG YR cs CENTeAL Ss COMP "COMPONENT TITLE ee ND ee 100 IMMUNOFLUORESCENCE RENAL BIO 101 ALA_UTEROCERV CA SCREENING 102 WEST ALA MED CARE STUDY GREENE CNTY 103 PS RG REG TRNG 104 GAOSULEN STATE JR COLL HYPT CNTRL “105 MULTI DISCIPLINARY HLTH ED 105A , MULTI GISCIPLINARY HLTH ED 106 BRD LEVEL CARE HYPT AND HT DIS 107 TRNG KLTH PROFS HYPT ise TANG NURSG HOME PERS 10¢ CYTCTECHNOL TRANG SCH 110 WW ALA HOSP DEV 11 MORTLE CG CA SCREENING . 112. MOBILE CO HIGH eB P EOUC 43 MOS TLE CO HLTH EMER CMNC : 114 HLTH MPNPWR JTILIZATION & DEV PENG 115. FEADERSHTP TRAG NURSG SERV ADMIN 116 - REGION III COST CONTAINMENT CONF 117 REHAB FACILITY FEAS STUDY 113. DEV PILOT HYPT CNTRL 119 HOSP FACSMILE INFO SYS 126 INVENTCRKY PROF HEA INFO SERV DIRECT . REQUEST 49,725 114,010 4680 151,701 "39942 559866 562666 17932 629546 169706 145592 3979955 75,000 689737 31,7900 26,620 359610 9,657 252000 1424530 677403 59,887 INDIRECT . — REQUEST 8736 0 702 0 0 209372 17,415 0 39564 79470 0 16,012 OSH—PWBO TOTAL .. REQUEST 582455 114,010 5382 151,701 39942 765238 14,081 173932 66,110 16s 706 147592 399955 75,000 68,737 3217000 269620 35,610 9657 25,000 15C, 000 674408 T5899 MA 974 _ a REQUESTED @..... OSM~Pw ~23 COMPCNENTS BY REGION 06/74 COUNCIL ALABAMA _PKOG YR 05° fH CENTRAL comp COMPONENT TITLE DIRECT INDIRECT TOTAL _. NO. REQUEST | REQUEST REQUEST 121 TROPHOSLAST DIS ENDCCRINE DX & FOLLOW UP 109788 - 720 11,508 122. INDIVIDUALLY PACED TRNG MCDULES HEA ADMIN 369545 41050 409595 ae “123° MAP ABSTRACT HEA STAT ALA 1971 . By422— 9264 BG 124 ANAL EVAL REFINITIGN NU&SG SERV JOBS 375196 0 374196 ‘F COMPONENTS. 48 . . ee — REGION TOTALS . 223789363 .270s076 296482439 RMP ALBANY RM 00004 MAY /JURE, 1974 REVIEW Request! $1,066,175 $1,066,000 Gommnittce Recommendation: . Overall assessment by Jndividual reviewers: Superior Critique: The reviewers believed the Albany RMP to have: Excellent program leadership Experienced, competent staff A strong, active, dominant RAG Excellent past performance Goals and objectives realistic and based on identified needs of the Region Proposed activities are consistent with goals and objectives (No CHP-b agencies in this area) JULY /AUGUST REVIEW Estimated request as of May 1974: $455,000 ‘ , . RM 00004 eae nt NT ALBANY Regional Medical Program Coordinator: Girard J. Craft, M.D. On duty since: 1966 (Coordinator since 1/73 Staff: Full Time Prof. 7.7 Proposed: 9.7 Full Time Other 10,2 10.2 Total 17.9 19,9 Funds Requested: Total .cscecrececsceceees 1,066,175 Continuations.rcrcaesevess ( 732,461 ) (projects); 333, 714 Program Staff oe -” ( ) Period of Time Requested: July 1, 1974 to June 30, 1975 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) : ‘ RM 08004 Albany List any continuation project or staff activity for which substantial increase over annualized current funding is requested. 4 . : HMO project: C005 - 11,140 - This activity will facilitate the development of an HMO in the Capital District area predicated on capitation and the provision of comprehensive and continuous range of services as a viable alternative to existing health care plans. . t 54 EMS project: CO11 - Emergency Medical Service Feasibility Study - 52,920 - This represents a cooperative endeavor which relates to the conduct of Project #45. Project #45 - Upgrading EM Care in the ARMP Area - 138,600 - The goal of this activity will be to establish and support the expansion and imptovement of existing communications facilities : | psro; C003 - 15,800 - This activity is to provide technical assistance in the development of four PSRO's in the ARMP region Kidney; Project #44 - N.E. New York Program for End-stage Kidney Disease — 158,197 - This program will provide adequate therapy to patients with end-stage kidney disease by expanding the patient base, facilities and trained personnel for their care. CHP comments: There are no approved operational CHP "b" agencies exclusive to the ARMP, This application was submitted to the Upper Hudson Regional CHP Agency for their considered information. The 1 ot , application was also submitted to the CHP “a” agency. E0/5/20/74 * COMPONENTS. REQUESTED FUMMMPLISTING COMPONENTS BY REGION MA 974 ALBANY PROG YR O07. ERN comp COMPONENT TITLE ce NO Co00 = PROG:_ STAFF 6663. PSRO FEAS «6004 ~~ CHP OFEAS SO a ~~ €Q05 «HMO: -FEAS coll € mS FEAS "C912 COMMUNITy HyPT FEAS COl7 DEVELOP HLTH SERV. AGY FEAS - 920 $0 END COMMUNITY HLTH CTR rs! CARVER COMPRE COMMUNITY HLTH CTR a 022 TRNG DEL HOME CARE — 029 COMMUNITY HLTH EDUC SERV "639 EXPANDED CONCEPT HOME HLTH CARE — "044 ONE NY PROG END STAGE KIDNEY DIS 045 UPGRADING EMERG MED CARE " (047 RURAL HLTH ACCESS STATION 048 SUNNEN DEATH 049 HLTH CARE COMPUTER RESGURCE 1? 06/74 COUNCIL REGION TOTALS DIRECT REQUE ST | 22249763 109250 164200 _ 7150 32,700 8y150° " 17,300 24,833 247000 293000 579445 37,716 106,242 1389600 119160 10,875 299570 7833954 INDIRECT REQUEST . 110,952 $9550 6180 34990 174220 49240 94270 74200 6,000 102010 17,018 14,140 51,955 0 34492 5,775 99330 2824221 OSM~PWE TOTAL REQUEST 3339714 15800 222380 112140 492920 12,290 269570 32,033 30000 392010 T43463 512856 158,197 1383600 149652 169650 38,900 12066,175 a -23 RMP oO Ldn he SAIL | RM 00055 MAY/JUNE 1974 REVIEW Request: _ $1,351,128 Committee Recommendation: $860,000 Overall assessment by individual reviewers: Below average Critique: Arizona is considered below average for several reasons, none of which is of recent origin. Non-compliance with DRMP guidelines concerning grantee-RAG relationships has made it necessary to withhold certification of the review process of the Region. It appears, also, that individual representatives of the grantee may unduly influence the programmatic direction of ARMP, includ- ing program staff. activities. Finally, the leadership ability of the Coordinator is questionable. The RAG membership, which is appointed by the Dean of the Medical School, has recently been increased by six. The staff appears stable. , To the Review Committee, this appeared to be a pedestrian appli- cation. Future support of the continuing education program is still under study. The region needs encouragement to move out of the urban areas and to focus on rural health problems. The Regional Advisory Group is scheduled to meet on June 20, 1974 to review new by-laws. ARMP staff will be in contact with the — Region to determine what progress is being made in this regard. “The Committee recommends approval of the application at a reduced level of $860,000, pending final resolution of the RAGegrantee relationships and verification of a review process. JULY/AUGUST REVIEW Estimated request as of May 1974: $350,000. ~425,000 | : — 6/6/74 . . WOB STAPF. SUMMARY FOR MAY L REVIEW ARIZONA REGIONAL MEDICAL PROGRAM: RMO0055-04 University of Arizona School of Medicine COORDINATOR: Dermont W. Melick, M.D. ~ since 1967 STAFF: (FTE) Total ~ 16 Proposed: 20 Professional: 11 Professional: 20 Other: 5 Other: 7 FUNDS REQUESTED: Total (D.C. & i.d.c.) $1,351,128 Program Staff (Administrative) 665,400 Scaff Components (3) 389,790 1,055,190 Projects: (3) total (295,938 total budget - $ 1,351,128 Continuation; 2 = #28, 29 New L = #22 CHP COMMENTS : CHP comments have been received and have received replies from ARMP, The one "b" agency that has not commented on the application is the Health Planning Council of Pima County. OTHER COMMENTS FOR REVIEWERS ATTENTION: 1. None of the activities proposed appear to conflict with other Federal grant programs such as HMO, PSRO, Kidney and EMS, ~ 2. The Program staff budget includes several discrete activities. The largest of these, Expansion of Health Service Sites, is to develop a network of health services in underserved primarily remote areas of the state. This activity was the result of ARMP's working with CHP areawide agencies to determine areas of need, DRMP/DOD WOB 5/21/74 REGIONAL MEDICAL PROGRAM OF ARIZONA Funding Information No. Component 04 yr. voy May request Comments co00 Program Admin, 331,259 665 ,400 (1) Central Regional Services cooi 339,690 Aétivities which include: coo2 20,100 COO1l - Expansion of Health c003 30,000 Service Sites, C002 ~- Manpower recruitment 22 (new) Reduction of Strep. a 88,077 c003 - Self provider education Infec. in 2 counties 27 (cont.) | Hypertension 26,945 140,261 Total amount invested in these three from 10/1/73 to 6/30/74 28 (cont.)| EMS 37,855 67,600 was $229,700 for ca0dl; 34,600 for C002 and 77,000 for 20 Develop. of Health 103,526 * c003. Inform. Systems $499,585 $1,351,128 *This is from FY 73 restricted funds WOB- R.Sadin 5/16/74 MAY 1551974 ARIZONA :RN - COMPONENTS... REQUESTED FUNDS LISTING COMPONENTS BY REGION Oo/74 COUNCIL . PROG YR 04 comp NO cooo cool coo2 C003 O22 027 028 7 COMPONENT TITLE PROGRAM STAFF EXPAN HLTH SERV SITES "EXT MED MNPWR UNDERSERVED AREAS PROG STAFF SELF PROVIDER HLTH EDUC REDUCTION STREP INFECTION TWO COUNTIES COMMUNITY HYPT CNTRL METRO AREAS EMS REGION TOTALS. DIRECT _ REQUE ST 551,823 3391690 20,100 "30,000 844255 1401261 677600 192335729 INDIRECT REQUEST 1139577 0 117,399 OSM—PWBO1LO-23 /of TOTAL REQUEST * 6654400 339,690 20,100 30,000 88,077 140,261 677600 ' 1¢351,128 RMP _ ARKANSAS RM G00 52 © MAY/JUNE 1974 REVIEW Request: _ $1,830,751 Committee Recommendation: _ $1,500,000 Overall Assessment by Individual Reviewers: The primary and secondary reviewers rated the overall assessment of the Program as average at this point in time. Critique: This Region had been considered above average while it was under the direction of Dr. Charles Silverblatt. However, Dr. Silverblatt resigned in February 1974. Reviewers were concerned that the present staff would not be able to significantly expand the Program beyond the current dollar level of operation. The Search Committee has not yet recommended a replacement for the Coordinator but has appointed Mr. Roger Warner in an acting capacity. (Mr. Warner is one of the four candidates being considered.) He has been with the Program for four years and has demonstrated expertise in the monitoring and evaluation aspects of the Program. The RAG remains intact with relatively little turnover. Relations with the CHP, the Grantee, the Arkansas Health Systems © Foundation (EHSDS Program) and the other health provider institutions appeared to be most satisfactory. . Programmatic thrusts covering the 10 identified "umbrella activities” were considered ambitious. Several new project proposals such as sickle cell, audiology and stroke rehabilitation were questioned as to the possibility of obtaining impact in a one-year period. Twelve other new project proposals were included in the application. A clear evaluation protocol was not included in the application. More information in this area is to be expected in the July | application. Also, a clearer staffing pattern is expected in the next application. JULY/AUGUST REVIEW: Estimated request as of May 1974: _ $800,000 MCO 6/4/74 STAFF SUMMARY FOR MAY | REVIEW ARKANSAS REGIONAL MEDICAL PROGRAM: RM 00052-05 Little Rock - Univ. of Arkansas Med. Center COORDINATOR: Roger Warner, Acting - since 2/15/74 On Duty Since July 1969 STAFF: (FTE) Total - 16.6 Proposed: 29.6 Professional: 11.1 Professional 21.1 Other: 5.5 Other: 8.5 FUNDS REQUESTED: Total (D.C. & I.D.C.) $1,830,751 Program Staff(Administrative) 173,785 Staff Components (10) - 5 new activities 716,715 Total Program Staff & Components 890,500 Projects: (17) total 940,251 Continuation (2) 157,630 New (15) 782,621 CHP COMMENTS: CHP "A" and 7 of the 8 funded CHP "B" agencies have submitted comments. Transmittal letter reveals that all activities were reviewed by all CHP agencies since each was involved in the drafting of those proposals within their respective local juris- dictions; is interesting to note that of the 6 activities receiving unfavorable comments from the N.W. CHP "B" agency, the RAG disapproved 4 of them and required administrative changes in the other 2 before giving them approval; CHP "A" prioritized activities which can be compared with the RAG's prioritized Listing. ITEMS FOR REVIEWERS ATTENTION: EMS - Project #82, Burn Center and Project #90, Q.A., EMS Dept. Personne] might be considered new EMS activities - however, DRMP staff has checked with Dr. Larry Rose and Mr. Reardon and find there is no conflict or duplication ol activities being funded with H.S.A. funds to Arkansas. HMO and PSRO - no problems anticipated; activities labeled C072, 71 and 90 deal with Quality Assurance but are not funded to either HMO or PSRO organizations. Continuation Activities Only one of the seven continuation activities request more than twice the amount as was funded for a six month period in the 1/1/74 award. Project #71, Quality Assurance, Arkansas Nursing Homes had been budgeted for $49,000. The current request for this activity is $127,630. Target Funding Amount (140% of the annualized level) = $2,210,742 . May 1 application requests $1,830,751; expect $800,000 request in July | application. REQUESTED Fu LISTING OSK-~PWBO10—23 COMPONENTS BY REGION . 06/74 COUNCIL ARKANSAS =. ~PROG-YR OS CONTINENT COMP COMPONENT TITLE DIRECT INDIRECT TOTAL wee ee eee ee ND . ; | REQUEST |. REQUEST | REQUEST CORO ADMIN , 1679700 = yOB5.—s«!:s«iiT 3 7B 7 C072 COORD CUAL ASSUR PROG ACTIV . 754000 17801 76,801 "6073 COOP LOCAL PLAN PROCESS ACTIV 140,000 3,352 "143,352 - CO74 «= KIDNSY MIS COORD ACTIV 25,000 593s 254 593 CO75 MS SUPPORT ACTIV _ 309000 730 30,730 “Co? | CooP HYPT CNTRL ACTIV . i . . 50,000 1,186 51,186 COT? CA -SERV SUPPORT ACTIV 504000 "14186 51,186 cove ARTHRITIS SERV SUPPORT ACTIV 50,000 1,186 51,186 “6079. PHYS EXTENDER SUPPORT ACTIV "50,000 19186 51,186 Cof6 © COOP SYS DEVELCP . 150,000 3,560 1539580 CO&L HT SERV SUPPORT ACTIV 80,000 19915 g1,915 O54 SHARED IN SERV TRKNG NW ARK HOSP , 639300 . 0 63 4300 C62 H¥PT CNT2L IMPLE 30,000 0 304000 C71 QUAL ASSUR ARK NURSG HOMES 1274630 0 127,630 : : Cez EXPAN SURN CTR AND RECOV RM SERV , 1244925 0 1244925 CLS COMP PERAK STROKE PTS 544375 0 544375 On 4 CONT 2uuc CTR 54,020 o 54,020 085 ° SICKLE CELL ED SCR COUNSEL | 334475 . o 334475 CE4 | SUREGRT INTERIM OPER FUNDS CARTIO | 545950 8 54,950 oe ALOTGLTO SCREEN AMO Test 27,858 0 27,ELE CUee22 NEONATAL CARE TEXARKANA 334160 0 53,100 OR? TEAM APPROACH COMP HLTH CARE (385150. 0 38,150 1591974 : REQUESTED FUNOS LISTING ‘ COMPONENTS BY REGION C6/74 COUNCIL 52 ARKANSAS PROG YR O05 MIC CONTINENT COMP COMPONENT TITLE cee ee NO 290 CUAL ASSUR EMERGY DEPT PERS O91 SCK CCMMUNICA PHYSIOLOG DYSFUNCT 092 HLTH SCR COUNSEL CLINICS ELDERLY 993 TEL MED 094 J98 ATTITUDE SURVEY UTILIZ &N 096 ENTERCSTOMAL THRPY PT NURSG ED NO CF COMPONENTS 28 a REGION TOTALS OYRECT REQUEST $2656 98885 544645 23,115 9615 3299552 198077951 INDIRECT ~ . REQUEST fo) o © © 222800 OSM~PWBO10-23 TOTAL REQUEST 522656 98,885 54645 239115 9,615 39,552 1830, 751 ave neni NLA ND RM 000 56 MAY/JUNE 1974 REVIEW Request: $1,129,608 Committee Recommendation: See Below Overall Assessment by Individual Reviewers: Average to below average Critique: The réviewers were disturbed that the Program has not substantially addressed the problems of accessibility and availability of care except for EMS, nor have they addressed themselves to the needs of minority groups with the exception of Project #55, Health Services Recruitment of Minority Groups, nor to health delivery systems. Tt was recognized that the Program was in a very difficult situation because they are attempting to provide a program for the rural area of Southern Illinois as well as the Metropolitan area in St. Louis. The proposed two new project activities do not appear to conform with the document entitled, "The Health Needs of Bi-State RMP Region as identified by Joint RMP and CHP Planning Conference” which met in February, 1974. Reviewers expressed hope that the new activities proposed in the July 1 application will more adequately reflect upon those identified needs. Reviewers were surprised that the Bi-State RMP Regional Advisory Group had disbanded and had relinquished its responsibility to a 15-member Executive Committee. Hope was expressed that a larger Regional Advisory Committee should provide stronger leadership. Reviewers rated Program leadership as minimally satisfactory. Although reviewers did not recommend disapproval of Project #54 - Graduate Follow-up Study, they were not in sympathy with this particular activity. Program staff performance was considered satisfactory. Reviewers felt the Bi-State RMP Program Staff request for additional secretarial/ clerical assistance is out of proportion to the professional staff complement. Recommendation: 1. Review Committee recommended $800,000 which is 63% of the target and $329,608 under the requested amount. 2, Review Committee reaffirmed the November 1973 National Advisory Council recommendation that membership of the Bi-State RMP Regional Advisory Committee should be increased in size and become more involved in the decision making-process. JULY/AUGUST REVIEW: Estimated request as of May 1974: $410,000 MCO 6/4/74 — STAFF SUMMARY FOR MAY REVIEW BI-STATE REGIONAL MEDICAL PROGRAM: RM 00056 COORDINATOR: William Stoneman III, M.D. - since March 1968 STAFF: (FTE) Total - 8.2 Additional proposed: 5.5 Professional: 6.2 Professional: 1.5 Other: 2 Other: 4 FUNDS REQUESTED: Total (D.C. & 1.D.C.) $1,129,608 Program Staff 553,605 Staff Components 0 Projects: (17) total 576,003 Continuation (15) 532,765 New (2) 43,238 Target Funding Amount: (140% of annualized level) = $1,223,758 CHP COMMENTS: The Comprehensive State Health Planning Agency of illinois and the Missouri Office of Comprehensive Health Planning ("A" Agencies) have submitted positive comments. In addition to CHP comments on pages 99-104 of the application, the CHP(b) agency, Central Illinois Health Planning Council, Inc. has not developed Standards or Criteria or a project review mechanism necessary for the review of these proposals and, therefore, unable to provide the Bi-State RMP with a requested review and comment. The May 1, 1974 letter should be included as part of the application and be considered as page 105. Items for Reviewers 1. Dr. Stoneman will be leaving 6-30-74. The RAC Search Committee has nominated Robert H. Felix, M.D. to be new Coordinator. Dr. Felix was former Dean of Saint Louis University, School of Medicine and former Director of the National Institute of Mental Health. 2. Deputy Coordinator, A Stephen Coburn joined staff 5-1-74. 3. Health needs of Bi-State RMP Region were identified by Joint RMP-CHP Planning Conference February 7, 1974 and are listed on page 338 of application. 4, July 1 expected request - $410,000. 61 STATE... - MAY 1551974 CONTINENT REQUESTED FUNDS LISTING COMPONENTS BY REGION 06/74 COUNCIL P2OG YR. 05. come NG ‘C000 “O17 ole O21 036 O3E 044 045 — O47 O4F COMPONENT TITLE PROGRAM STAFF EMS HLTH SERV AIDE EDUC HLTH CARE STANDARDS AMBULATORY PTS CA CHEMOTHERAPY SUPPORT COMMUNITY BASED MNPWR EDUC CONSOATIUM COMPUTERIZED MCUEL DISTKIBUTION HLTH MNPWR COMPUTER SUPPORT PSRO ‘DEV PUS PARTICIPATION EMS PLAN USE AUXIL MED FERS IN HLTH CTR STANDARDIZ HISTOCCMPATISIL TEST KIDNEY ORGAN HARVEST TRNG , CUAL ASSUR AMBULATORY MEO CARE MNPWR EDUC CONSORTIVA INFO CTE CLukG FUREAU HOSP MNPWR EDUC ANG EXCH 5 SEG INFO SYS CA CNFRL GAROUATE FULLCW uP STUDY HLTH SERV RECKUIT MINORITY REGION YOTALS DIRECT REQUE ST 3589546 78807 14,685 28,086 11750 49 464 © 15 9439 | 21,675 89455 4249340 9,082 17,2115 339954 259970 15,960 517623 13,130 20717 816,192 INDIRECT REQUEST 195,059 0 0 99910 69120 12,770 0 8,272 29380 264520 0 6,000 " 18,148 29920 0 154920 39467 59924 3239410 OSM-PWBOLO—23 © TOTAL REQUEST 5534605 78,607 14,685 374996 17,870 624234 159439 299347 1°, 835 68,450 99022 23y115 52,102 284890 154980 677543 164597 262641 1,129+6C5 * 5 Bt Me WRRAT ED RMP California a marine nmncnemenn attnte RM 000,19 May/Jun 3974 REVLEN Request: $8,170,374 _____ Cominhetec Recommendation? ($7,353,000 Overall assessment by {ndividual reviewers? ___Above average — Critique: This application requests continued support for staff and 75 ongoing projects. Based on an analysis of the application alone, the reviewers noted that program activities had been developed around six program goals with priorities defined by the RAG. The staff appeared strong and very active in program development. The RAG seemed to be’ a stable group which depended on the well- developed review process and three special committees. The RMP has a good track record. regarding continuation of activi- ties after grant support is ended. The reviewers were uncertain about CHP relations and had quest- ions about the effect of the closing of area offices and the elimination of the area advisory groups. é Staff who had recently spent considerable time in California, studying the review process and CHP relations, explained that relations with most of the CHP (b) agencies were good but very strained in the Bay area and San Diego. The staff also explained . the long history of the area offices and the fact that the DHEW . audit recommendation was to close them. Previous site visit teams had also stressed the importance of stronger central direct- ion which, is possible under the present organiz ation. Panel B at first recommended that the application be approved at the requested level. However, jin its review of actions on 25 RMPs, changed the recommendation to approval at the reduced level of $7,353,000. The Committee concurred. JULY/AUGUST REVIEW: Estimated request as of May 1974 $5,829,533 woB 6/6/74 t? STAFF SUMMARY FOR MAY 1 REVIEW CALIFORNIA REGIONAL MEDICAL PROGRAM: RM 00019 California Medical Education and Research Foundation COORDINATOR: Paul D. Ward - since 1967 STAFF: (FTE) Total - 54 Proposed: 79 Professional: 38 Professional: 52 Other: 16 Other: 18 FUNDS REQUESTED: Total (D.D. & i.d.c.) $8,170,374 Program Staff (Administration) 1,309,727 Staff Components ____ 291, 582 “1,601,309 Projects: (75) __ 6,569,065 total budget $8,170,374 Continuation: All New: None CHP COMMENTS: CCRMP has a log of applications mailed to CHPs and comments received. Negative comments such as the following have been responded to: (1) CHP "b™ comments on 146B EMS Statewide Data Coordination request the addition of staff for all CHP "b"s throughout the State, The objective of this project was to help produce a statewide data system by 6/30/75. The addition of staff to CHP "b"s at this time would be to plan for new activities which are now not permiss ble, It would also more than double the budget. CHP and CCRMP are now in the process of working out agreements, (2) 146E -_Central Valley EMS. The Project Director and the Central Valley CHP "b" Director and Mr. Campbell,. the CCRMP Coordinator for EMS, are now rewriting the objectives and restructuring the proposal. (3) CHP had negative comments on #111, San Bernardino hs/ea; #112 San Diego hs/ea and #105 Santa Clara hs/ea. A letter of understanding has been worked out between #105 hs/ea Directorp and the CHP involved. Program audits have been conduted, as requested by CHP, on projects 111 and 112, All the above CHP comments were heard at the RAC meeting on April 17, 1974, The RAC recommended that all appeals be in writing; that they be presented to the Evaluation Committee of the RAC which meets June 4, 1974; that all involved parties be present at that meeting to present their case. As noted above, the issues are being worked on by staff and may be resolved before the meeting of the Evaluation Committee, 4? CALIFORNIA SUMMARY Page 2 © OTHER ITEMS FOR REVIEWERS ATTENTION: (1) The budget request for #104 Redwood Health Consortium seems hiph compared to the first 6 month request, There are several reasons for this - a) former project #2785, Family Practice, UCSF has heen added to the budget of project #104 for two months (b) a project to train Indian health aides in Eureka has also been added to #104, (2) The budget request for 146A EMS Regional Coordination is being reduced. DRMP/DOD WOB-5/17/74 - © bal 19 CALIFORNIA WESTERN MAY 1591974 comp NC coco 069 Ge3 OBEA OB7A 087) af?G lle 114 REQUESTED FUNDS LISTING COMPONENTS BY REGION 06/74 COUNCIL PROG YR 06. COMPONENT TITLE PROGRAM STAFF COMPRE CARE RESP AIS PTS FREE CLINIC COuRD KINNEY OTS INFOR & EVAL SY¥S GREATEP L A ORGAN PROCUR “REG TRANSPL REG TRANSPL REG TRANSPL & ORGAN PROCUR “REG ORGAN PROCUR REG TRANSPL & MRGAN PROCUR REG OVGAN PSESERV KIONEY ADMIN VENTURA CNTY HLTH SERV DEL SYS HLTH CAREER RETENTION PLOWOND HLTH CONSORTIUM SANTA CLARA HS/EA SAN JOACUIN VAL HLTH CONSORTIUM SAN FERNANDU HS/EA EAST L A HS/EA SAN SEANARDINA RIVERSIDE HS/EA SAN DIEGO £ IMPER CNTY HS/EA RS/EA REG COORG DIRECT REQUEST 116017319 16,079 8,559 249646 29145 29300 29628 3,227 49952 24407 34439 25368 25,007 59,080 426 9242 3984790 1649580 221,550 2389430 211,000 2807630 1469334 INDIRECT REQUEST 82499 878 1,l73 210 1,104 1,699 Leité 3,602 po oo Db 80 © OSM-PWEO1LO=2: / 7 7 TOTAL REQUEST 396017319 219578 84559 249646 35023 34473 2,838 42331 | 64650 39239 4,615 29368 26,5603 §9,C80 164,580 2219550 2389430 2liycoo 26.0,630 1465334 @...... ‘ REQUESTED NDS LISTING COMPONENTS BY REGION 06/74 COUNCIL 19 CALIFORNIA . prog yr 06 WESTERN comP . COMPONENT TITLE See ee NO CS 118 SO SAN JCAQUIN VAL HLTH MNPWR. CONSORTIUM 137 TEL MED» 142 SUPERTOR CALIF HLTH MNP WR COUNCIL 143 POMONA E SAN GABRIEL HS/EA 1454 QUAL CARE COORD “1458 PT CARE AUDIT 145€ PROG DEVELOP 1450 EDUC NURSG ASSESS 145E REG MED KECORD ADMIN COORD 145F GUAL ASSUR me 1456 QUAL CARE 145K QUAL CARE REG EDUC 1451 QUAL CARE REG EDUC . 1453 QUAL CARE REG EDUC OS 1gSK QUAL CARE REG EDUC” 14EL = PT CARE APPRAISAL 145M « QUAL CARE R56 EDUC 145N CUAL CARE REG FOUC 1450 | QUAL CARE KEG Epuc 1464 2G CURD EXS | 1463 STATEWICE DATA COLLECT & RECIONALTZ 1490 SANTA CLARA EMS OIRECT REQUEST 118,030 10,337 2009450 118,048 1299164 3369216 235,872 163,373 600111 68 ¢ 804 66 5848 699460 769600 702000 76,537 809044 669490 672663 7189636 2155849 1769286 429430 INDIRECT REQUEST oc o 8 9y TST 554195 oO 169312 259716 144038 14,726 26,197 $2600 13,777 11 ¢647 22,569 134255 $9291 0 0 0 OSM-PWB8O10-23 TOTAL REQUEST 118,030 10,337 200» 450 118,048 1295164 3454983 291,067 1635373 769423 94,520 60,5886 842186 1025797 759600 909314 91,89] 89,059 81,118 84,927 215 2b40 176,256 429430 2 x a ©. 1974 » CALIFORNIA “STERN REQUESTED S LISTING COMPONENTS BY REGION 06/74 COUNCIL PROG YR 06 comp COMPONENT TITLE NO 146E CENT VAL EMS SYS DEVELOP 146F INYO MONO EMERG MED CARE 1466 EMS DEVELOP / 146H BAY AREA MED SERV 1461 L A COUNTYWIDE EMS 1465 LONG BEACH 4OBL EMERG MED CARE 14€K EMS TRNG MOBL L4é6t RNG CLINICAL INSTRUCTORS EMERG CARE ° 146M MED MGMT AUUIT HOSP EMERG DEPTS 146N CALIF EMS CONSUMER EnUC : 1469 EMERG CARE CRITICALLY ILL NEWBORN & PEDIATRIC PT “1474 HYPT ConRa , 1470 «PITTSBURG HYPT CNTRL AND EDUC L47E MODEL HYPT EDUC AMBULATORY CARE “147F HYPT CNTRL 13 RURAL CNTY 147H CLINICAL EDUC SYS HYPT CNTRL “1475 IMPROV HYPT CHTRL VOL ACT “247K HYPT AMGNG CHINESE AMER L47L HYPT CNTRL STIMULATING COMPLIANCE 1474 COMMUNITY HYPT INTEXVENTICN 2G7N -HYPT TRNG CLINIC 1470 HYPT CLINIC HOME FOLLOW THRU DIRECT REQUE ST 113,000 35 486 654566 82392 2125303 52,566 "112,000 18,252 * 92,625 2749959 68,296 1524927 12,666 12+000 42400 145409 149433 45900 49165 13,270 29157 $1,526 INOIRECT REQUEST 41828 92462 12460 0 . @ 297362 0 Q 0 Qo oO 172 . OSM~P 10~23 TOTAL REQUEST 113,000 354480 655566 87_ 220 212,303 62,028 1122000 195712 | 929625 273959 97647 192,927 125566 12,000 49400 149409 149433 41900 4-165 13,270 22329 S19826 3 og of MAY. 1591974 NO OF COMPONENTS .. . 76 - REQUESTED FUNDS LISTING COMPONENTS BY REGION Co/T4& COUNCTE 19 CALIFORNIA PROG YR . 06 WESTERN CON COMPONENT TITLE NO 1467P nYPT CHILDREN & YOUTH 1470 HYPT CNTRL 7 147k EXTENDED HYPT 1478 HYPT & PALO ALTO/MFILD PARK 1471 COMMUNTTY COORD COUNCIL HYPT CNTRE 148 SECTION 1122 . wii 149 SO CENT-L A HLTH CONSORTIUM 150 INGLEWOOD CENTINELA SO BAY HAREOR HS/EA ‘151 ORANGE CNTY LONG BEACH HS/EA 152. TRE CNTY CHP COUNCIL - es REGION TOTALS DIRECT REQUEST 11,7013 1119964 79924 12,388 - 30,094 100,000 1549030 62944 9e100 84750 Te87T2,898 INOIRECT REQUEST o oo 828 939 090 94 1,390 297,476 OSM-PHBO1L0—23 44 f - TOTAL REQUEST 11,013 11,9964 73924 12,288 10,094 100,000 154,639 G,334 92109 8,750 Bs170;374 Page @ REGIONAL MEDICAL VI oF CALIFORNIA : oo =“ total-§3,937,316 Total-$8,170,37%4 , : MIS 1/74 (MIS) No. EMS Component: |’ 05 yr. 06 yr. May request Comments Bepin cate . 146A! EMS Rep, coord. HOPETTS 1%, 739 71,951 215 ,840% B! Statewide data Col, . 0 78,800 176,286 EMS Coordination 146A budget was predicated on D jsanta Clara EMS 20,345 | -0 ~ 42,430 14M dollar award. Budget will be reduced, E Central Valley EMS 67,730 -~O- 113,000 . F Inyo*Mono 18,180 -0- 35,480 , G Ventura 31,084 - 0- 65,566 1461 ~ This is the second phase of this project * Hi Bay Area ° 32,643 ~ O- ‘ 87,220 It includes all of Los Angeles county an » IUL.A. County 75,000 -0O- 212,303* has the cooperation of CHP plus the L.A. J jLong Beach 55,252 - 0+ 62,028 Board of Supervisors. K | EMS Training ‘ 50,000 -0- 112,000 L'j Training Instr.Drew 25,000 , -0- 19,712 146M - This started with the northern hospital Mj Audit Hosp. Em.Depts. 35,000 -0- 92,675% council. It now has extended to includ N j Consumer Educ 14,179 - 0- 27,959 the central and southern hospital counc O, Critically I1f Newborh -0- 50,00 96,647 | to do data analysis of hospital emergen C Neighborhood EMS . 65,248 ~ -0- rooms. ‘ ‘ Total 504,590 "200,751 1,456,743 eo. Begin date. : . Ind.cli. 83 REALTH RESOURCES | 1/73 48,995 22,270 8,559 (2 mos) Project 100 - This two month request is for mc Venturs 100 | PLANNING 9/71 56,027 25,017 28,008 (2 mos) than level funding. Budget was Sec.1122 148 "Access" 10/73 12,006 70,000 100,000 (12 mos) back during phaseout aad was now Resp.Dia. 69 : 9/71 49,789 19,910 21,578 ° (2mos) approved at a prephaseout level. Tel-Med 137 1/73 71,716 31,000 10,337 (2 mos) Total 238,527 168,197 168,482 KIDNEY i Begin date 86A | Info. & Eval. System ! 9/71 106,886 68,805 24,646 (2mos.) . g7a |Greater L.A.Organ Proc. 9/7) 37,484 8,361 3,023" Except for 87K Regional Transplantation at Dav 87D |Reg.Trans, UCSF 9/71 42,171 11,506 3,473 all other Kidney projects will have had 3 year 876 USC 9/71 45,280 8,513 2,838 funding by 8/31/74 \ 87H “ " Organ.Proc. Irv 9/71 48,083 13,123 4,331 , 871 " " Presv, San Diegp 9/71 47,878 15,654 4,615 873 " "Proc. USLA 9/71 49,712 11,299 6,650 87K " Transp. Davis 10/73 6,934 8,876 3,239 B9a | Kiddey Admin. 9/71 42.510 6,863 2.368 Total 426 ,938 150,000 55,183 RECIONAL MEDICAL PROGRAM Funding Inforr Bt CALIFORNIA + Pace = . @ a 3 ° Component : 05 yr. 06 yr. May request lade — - Begin date 10/1/73 ‘ ; HYPERTENSION Coor. 17,370 84, 630 152,927(12 mos) Except for 147A, all hypertension requests are for D " Cont. Pittsburgh 35,965 -O0- 12.566 (2 mos.) two months only. The Hypertension Program Committee i og " Educ.-Amb. Care . 335800 -o0- 12000" requested that all proposals be rereviewed.and F " Cont. 13 rural edm, 18,500 * -O- 4,400 " resubmitted July 1/74. t .™ Coord. Counc. L.A, 27,595 -0O- 10,094 =" , BR Clin.Educ, N.E, Valley 41,520 -0- 14,4090" J Voluntary Action 41,487 - O- 14,4330" K | typ. Chinese-American -O0- 214,650 4,900" L " Control-Santa Clara ~Q- 13,147 4,165 7 x Comm. Intervention -O- 33,174 13,270 =" NO Trng.Clinic-Drew - 0 16,636 2,329 " . . 0 Home follow-thru 0 52,068 51,826 " * R Dependency Prev, ~ O- 24,958 7,924 $ 5 E. Palo Alto ~O- “42,520 12,388 =" _. 0. Ponatrol - Drew , J -O0- 37,697 11,964 P s will have had three year funding by 8/31/74. CRMP has devel- oped a dialysis cost analysis study which the Social Security Administration is interested in and is developing a similar cost study for kidney transplants. EMS (Section VIII) The EMS request is for $1,360,096 to continue 14 already funded projects until 6/30/75. CCRMP received $100,000 in EMS earmarked funds, 7/1/72 - 6/30/73, for two projects, #91 in Area VI and #92 in Area IX. Two others, #128 in Area II and #140 in Area IV received l-year funding out of regular grant funds. However, it was not until the fall of 1973, when supplemental funds becaine available, that CCRMP embarked on a major EMS program effort. A committee of 15 persons has guided these EMS programs and estab- lished priorities of: regional coordination support, the develop- ment of community councils, development of systems criteria, con- sumer education programs, and health impact evaluation. Of the 14 projects, two are Statewide; six are concerned with county level development of EMS systems; seven have training components and six include consumer education. Since 10/1/73, approximately $710,000 has been invested in EMS. The CCRMP Evaluation Committee endorsed the recommendations of the EMS Program Committee recontinuation support except for Project 146-0 - Emergency Care Critically Ill - Newborn. ‘the applicant, Stanford University, has appealed the decision of both the ad hoc Technical Review Committee and the Program Committee to disapprove this project. This appeal will be con- sidered at the next meeting of the Evaluation Committee on dune 4, CCRMP has received more CHP comments and concerns on EMS than any other program element, particularly on the two Statewide projects, #146A and #146B. EMS Statewide Coordination, #146B,is housed in the State Health Department in Sacramento and the Areawide agencics are concerned about their roles in this EMS effort. They have requested that CCRMP pay for a staff position for each of the "b" agencies. This would more than double the present project budget. At its April 17 meeting, the RAC directed that decisions on the state- wide projects plus #1462 Central Valley EMS, be deferred until the issues have been resolved by the parties involved. It requested that appeals brought before the Evaluation Committee be in writing. Division of Regional Medical Programs has since oO. been informed by CRMP staff that the issues raised by CIP may be successfully resolved before the June 4 meeting of the Evaluation Committee, at which appeals will be heard. High Blood Pressure Control (Section VIII) Although CCRMP has previously funded several small feasibility studies in hypertension, this has been essentially a new program area for California. A Statewide High blood Pressure Council was formed last fall, which decided that projects in the following areas would qualify for funding: (1) establishment of community councils for HBP control (2) organization of ambulatory care serv- ices to manage persons with HBP and (3) development of innovative education and training programs in HBP Control for consumersand providers. Sixteen projects have been funded between 10/73 and 6/30/75 for a total of approximately $570,000. The present request for $340,608 is to continue this statewide coordination project for 12 months and the others for just another two months because of the decision by the High Blood Pressure Control Committee that all project sponsors submit new proposals for complete local and technical review before the July 1 review cycle. Section 1122 Program (Section X) Since September 1973, CRMP has been involved in a State Health Department Task Force study to determine how Section 1122 of Title XI, of the Social Security Act should be implemented. It has invested approximately $82,000 to date in this effort. The Program Evaluation Committee of the RAC has recommended that this activity be continued from 7/1/74 ~- 6/30/75 at $100,000. Access to Care (Section IX) This includes a request for $168,482 for continuation of Section 1122 for 12 months and two months continuation of four ongoing projects: #69, Respiratory Disease; #83, So. California Council of Free Clinics; #100, Ventura Health Network and #137, Tel-Med. Project 69 reaches the end of its 3-year authority August 31, 1974. ‘The others may request additional extension on July 1, 1974, in which case they will have to undergo new review and evaluation. Ko CE 6 Lion, Jain obecca Sadin WO/5/16/74 ne reper ea ates oe nara moment oe ton a os TOR am a eee men LOA Ne RR RE i OO ae Rep ge ae rR ge end mm Een ma ye ou 500 MAY fie LITA RENE Requcst: $796,986 Commi Lice Recommendation: $615,000 oe Overall assessment by individual reviewers: — Average ce Critique: Reviewers found the CNYRMP RAG to be active and effective. The Region was noted to omit its Goals and Objectives from its current application and presented its program in terms of thrusts. The present number of staff relative to the multiple number of activities raised serious questions concerning the Region's monitoring capability. However, proposed staffing patterns seem adequate. The Region's accomplishments in the North County in reference to recruiting sixty physicians was cited as a remarkable gain.- Also the local matching identified in the CNYRMP EMS actsvity was considered deserving of credit. The hypertension project's lack of CHP comments was found to be an oversight on the Part of the Region and will be corrected by the “next submission. . JULY /AUGUST REVIEW Estimated request as of May 1974: 1,150,000 \ @ , RM 00050 1972 CENTRAL NEW YORK Regional Medical Program Coordinator; _ John J. Murray On duty since: Staff; Full Time Prof. 5 Proposed: 8 Part Time Prof. L 1 Full Time Other 2 3 Part Time Other 1 1 Total 9 13 Funds Requested: Total seseccecaccascceres 796,986 Continuation. scree doves (444,755) eo” ee ( 36,284 ) Period of Time Requested: All projects core and activities are requested until 6/75. Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . RM 00050 Central New York List any continuation project or staff activity for which substantial increase over annualized current funding is requested. 1. Although Project 22C EMS Communication was funded at $107,250 & 89,455, the Region is requesting 147,515. The Region now plans to equip radfos in volunteer and rescue squads. *2, (See Below) | HMO project: NONE I EMS project: All facets of the EMS Project 22B, C, F, request increase in funds. , PSRO;: NONE Kidney: NONE CHP comments: Note: No CHP comment received on new Project 57 Model Hypertension Program. The Coordinator indicated this as a core staff activity and felt it was not new to the region. It should however, had CHP comments. *2. Projects #35,36,37 (mis. numbers 58,59,60) - Health Education Network. If one refers to the region's efforts in continuing nurse education, as noted on 15 of the application as the forerunner to the HENs and if one analyzes the core staff budget & project efforts, the following funds have been set aside for these types of activities: Proj. 1 Nurses Continuing Education $639,500 s.t. COO1l Program Staff Community Based Manpower . 31,047 Proj. 18 Area Health Education Cooperatives 109,024 Proj. 30 Health System North AHEC 30,104 Proj. 45 Health Education Network : 52,382 222,557 s.t. *QL9 NKF . faaneta y RM 00050 Central New York Continued To invest an additional (19,296, 18,295, 28,000) $66,221 to support projects which should have been developed a few years ago, most of what they proposed to do now would seem to be an unwise investment. The thrust of each project also appears to have deviated from the major mission of DRMP health service education activities. MAY “T941974 REQUESTED FUNDS LISTING COMPONENTS BY REGION . 06/74 COUNCIL CNT NY SYR PROG YR 06 ERN ——s Comp COMPONENT TITLE wecneee ne eee. NO” ns . o ~€000 PROGRAM STAFF 022R EMS R COUNCILS 9226” EMS ~C RADIG COMMUNICATIONS gaa Cert 040 GEORGETOWN SATELLITE CLINICS 844 COUNCEL COORD HLTH SERV 055 NO COUNTRY CHILDREN*S CLINICS (056 ADULT SCREENING EXTENSION CLINICS "057 MODEL HYPT COMMUNETY 7 058 NO COUNTRY HLTH EDUC CONSORTIUM 059 NY PENN AHEC 060 MOHAWK VALLEY HLTH EDUC COUNCIL COMPONENTS -~ 12 REGION TOTALS DIRECT REQUEST 248 486 865065 “147,515 41,331 274000 249386 29 4200 23,037 309880 28%000 184925 1949298 7249121 INDIRECT REQUEST 677461 o fo & 8© @ oo 2@a 5,404. 72,865 OSM=-PWB010=<23 TOTAL REQUEST 315,947 86 065 147,515 41,331 27,000 245386 294200 23,037 369284 281000 189925 199296 T96_ 986 ” S "MAY /JUNE 1974 REVIEW Request: Committee Recommendation: EMP hs wy iv Uys Vey VIE Ii RM 00040. $1,879,646 $1,587,644 Overall assessment by. individual reviewers: Superior - Above Average > Critique: The Committee concurred with the staff analysis that Dr. Thomas Nicholas, Executive Director, has provided excellent leadership for the Program. Past performance. of the Program has been very good. The goals and objectives have remained constant and have been adhered to by the Program. Health resources within the region have been utilized and projects are directed _ toward health resources planning. This was considered a commendable feature by Committee. Concern was expressed regarding the:cancer activities in the application, especially Project #48, Colorado Cancer Registry, which had been funded by NIH through June 30, 1974 with additional funding anticipated from NIH in the late fall. The kidney projects, #29, Pediatric Hemodialysis Center for the Rocky Mountain Region, #47, Diagnosis/Treatment, Kidney Stone Disease, and #50, Pediatric Nephrology Center, raised questions as to any overlap of activities. JULY /AUGUST REVIEW Estimated request as of. May 1974:° $227 ,000 MCO 6/4/74 STAFF SUMMARY FOR MAY REVIEW Prepared by: M.E. Murphy COLORADO/WYOMING REGIONAL MEDICAL PROGRAM: RMP #40 COORDINATOR: Thomas A. Nicholas, M.D. - since 7/72 STAFF: (FTE) Total 17.63 (18 persons) Professional: 13.63 (14 persons) Clerical: 4 Requested positions: 6 (5 prof., 1 clerical) FUNDS REQUESTED: Total (D.C. + 1.D.C.): $1,879,646 Program Staff: 673,351 Staff Activities: 1,012,271 Staff TOTAL: 1,685,622 Projects: Continuation (2): 98,191 New (13): 769,184 Projects TOTAL: 867,375 © CHP COMMENTS: Received from 'A' agencies in Colorado & Wyoming and responded to by RAG. Both agency directors sit on C/W RAG. Two funded 'B' agencies, Big Country CHP Council, Inc.(Montrose, Colo.) and Denver agency (without a Director). Big Country CHP Director on RAG, also, ANd comments good. CONCERNS: 1) EMS Activities: C005 Quality Control for EMS, Rural Areas - 15,000 CQ06 Regional Planning for EMS, Wyoming - 25,000 C007 Regional Planning for EMS, Colorado - 35,000 C008 EMS Systems Development, San Luis Valley - 35,000 2) Kidney Activities: #29 Pediatric Hemodialysis Ctr., Rocky Mt. Region: Continuation 60,000 #47 Diagnosis/Treatment, Kidney Stone Disease: New 35,51] #50 Pediatric Nephrology Ctr.: New &3,510 Target Funding Amount (140% annualized amt.) = $1,543,284 Application request ($1,879,646) is $336,362 above target figure. ‘Anticipate July 1,++974-request of additional $227,000 for 4 new activities. Mid-Continent Operations @ Staff Analysis: Mary E. Murphy Colorado/Wyoming RMP: #40 The Colorado/Wyoming Regional Medical Program application requests funding From July 1, 1974 through June 30, 1975 for Program Staff, 2 ongoing and 13 new activities. Application Request for $1,879,646 ‘includes: Program Staff C000 Program Staff $673,351] COO] Strep Awareness Ed. Prog./Chicanos 5,000 C002 Health Program in Cyig. Schools 4,000 C003 Maternal/Child Health & Family Planning 1,600 C004 Hypertension Screening Program 29,500 C005 Quality Control for EMS, Rural Areas 15,000 C006 Regional Planning for :EMS., Wyoming 25,000 C007 Regional Planning for EMS, Colorado 35,000 C008 EMS Sys. Development, San Luis Valley 35,000 CO09 CWRMP Grand Junction SRO Activities 33,500 CO1O Western Health Educ. Center. 3,000 COll Expanding Primary Social Services 16,840 COl2 Extending Primary Care to Rural Communities 6,480 C013 Health Resources Development Project 104,000 C014 Primary Care Development, Western Slope 20,000 © CO15 Continuing Education & Training Activities 5,000 Total P.S. Activities 1,012,271 TOTAL PROGRAM STAFF 1,685,622 Projects C #29 Pediatric Hemodialysis Ctr., Rocky Mt. Region 60,000 C #35 Quality Control for Ultrasound Facilities 38,19] #38 Pediatric Oncology Ctr. 53,013 #39 Quality Control Diagnostic Radiology Facilities 58 ,566 #40 Electrical Safety in Hospitals 53,030 #4] Bone Pathology Ctr. for Ca. Diagnosis 26,325 #42 Core Prog., Primary Health Care Nurses 72,957 #43 Diagnostic Ultrasound Training 40,172 #44 Quality Control for Ultrasound Facilities 38,19] #45 CEIS Automatic Confirmation System 170,280 #46 Train. Prog./Prim. Care/Inheritable Dis. 79,547 #47 Diagnosis-Treatment, Kidney Stone Disease 35,511 #48 Colorado Cancer Registry 31,688 #49 Colo. Hosp. Assn., Shared Educ. System 20,000 #50 Pediatric Nephrology Center 83,510 e TOTAL PROJECTS $867,375 -2- The Colorado/Wyoming RMP goals for the request year are: 1) to improve availability, accessibility and the quality of primary health care; 2) to improve accessibility and maintain quality of secondary-tertiary care to the people in the C/W region; and 3) to assist in local planning of health resource development. The C/W RMP plans to submit a July 1, 1974 application request for approxi- mately $227,000 for the funding of 4 new projects. An Arthritis application was submitted for review and requests $362,621. The proposal is to be critiqued by an assigned body of reviewers. Analysis of the Colorado/Wyoming Regional Medical Program The Colorado/Wyoming RMP is in the second year of its triennium. Present funding (1/1/74 - 6/30/74) is in the amount of $694,541. Project activities number 19 at a cost of $335,346. Dr. Thomas Nicholas has served as Executive Director of the Program for almost two years. He has exhibited excellent leadership and is supported by a competent staff of 18 persons (17.63 FTE - 13.63 prof. & 4 clerical). The C/W RMP staff prior to phase-out numbered 19(14 prof. & 5 clerical). Therefore, staff number has remained stable, but with a slight change in personnel. The Regional Advisory Group of the C/W RMP has remained active, maintaining supervision over all projects and program staff activities. This has been accomplished through the cumulative information received through three mechanisms: 1) Quarterly reports received from project directors, 2) site visits and subsequent staff reports, and 3) site visits conducted by sub- committees, and/or technical review committees consisiting of members of the RAG, or appointed by them. RAG recently increased its Executive Committee from 6 to 9. Total RAG membership has been increased from 40 to 55 members. This was accomplished for two reasons: 1) to provide more experienced people for health care planning and implementation, and 2) to provide a more comprehensive and better geographic distribution of membership. The RAG distribution is uniform throughout the two states, and every planning region is represented. The RAG's relationship with the grantee, the University of Colorado Medical School, remains good. The C/W RMP has acted as a coordination point for EMS planning activities in Colorado. The Program developed a statewide EMS plan and, in addition, has assisted local communities with their individual planning and coordination activities in accordance with the state plan. The C/W RMP has extensive experience in assisting with local planning for health resources, as well as data collection. Community organization in rural areas, as well as health planning, has remained a major Program thrust. It continues to be apparent that plans must be developed locally, based on an assessment of local needs. In Colorado, a wide variation of planning ~3- capabilities exist. CHP 'B' agencies are mostly small, understaffed and underfunded. C/W RMP has an excellent relationship with most of the planning organizations. In the Western Colorado area and the Western Wyoming areas, these activities will be accomplished in cooperation with the Intermountain RMP and Mountain States RMP. Comprehensive Health Planning Agencies 'A' Directors in Colorado and Wyoming are voting members on the RAG. There are only two funded 'B' agencies in the two states, located in Colorado, and Denver is presently without a Director. Comments received were responded to by the RAG. The negative aspect related to the brevity of the Form 15s and the short time period allowed for review of the projects. Colorado comments alerted the Program to the relationship of the Grand Junction Sub-Regional office to oil shale development in Western Colorado. Much previous activity had been expended in that field through the efforts of CHP and the Colorado Department of Health. Several of the new project activities are variations of formerly funded projects: #38 - Pediatric Oncology Epidemiologic, Diagnostic and Surveillance Center and #15-Regional Pediatric Oncology Center for Research and Training; #46-Training Program/Primary Care/Inheritable Diseases and #30-Rural and Urban Genetic Counseling and Screening; #43-Diagnostic Uitrasound Facilities and #1/-Training in Diagnostic Ultrasound in Community Hospitals (untunded). Assurance was given by C/W RMP that the new projects are not mere extensions or requests for continued funding. On all activities to be conducted in areas which overlap with Mountain States and Intermountain RMPs, written assurance will be submitted that projects have been reviewed and approved by the three coordinators and their respective RAG chairmen. COLO WYOMG 3 CONTINENT REQUESTEG LISTING COMPONEN mY REGION 06/74 COUNCIL PROG YR 06 comp NC C000. Cool “002 _ C003 C004 “Coos ‘ C006 C007 “008 | Cog Cog “CO1l C612 ris col COQ1l4 2 oO ND ~ oO Se An QoQ iar yn CGMPONENT TITLE PROGRAM STAFF COLCRADD WYOMING RMP PROGRAM STAFF DISCRETE PS 75-01 “PROGRAM STAFF DISCRETE PS 75=02 PROGRAM STAFF DISCRETE PS 75-03 PROGRAM STAFF DISCRETE PS 75-04 PROGRAM STAFF DISCRETE PS 75-C5A ‘PROGRAM STAFF OISCRETE PS 75-058 PROGRAM STAFF DISCRETE PS 75-05C PROGRAM STAFF DISCRETE PS 75-050 PPGGRAM STAFF DISCRETE PS 75-68 PROGRAM CTAFE DISCRETE PS 75-68 PROGRAM STAFF DISCRETE PS 75 6C PROGRAM STAFF DISCRETE PS 75 6D PROGRAM STAFF BISCESTE PS 75-7 PROGRAM STAFE GISCRETE PS 75~8 PROGRAM STAFF DISCRETE PS 75-9 PEBLATRIC HEMGOTALYSIS CENTER ROCKY MOUNTAIN REGIO _EUALITY CONTROL FOR NUCLEAR MEDICINE FACILITIES PROIAT&SIC CxCOLOSY CENTER OUALITY CONTROL/DIAGNGSTIC RADIOLOGY FACILITIES ELECTRICAL SAFETY. IN HOSPITALS SONS PATACLOGY CENTER/CANCER DIAGNOSIS DIRECT REQUE ST "5929200 5,000 4,000. 15600 29-500. 15,000 254000 35,000 35000 334500 34000 "169840 &s480 914580 20,000 5,000 524872 354547 434187 46,158 425737 239220 INDIRECT REQUEST. .... 81,151 0 0 0 0 0 0 Q 0 121420 6 9 72128 97038 9-826 12,408 109293 _ 39105 oon A. TOTAL REQUEST 673 9351 5,000 49000 1,600 292500 15,000 25,000 353000 35000 334506 3,000 169540 69480 1045000 20,000 5,000 60,600 442585 53,0613 58 566 534030 269325 MAY 1551974 . a . a REQUESTED FUNDS LISTING COMPONENTS BY REGION 06/74 COUNCIL COLO WYOMG.... PROG YR 06 ) CONTINENT: COMP - COMPONENT TITLE we ee eee NO 042 CORE PROGKAM/PRIMARY HEALTH CARE NURSES 043 DIAGNOSTIC ULTRASOUND TRAINING 044 QUALITY CONTROL FOR ULTRASOUND FACILITIES 045 AUTOMATIC COMPUTER ASSISTED CONFIRMATION SYSTEM 046 TRAINING PROGRAM/PRIMARY CARE/INHERITABLE DISEASES 047 | DIAGNCSIS-TREATMENT KIDNEY STONE DISEASE 043. COLORADO CANCER ‘REGISTRY ~ . - . 049 CHA SHARED EDUCATIONAL SYSTEM 950 PEDIATRIC NEPHROLOGY CENTER OF COMPONENTS 31 - - Loe .. REGION TOTALS DIRECT REQUEST 572963 36,518 309247 154,800 67,685 353511 31,688 207000 659276 19662,109 INDIRECT REQUEST 144994 31654 79944 155480 119862 9 0 6 189234 217,537 OSM~PWBOLO—23 TOTAL REQUEST 722957 404172 384191 ~ 170,280 799547 35—511 315688 20,000 834510 198795646 vat ee y . he a pes , re a Vogue “connecrtcur _ } a RM 000 08 - MAY/JUNE 1974 REVIT! Request: $636,220 Comnittee Recommendation: $510 000 Overall assessment by individual reviewers: Below Average to Poor Critique: This application, requesting 12 months support for an expanded staff (from 5 to 8 professionals) and two months support for ongoing activities, lacked substance for the reviewers. It was agreed that needed staff competencies in the area of fiscal management and evaluation were much needed, in fact, the Committee noted that the absence of evaluation staff had been a concern in previous reviews. The unique characteristics of this Regional Medical Program, with its emphasis on building long-term university- hospital relationships was discussed, but the application lacked information regarding the outcome of the linkages. While grant support for full-time chiefs of staff in community hospitals has been discontinued, the support Bo of, and dependence on university resources, including students, still prevails. " Staff leadership was not apparent to the reviewers, but the argumentative tone of the RAG Chairman's responses to CHP comments, as well as the CHP comments themselves, indicated that the RMP-CHP relationships remain a problem in Connecticut. The role of the Regional Advisory Group in relation to the Committee structure was unclear, as well as the criteria used in priority ranking. Because. the Committee realized that concerns of staff leadership, RAG functioning and cumulative impact of this RMP's unique characteristics have been delineated by Committee and Council in previous years with little apparent effect on the RMP, the Committee recommends that reduced funding i of this continuation request may be a more patent message. The Committee recommends, therefore, that this application be approved at the reduced level of $510,000. | JULY/AUGUST REVIEW Estimated request as of. May 1974: ° $1,963,780 ¢ om RM 00008 CONNECTICUT Regional Medical Program | | Coordinator: _ Ed Morrissey On duty since: 7/73% _ Staff: Full Time Prof. 5 Proposed: Q Part Time Prof. 0 0 Full Time Other 3 4 Part Time Other . 0 QO Total 8 » 12 Funds Requested: Total eeoeov eee eeeeeoeeresae 636,220 I Continuation. .ccscesceene ( 157,040 )- 9 projects ** NQWe cca secerccscscacseccen ( -0- ) Period of Time Requested: projects until 8/30/74; program staff until 6/30/75. New projects will be requested on 7/1/74 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) * Was Deputy Coordinator from 1967 - 1973 ** Represents 2 months extension only; new proposals will be requested 7/1/74 ar RM 00008 Conn. © List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: EMS project: no significant increase; 2 months extension PSRO;: Kidney: no significant change in support; 2 months extension CHP comments: At best, CRMP/CHP relations can be described as strained, particularly between CRMP and the Connectict "a" agency. In the application, it appears that all CHP comments were received in time for consideration by CRMP. Copies of correspondence indicate that CRMP appropriated addressed concerns submitted by the "b" agencies. The Deputy Director of the "a" agency submitted some rather salty comments (supposedly representative of the agency, but this is under question) making general statements charging’ "waste of money and pork barreling." £0/5/20/74 7 se @ MAY 1551974 oo, | REQUESTED FUNDS LISTING COMPONENTS BY REGION 66/74 COUNCIL CONN PROG YR O05 | on . Lone ERN - comp ‘COMPONENT TITLE NO. — oo COOO §=—— PROG: STAFF cool EMS “C002 REG HYPT CNTRL 0282 COMMUNITY STUDIES PERS 0283 COMMUNITY STUDIES PERS . Tee "928s CONN KIDNEY DIS YALE=NH MED CTR 044 STATE & REG HLTHMANPOWER DEVELOP CIHMR O6Al UNIV BASED REG FACULTY oO "0681 UNIV BASED REG FACULTY. * COMPONENTS. 2. 90 00 0’ ee - a REGION TOTALS DIRECT REQUEST 3955727 17,092 "389262 89493 59398 11,281 "15 9669 129215 199285 523 3422 INDIRECT REQUEST | 839453 19548 0 34753 29859 2,219 29453 7,247 99266 112,798 OSM—-PW8010—23 TOTAL REQUEST oe 479,180 181640 | 38,261 125246 89257 134500 18,122 199462 28552 636%220 ‘ , s FLORIDA REGIONAL MEDICAL PROGRAM RM 00024 MAY/JUNE 1974 REVIEW Request: $3,000,791 Committee Recommendation: $2,700,000 Overall Assessment by Individual Reviewers: Superior Critique: Considered by reviewers to be well organized with good leadership, program staff, excellent RAG, excellent past performance and accomplishment, good CHP relationships with program activities that address key issues that are congruent with the region's explicit priorities and areas of emphasis. Reduced recommendation made on basis of whether all new activities suggested could.be successfully completed in the time-frame left for life of the program or could be continued under other funding. JULY/AUGUST REVIEW Estimated Request as of May 1974: $1,500,000 DRMP/DOD 6/6/74 MAY REVIEW STAFF SUMMARY Prepared by: Lee E. Van Winkle FLORIDA REGIONAL MEDICAL PROGRAM Grant #: RM 00024 1 Davis Boulevard, Suite 309 Tampa, Florida 33606 H. Phillip Hampton, M.D., Coordinator (202%) On Duty Since: 1969 Granville W. Larimore, M.D., Director (100%) On Duty Since: 1969 CURRENT STAFF PROPOSED STAFF Full-time Professionals - 14 Full-time Professionals - 18 Part-time Professionals - 2 Part-time Professionals - 2 Full-time Other ~-~ 7 Full-time Other - 9 Part-time Other ~ 1 Part-time Other ~ 41 FUNDS REQUESTED: (Target Figure $3,232,398) Total Cost - $3,000,791 Program Staff - $398,792 Continuation - $845,121 New - $1,756,878 Period of Time Requested: 7/1/74-6/30/75 CHP COMMENTS: No problems noted. See page 61-62 of application for working relationships. All activities were reviewed by CHP (a) and (b) agenctes. Thirteen projects were recommended for disapproval by CHP agencies and were subsequently disapproved for funding by the FRMP Review Process and the FRAC. Twenty-six applications for multi-media ROCOM which were approved by the CHP (a) agency director were deferred for action by the FAAC since the CHP (a) Council had not submitted a disapproval action. ITEMS FOR REVIEWERS ATTENTION: #267-A: MAST Program for West Central Florida. This does not conflict with the Emergency Medical Services Act as interpreted by Mr. Reardon. Discussions have been underway between FRMP and the civilian Coordinator of MAST since December 1973 in the development of the Logistical Emergency Transportation Support Activity. DRMP /DOD SCOB/5-17-74 REQUESTED FUNDME LISTING MAY 4 COMPONENTS BY REGION 06/74 COUNCIL “LORIDA | PROG YR 05 3 CENTRAL comp COMPONENT TITLE oe eNO nn - : €000 PROGRAM STAFF 6235) ELA PERINATAL (0468 124 126 135Y 162 162 “169 177 179 193 194 196 206 219 * 131Y_ ~134Y AREA WIDE HLTH PLNG SUPP REG VIII A. 207. COMMUNITY CREAN DONOR PUB HLTH NURSG TRANG C267 MAST PROG W CENT FLA HOSP ENF SURVEIL TAMPA COMMUNITY BASED HYPT CNTRL PALM BEACH "MS. FPGSTPROGF AREA MIGRANT WORKERS SITUATIONAL ANAL HYPT HwSep INFECT SURVEIL CHARACTERISTICS HOME CARE NURSG SERV BUQN REGISTRY EST STDS CARE a COMMUNITY HLTH ADVOCATE $0 SADE HLTH - we SYS CONT ED NUKS~ CV RISK FACTOR REVERSAL WARNING SIGNS STROKE CLINICAL NUTRITION COMMUNITY DIETARY SERV PT FD IN FAMILY PRAC SETTING PILINGUAL CMNC SYS DIRECT ~. REQUEST 398 9792 2123482 99740 219493 32 9653 409860 429356 66,718 ‘15,000 339533 111,695 299645 — 67,000 712080 100,000. 902000 20,000 419645 T9784 36 9547 339288 85000 INDIRECT . REQUEST .. ° 0 0 2,011 29552 0 171644 135343 0 16 467 259876 129827 28% 763 0 0 3,605 0 124355 27980 29421 69658 369317 OSM-PWEO10=—23 . TOTAL .. . REQUEST (398,792 "222,482 99740 | 234504 355205 40,860 60,000 805061 "15,000 502000 137,571 429472 95763 71,080 100000 93,605 20,000 54,000 10,764 385968 39,946 1212317 + i MAY . . - * REQUESTED &.... COMPONENTS BY REGION . 06/74 COUNCIL LORIDA . ‘PROG YR OS CENTRAL —-CnMp COMPONENT TITLE So RO . ! 214 MED ONCCLOGY 220 DRUG INF AND PRAR RES CTR 223 VISITORS NEEDS FOR HLTH CARE 230 HLTH CARE COLLAR FLOW STUDY 232 FAMILY PRACTICE SATELLITE 236 IMPROV HLTH CARE ASSESS - 241 SURGI CTR STUDY 243. STATEWIOE RES HLTH MNPWR 248 MODEL DENT SERV oo . 249 “NURSE MIDWIFERY SERV 250 «DEL MATERNAL HLTH CARE SERV .259 CONT =p ORAL CA Zé5 ACUTE CRITICAL CARE SERV EWIDE PCOL MECH TEACH EQUIP AV AIDS . 269 STAT COMPONENTS 36 / . ve . REGICN TOTALS DIRECT _ REQUEST 559924 329474 "15049932 20,000 859589 2873010 10,000 534750 499675 779175 693800 169600 "899104 125,000 296909344 INDIRECT REQUEST 19,076 10,321 "37,793 o 69847 0 0 214250 41655 109249 5,541 0 109896 o 3109447 OSM-PWBO 3 Y TOTAL REQUEST 75,000 42,795 "188,725 20,0006 9249436 287,010 107000 75006 542330 872424 759341 167600 100,000 225,000 3000s 791 WI LAWS RS tee GEORGIA REGIONAL MEDICAL PROGRAM RM 00046 MAY/JUNE 1974 REVIEW Request: $3,629,757 Committee Recommendation: Approval at the requested level of $3,629,757. Overall Assessment by Individual Reviewers: Both reviewers rated the Georgia RMP as "Superior." CRITIQUE: The reviewers believed the Georgia RMP to have: An excellent experienced coordinator ' A strong Regional Advisory Group and Committee structure An adequate experienced program staff Good CHP working relationships t A well managed and a well administered Regional Medical Program. JULY/ AUGUST. REVIEW Estimated Request as of May 1974: None RMP /DOD ScoB/6/4/74 MAY REVIEW STAFF SUMMARY Georgia Regional Medical Program Prepared by: Joe Jewell 938 Peachtree Street, N.E. Grant # : RM 00046 Atlanta, Georgia 30309 J. Gordon Barrow, M.D., Coordinator On Duty Since : Jan. 1967 Current Staff: Proposed Staff: 15 Full-time Professionals 15 Full-time Professionals 2 Part-time Professionals 4 Part-time Professionals 9 Full-time Support 12 Full-time Support 2 Part-time Support Funds Requested: (The Georgia RMP does not intend to compete during the July-August 1974 Review Cycle.) Total Costs - $3,629,757 Program Staff - (749,557) Continuation - (606,380) New ~ (2,273,820) Target Figure - $3,588,200 Period of Time Requested: 7/1/74 - 6/30/75 Activities Proposed: See attached printout. Items for Reviewers Attention: Because of the limited time frameallowed in the preparation of this application, the region opted to utilize its time tested, GRMP-developed umbrella program approach. On March 13th a letter of invitation, listing the three major GRMP areas (Primary Health Services, Manpower Development and Utilization, and Specialized Services) was sent to all GRMP past and current Project Directors, Hospital Administrators, task force members, chiefs of hospital medical staffs, directors of nursing services in hospitals, ad hoc committee members, the RAG, and health agencies, organizations, and professional groups throughout the region. By April Ist, 150 letters of intent had been received (the total now exceeds 270 such letters). The time lag between May lst, the date of this application, and the date the region receives its funding level will allow the various committees, task forces and staff the necessary time for the development and preparation of the proposals for final considera- tion by RAG. The RAG will exercise its program authority and allocate funds to specific project activities -- developed from among the letters of intent -- within the umbrella program framework. Basically this has been the region's mode of operation during its first triennium. Page 2 Georgia Regional Medical Program Summary On June 8-9, 1972, a review process verification site visit was conducted to Georgia RMP. The region was found to exceed the mimimum standards. A management survey is scheduled for May 30, 1974. EMS Georgia has an EMS plan. Project #55 is to assist in the continuation and expansion of the service. During June 1972, GRMP received $100,000 as a supplemental award for emergency medical service. They utilized these funds to partially support a model system in DeKalb County, a bedroom community of Atlanta. The system is now operating under local funding. PSRO: Project #64A has (and will) provide for the development of guidelines for the care of specific diagnoses. The funds will not be used to support a PSRO agency. KIDNEY: Project #69A will provide support, in part, for the further development and expansion of the capabilities of tertiary nephrology centers at the two medical schools to include training of personnel, further development of criteria of care, and strengthening relationships with regional and national organ procurement and sharing networks. ap: The region addresses its relationship with the state's planning agencies in its April 29th cover letter to Dr. Pahl. In addition, at the request of the steering committee, a report of the CHP review was presented to the Regional Advisory Group by the Director of the Office of CHP, who is also a member of RAG. The report, along with a letter from the same individual, are included in the section tabbed "CHP Review." DRMP/DOD 5/17/74 - ~- y . MAY 9T4 . - - REQUESTED FUNDS LISTING ee . OSM~PWwB010-23 COMPONENTS BY REGION 06/74 COUNCIL CEORGIA ... .. PROG YR 06... ‘H CENTRAL = COMP, s—s—“ COMPONENTS - 15 . - . ; REGION TOTALS - 395535408 764349 326299757 RMP GREATER DELAWARE VALLEY RM 000 26. MAY/JUNE_1974 REVIEW Request: $2,809,108 Committee Recommendation? $2 300,000 Overall assessment by individual reviewers: Above Average Critique: Two reviewers, both of whom had previously site visited this program, concurred that many improvements have been made and that many of the prior expressed concerns about this region appear to have been resolved. It was noted that the program now has good leadership, a RAG which (since reorganization and elimination of the Board) now provides the proper program leadership and direction and a democratically elected Executive Committee. The program's goals, objectives and priorities are consistent with needs identified in the region as are projects and activities proposed for funding in this application. This program appears to have been quite effective in bringing together providers to improve both quality and accessibility of health care. ‘ Overall relationships with CHP appear good. The review panel did express a concern with the program and recommended this concern be transmitted to the region. This concern is not new, having been raised by most reviewers and site visitors of the past: namely, the continued practice of supporting salaries of medical school personnel. JULY /AUGUST REVIEW Estimated request as of May 1974: $1,386,898 \ GREATER DELAWARE VALLEY Regional Medical Program RM 00026 Central Office (including field staff for 5 subregions) Coordinator: Staff; Full Time Prof. Full Time Other Part Time Prof. Part Time Other *Dean Roberts, M.D. Total Funds Requested: TOtal wecseseescccceevess 2,809,108 Continuation. .cscescveens (400,624 cece cca scar ecenes (960,147 eo Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. 14 10 ) 6 projects 13 projects On duty since: 11/73 Proposed: 17 11 (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) *Is on leave of absence from Hahnemann Medical School, where he served as this medical school's RMP "unit coordinator" for several years. RM 00026 Greater Del. Valley List any continuation project or staff activity for which substantial increase over annualized current funding is requested. #39 Community Hypertension Control HMO project: NONE EMS project: Continuation at same level ‘of support PSRO: NONE Kidney: #47 ~ Cont. Ed. of Kidney Disease (new). No other resource available for this expanding field. #52 = Reg. Kidney Disease (new). This is the operational phase of extensive planning done in the past for coordinating the development of a total kidney program. CHP comments: Eighteen of twenty propoSals were reviewed and commented on by CHP in time for RAG consideration. Time did not allow for comment on the other two, but the CHP agencies involved stated that their comments would be available by June 1, 1974. There appears to be no problem with aspect of the request. eo E0/5/20/74 RM 000 26 GREATER DELAWARE VALLEY Regional Medical Program Temple Unit Coordinator; Daniel Hall, M.D. Staff: Full Time Prof. Part Time Prof. Full Time Other Part Time Other Funds Requested: Total eoeovptetoovoep seen oe eaee Continuation. .cccscsevves ( NeWesrsccccevcececcsnenvene ( Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. 1972 On duty since: Proposed: 0 2 0 l will be placed next to activities which extend beyond June 30, 1975.) (Also, note symbol C © RM 00026 . GREATER DELAWARE VALLEY Regional Medical Program Jefferson Unit . | Coordinator: Willard Krehl On duty since: 11/73 Staff; Full Time Prof. 0 Proposed: 0 Part Time Prof. , 3 3 Full Time Other 1 1 Part Time Other 0 1 Total 4 TA Funds Requested: Total eee een e eee ener eens Continuation. .ccccsceseces ( ) @- ee ( ) Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) 6 RM 000 26 @ GREATER DELAWARE VALLEY . | Regional Medical Program Univ. of Penn. Unit . | | I approv. Coordinator: _ john Clark, M.D, On duty since: _ 1967 | Staff: Full Time Prof. 0 Proposed: 0 Part Time Prof. 2 2 Full Time Other 1 Part Time Other 1 Funds Requested: we ee ee fp Total ease oeseeoeeeeeesesans Continuation. .csrscessoes ( ) eo" °C ( ) Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . e @ RM 00026 GREATER DELAWARE VALLEY _ Regional Medical Program Medical College of Pa. Unit ~ | ‘ approx. On duty since: 1968 Coordinator: Gerald Escovitz, M.D Staff: Full Time Prof, 0 Proposed: Q Part Time Prof. 2 2 Full Time Other 2 2 Part Time Other 0 0 Funds Requested: Total et#+oeese sev vuvpaecee esate Continuation. .cccccecrece ( ) Qe ( ) Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) 6 © RM 000 26 - GREATER DELAWARE VALLEY "Regional Medical Program Hahneman Unit . Coordinator: Dean Roberts, M.D.* On duty since: 1967 Staff: Full Time Prof, 0 Proposed: 0 art Time Prof. 2 2 Full Time Other 1 j i Part Time Other 0 0 | | { { Funds Requested: Total eevee euvpnevoeaovovunesee ue one Continuations.crccccscesse ( ) @m ee ( ) Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) | *On leave of absence, Acts as Coordinator GDVRMP 6 . A... - REQUESTED F S$ LISTING COMPONENTS BY REGION 06/74 COUNCIL GR DEL VAL. PROG YR. 05 STERN : Comp COMPONENT TITLE ve NOL . 000 PROGRAM STAFF : COOL HAHNEMANN BASED PROGRAM STAFF 6003 MED COLL BASED pROGRAM STAFF : C004 TEMPLE BASED PROGRAM STAFF : : COOS UNIV OF PENN BASED PROGRAM STAFF oe 929 CONT EDUC CA NURSG 030 PEDIATRIC TUMOR REGISTRY . - : 031 REG COUNCIL CONT EDUC ~ «032s COMMUNITY HOSPITAL MED EDUC WORKSHOP = 036 COMMUNITY ORGANIZ EMS SON J : 039 COMMUNITY HYPT CONTROL a 043 COMMUNITY HLTH EDUC CTR 044. DIAG AND EVAL CHILDREN WITH HANDICAPS 045 LEHIGH VALLEY AREA HLTH CONSORTIUM a “046 WEST METRO CONSORTIUM a a —_ 047 CONT EDUC KIDNEY DIS - 048 QUAL ASSESS AMBULATORY CARE. 949” COMMUNT TY SERV UNIT 951 IMPROV ADVISORY BOARD SKILLS 052 REG KIDNEY "053 REG RADIATION ISONOSE MEASUREMENT - : 054 FAMILY HLTH CARE ASSISTANT OIRECT _ REQUEST 801,175 45,531 642066 4349296 839743 7y514 12,020 444327 534532 469283 176 9336 68,4709 28 9492 629800 50,000 269348 1039968 79 487 329464 1277698 554840 375225 INDIRECT REQUEST 2949448 259136 31,677 214999 379266 842 29941 219482 134104 0 22,243 14, 742 39524 265628 69750 154150 155282 36,705 13,718 669677 189850 0 OSM-PWBO010=-23° . TOTAL REQUEST - "190954623 70667 | 954743 © 659295 121,009 89356 14,961 655809 667636 469283 198,579 839451 32,016 899428 564750 419498 119,250 | 116,192 460182 194,375 74690 373225 MAY. 1591974 aR DEL VAL IRN Come we ee cet NO 058 059 * COMPONENTS 24 REQUESTED FUNDS LISTING COMPONENTS BY REGION PROG YR OS. COMPONENT TITLE EXPANSION HOME HLTH THERAPY SERV HYPT SCREENING/PT EDUC ~ — =] rr ee a os e O&/74 COUNCIL . REGION TOTALS DIRECT REQUEST 34,678 - 229419 . 29107s951 INDIRECT REQUEST 0 11,993 7013157 OSM—PWBO10-23 TOTAL REQUEST .. w... 34,678 342412 23809108 8 - . 7 tl RMP Hawaii RM 000 O01 MAY /JUNE 1974 REVIEW Request: __$1,567,709 | Committee Recommendation: $1,100,000 hy Overall assessment by individual reviewers: Average ‘Critique: On April 1, 1974, Dr. Satoru Izutsu was appointed as the new Coordinator of the Hawaii RMP. Since that time, many positive changes are occurring in the direction of the program. The staff of the program is stable, having remained basically the same during phase-out. The Regional Advisory Group is being oriented to its role and responsibilities to the program. The reviewers, one of whom had been on the January 1974 site visit were much encouraged by the forward direction the program now © seems to have. This particular application, however, reflects activities developed prior to the changes in leadership. The Committee anticipates the “new flavor" in the July application. The Committee recommends approval of the application at a reduced level of $1,100,000 with the condition that the reduction be ‘ equitably applied to the Pacific Basin and to the Hawaii portion of the program. Thus, the proposed figures are $889,602 for Hawai and $305,107 for the Pacific Basin. JULY/AUGUST REVIEW Estimated request as of. May 19743" $484,000° _. WOB 6/6/74 STAFF SUMMARY FOR MAY | REVIEW REGIONAL MEDICAL PROGRAM OF HAWAII, AMERICAN SAMOA, GUAM AND THE TRUST TERRITORY OF THE PACIFIC ISLANDS ~ RMOOOOL The Research Corporation of the University of Hawaii, Honolulu COORDINATOR: Satoru Izutsu, Ph.D. Since - May 1, 1974 STAFF: (FTE) Total - 15.75 Proposed: 19,25 Professional 10.75 Professional 13.25 Other 5.00 Other 6.00 FUNDS REQUESTED: Total (D.C, & i.d.c.) $1,567,709 Program Staff Administration - Hawaii 541,315 Projects Hawaii (10) 7 new ones 568,287 Total Hawaii Program 1,109,602 Pacific Basin Administration 110,225 Pacific Basin Projects (10) 347,882 Total Basin Program 458 5107 GRAND TOTAL RMPH 1,567,709 CHP COMMENTS: Hawaii has no CHP (b) agencies. The comments submitted by the CHP (a) agency were not only considered by the RAG, but influenced the final decision on a number of projects. The CHP agencies for the Trust Terri- tory, Cuam and American Samoa were involved in the development of the proposals from the Pacific Basin. ITEMS FOR REVIEWERS ATTENTION: Past history and changes occurring as a result of new coordinator: . Staff, RAG, CHP, Hawaii Medical Society, University of Hawaii Schools of Medicine and Public Health. Continuing problems between St. Francis and Kuakini Hospitals over Renal Disease Programs, (Projects #47, Dialysis and Transplant Center - St. Francis - page 81 and #56 Kidney Dialysis Training and Education - Kuakini ~- page 94). RAG will not fund until hospitals have unified plan or justify separate programs, Project #42 - Health Screening for Elderly - RAG must rereview prior to funding. Project #68 - Cervical Cancer Detection, Trust Territory. NCI has similar request from T.T. DRMP and NCI staff working with RMPH s0 that RMPH will assist T.T. in further developing NCI proposal. . Need to "earmark" Pacific Basin Funds Page 2 HAWAII - staff summary © CONTINUATION ACTIVITIES: Of the 10 Hawaii projects only three are continuations. Of the 10 Pacific Basin Projects all are "new", in terms of location. Health Assistant Training, Otology and Cervical Cancer projects have been conducted success- fully in other districts of the Trust Territory. DRMP/DOD WOB - 5/20/74 oe 1974 Ol HAWAIT WESTERN 005 PROG YR G6 COMP COMPONENT TITLE No -. “€000 PROGRAM STAFF CCOlL PACIFIC BASIN ADMIN C003 FACIL PLAN RES & ANAL ‘C005 = PROJ DEVELOP MONITOR & EVAL Coo6 FUTURE PROG PLAN STRENGTHEN QUAL ASSUR EFFORTS 042 HLTH SCREENING ELDERLY 065 * IMPROVE HOSP MNPWR USE & RESTRAIN COSTS — 047 ~~ REG RENAL DIAL & TRANSPLANT CTR (048 HAWAII CTY HLTH SERV EDUC 049 CLINICAL ENGINEERING SERV & TRNG CTR 052 ORGAN PROCURE SUPPORT TRANSPLANT ACTIV 056 KIDNEY OFAL TRNG & EDUC 057 MAUIT CTY HLTH SERV & EDUC ACTIV 958 COGRD NURSG EDUC PROG 059 QTORHINDLARYNGOLOGY TRNG 060 COMPUTERIZED HLTH INFO SYS FEAS STUDY 061 = PT TRNG 062e IMPROVE ICU 063 SPEFCH & HEARING 064 = NUTRITION EDUC | Cé5 HLTH INFO SYS REQUESTE COMPO . 96/7 DS LISTING BY REGION UNCIL DIRECT REQUEST 192,183 105,128 129,765 90.375 99,044 471890 739193 84,550 634204 749222 579192 592556 44e111 11,674 7,846 173760 8,975 31,500 36,508 339440 134240 139394 INDIRECT . REQUEST 8,113 5,097 79355 72288 7,192 8,716 47462 0 229678 = 49223 0 Q 41h 359 o ee 8989 OF 3D DB ® os TOTAL 010-23 ; of z REQUEST . 200,296 110,225 137,120 977663 © 106236 564606 775655 84,550 65,682 78 9445 57,192 59 556 489522 119674 "By 205 17, 760 8,975 31,500 36,508 339440 134240 139394 ¥ . 6 vl974 'L HAWAIT 'ESTERN 067 HLTH ASSIST TRNG 0. OF. COMPONENTS PROG YR . 06 coMP NO _. REQUESTED DS LISTING COMPONENTS BY REGION COMPONENT TITLE 066 7 OTOLOGY ANO CLEFT LIP AND PALATE oes OC 25 CERV ‘CA DETECT PONAPE & MARIANAS + 06/74 COUNCIL REGION TOTALS . 194835987 OSM—PWB010~23 . Aot hk DIRECT INDIRECT TOTAL REQUEST REQUEST REQUEST 31,237 , oO 319237 124,000 39828 1279828 34,000 5 OCB, 000 83,722 15587, 709 » REGIONAL MEDICAL PROGRAM OF TAWAT ANERICAN SAMOA, CUAM, and the © TRUST TERRITORY OF * ‘TFIC_ISLANDS Page | Current (1/74-6/74) and Propos -6/75) Budgets Funded (6mos.) Proposed (12 mos.) No. Component 1/74-6/74 7/74 == 6/75 Remarks 300 Hawaii Program Admin, Staff 147,846 200,296 903 Facilities Planning Research & Analysis 40,946 137,120 304 Strengthening Area Quality Aesurance ' 32,143 - O- 005 Project Develop., Monitoring & Evaluation -~O- 97,663 906 Future Program Planning -O0- 106 , 236 (Total Hawaii Program Staff) (220,935)- (541,315) 28 Health Information Network of the Pacific 16,840 -~O- 36 Waianae Coast Comprehensive Health Center 58,665 -~O0- a 42 Health Screening for the Elderly ‘ a -0- 77,655 RAG must review again prior to funding 45 _ Hospital Manpover ~O- 84,550 47 Dialysis and Transplant Center -0- 85,882 #47 & 56 must jointly prove to RAG need (funded 1/73 = 12/73 $10,000) (St. Francis) s- for 2 programe or present unified plan . . before funding. 48 Hawaii ‘County Health Services/Ed. 14,642 78,445 49 ‘Planning for Community Based Clinical Eng. 4,490 57,192 50 Quality Assurance Trng. Seminars 7,500 56,606 52 Organ Procurement in Support of Transplant -O- 59,556 Funded 10/73+12/73 $35,000 53 Hypertension Detection & Treatment 4,500 -0- 56 Dialysis Training & Education (Kuakini) 7 O- 48,522 See #47 above 57 Maui County Health Services Educ, Activities -~ O- LL,674 58 Coordination of Nursing Educ. Programs -0- 8,205 Total Hawaii Projects (106 , 637) (568,287) Total State of Hawaii Program 327,572 * 1,109,602 . Total Pacific Basin Program 108, 518 458,107 Available Unbudgeted RMPH Funds 169,756 ~ 0 - GRAND TOTAL RMPH 605,846 1,567,709 ‘ , S/15/74 RLR /WOB/Leép s3e8png ($2/9-1/L) pesodorg pue (42/9-%2/1) auerang ' 4 _ SGNVISI S1alovd ai MOLIWYIL ISAaL 9ya pue ‘WYND ‘VOHVS NVOLUSRV ‘IL. KVUIONd IVOIGIN TwNOFDTY aHNd/a0M UTA . PL/ST/S 602295 1 | 9987509 Hawa IvLOL ONVED -O- 9S4°691 | Sspung HdWa peaezpnqun atqetyTeay LOL‘esy 81S ‘801 meaZorg uyseg BtzF}oed [eIOL Z09 ‘60T ST ZLS‘LZE MeIZ01d TIEARH JO 3IHIG THIOL LOL‘ 8S4 81s" sot weisoird uyseg OFF }Ied [RIOL *yeeodead ION (zee "Lve) ‘ (862519) (s299fo7g uYseg [e8I0L) — (be cab bocce eee pur sfty2 usaaqeq uot vot Idng= gog 000° 7E : -oO- (seusyamy 9 odeudg I'L) °0930q ouN9 [woTAIaD 89. , cs‘ Let -0- (ileysiey 9 dex “L°L) Suzy, squeqsjssy yaieaH ~ 49 LEZ‘ TE “0° C°L°L) “foad eae {ed 9 dt 33915 pues 4801039 99 HOESEL : -oO- (mend) wagsks vot eMI0zUy YI 189 $9 “ove ‘el -0- (wend) voTIeoNpA vOy3ITAINN 99 Oy EE . -O>-. (wend) ZuyaeeH pus yoaads €9 gos ‘9€ -o- ; wowUS “wy)*N areQ “suUaquT Jo Auawaacrdwy z9 ne 00S ‘T€ . -0o- (PISI T1eysaey “L°L) “Suay Aderayy perystya 19 _ . $16‘8 -o- | (eoweg sary) *seag ‘wizozul “yI]H paztaagndwog " “09 . O9Z°ét -o- . (somes my) *3uay AZ0]03uA4e] OUT Yy2G20 6S -O- 079° (mend) 3>eforg wazeds voTIewIOZuT yI1¥AH ss . -oO- $09‘9 SPIST TLeysreH “L'L) “yoaL % asany Buyuyezy 9S -O- | . . €67°L€ = J C198td NAL LL) 11°3uay aueqerssy ya 19297 se ' -0°¢- 000‘ST BSI NeTed' LL) 4301030 ysnoayy, aavp uaTesaH Le (szz‘o1 (ogd ‘9%) , ‘ (3381S wer801g [eI0]) a StZ‘OUL 084 °9% - boy IBIS TUTUPY Upseg I4;z Fed 1009 syreway , SL/9-~¥L/L. 9L/9-04/T juauodued *ON {*sou ZI) pascdoig “(som 9) papung ILLINOIS REGIONAL MEDICAL PROGRAM RM 00061 MAY/JUNE 1974 REVIEW Request: _ $2,816,935 Committee Recommendation: $2,816,935 Overall Assessment by Individual Reviewers: Average/Superior Critique: Members of the Review Committee agreed that the leadership of the IRMP is strong and the program has remained in good order inspite of the phase-out threats. There was a discussion of a possible leadership lag when, on July Ist, the current coordinator will devote 25% of his time to the Illinois RMP. The Board has established a search committee. It was agreed that with the obvious strength of the Creditor team, coupled with the short time-frame, that the decision to continue the coordinator on a part-time basis was a wise one. To bolster this, the region has been successful in re-employing many of its former staff members who had accepted other employment at phase-out. The RAG has remained in tact and are the decision-makers. The region has demonstrated a unique ability to initiate programs which have continued under other than RMP dollars. Illinois has had a history of joining forces with the CHP agencies in their objective type planning efforts. The reviewers agreed that the program proposed may begin to solve some of the problems of the Health Care Delivery Systems in a very complicated area of the country. JULY/AUGUST REVIEW Estimated Request as of May 1974: $1,000 ,000 DRMP/DOD SCOB/ 6-6-74 MAY REVIEW STAFF SUMMARY Prepared by: Lorraine Kyttle RM 00061 ILLINOIS REGIONAL MEDICAL PROGRAM 122 South Michigan Avenue Suite 939 Chicago, Illinois 60603 Morton C. Creditor, M.D. ,Coordinator On Duty Since: June 1970 CURRENT STAFF PROPOSED STAFF Full-time Professionals - 11 Full-time Professionals - 14 Part-time Professionals - 0 Part-time Professionals - 0 Full-time Support Staff - 7 Full-time Support Staff - 10 Part-time Support Staff - 0 Part-time Support Staff - 0 (total) 18 (total) 24 FUNDS REQUESTED: (Target Figure $3,814,015) Total Costs - $2,816,935 Program Staff - $656,833 Continuation - $1,155,128 (7 activities) New - $1,004,974 (6 activities) ACTIVITIES PROPOSED: Continuations - Two of the "continuation" activities (18 and 24) are traditional continuations. They represent major concept thrusts for the program in the fields of hypertension and the problem oriented medical record, and activities aligned to these thrusts have been sponsored by IRMP since 1972. The remaining continuations are activities funded from the October 1973 or January 1974 awards. New - The "new" activities (beginning with #35) continue the conceptual thrusts in several areas. CAM health trust is the result of an effort to demonstrate the more efficient delivery of existing health services. Fostering the design of new or refashioned health care delivery systems has been one of IRMP's objectives. The state- wide hypertension control program is an activity growing out of 2 years' preparatory activities. Having demonstrated the viability of the role of the computer in treatment of some chronic hypertensives, and with data concerning the epidemic proportions of hypertension in the State, IRMP had developed a conceptual attack on hypertension beginning with local "bs" and culminating in a state legislative package. This is the typical IRMP approach -- to precede a major statewide effort with political subdivision entires throughout the State. Problem-oriented medical record activity was handled successfully in this fashion. Renal disease activities were less staisfactory. Dr. Creditor is listed as the Project Director, but this is an interim arrangement. Page 2 - Staff Summary Illinois RMP CHP COMMENTS: All activities were submitted to appropriate CHP agencies and the comments are attached. ITEMS FOR REVIEWERS' ATTENTION: As of July 1, 1974, Dr. Creditor will no longer devote 100% of his time to the directorship of IRMP. He will be joining the University of Illinois at Urbana and will devote 25% of his time to IRMP leadership. The Board of Trustees of IRMP, Inc. have discussed arrangements with Dean Bloomfield at Urbana and have concluded that this is the best of immediate arrangements. Dr. Bloomfield is a member of the RAG, is deeply committed to the program and assures the Board of IRMP that such arrangements will be honored at least until December 1974. At one point following phase-out orders, IRMP staff was reduced to four professionals and two support staff. Its current complement of 18 professionals is almost entirely composed of former IRMP staffers who left other employments to return to RMP. It is a competent group, with experience in wotking together under stress. DRMP /DOD SCOB/5-17-74 &... - . wee Lee REQUESTED FUNDS LISTING CONPCNENTS BY REGION 06/74 COUNCIL ILLINGIS PROG YR 04 JTH CENTRAL come COMPONENT TITLE NO €co00 PROGRAM STAFF C005 PUMR EDUC ASSIST 018 ‘COMPUTERIZED HYPT TREAT (024 PLATO BASED PROSLEM ORIENTED Sys 026 PUBLIC AWARENESS V p O31 PEURTA FROZEN BLOOD 032 MIO_ SOUTHSIDE HYPT REGISTRY 01 033 \POMR FVAL MED CARE REESE MED sO 035 CAM HLTH TRUST 037 DIAL CONSUMER WORKSHOP 038 ACCESS CHICAGO 039 INTERINSTITUTIONAL CVA CTR 040 STATEWIDE HYPT CONTROL 041 PSRO EVAL & TECHNIQUE CHICAGO 3F COMPONENTS 14 a . oo, REGION TOTALS DIRECT. REQUEST 656,833 105,048 206 4456 3494192 125214 434113 1979677 1289428 449878 309839 124048 1385183 643,811 1354215 298162935 INDIRECT REQUEST o 9 9° © 8® © @ o© 60 6 o oO 4 ~ ~~ ee at OSM-PWB8010~23 TOTAL REQUEST " 6569833 105,048 2069456 349,192 125,214 435113 197,677 128,428 44,878 | 304839 127048 1385183 643,811 1354215 298216,935 § INDIANA REGIONAL MEDICAL PROGRAM RM 00043 _ MAY/JUNE 1974 REVIEW Request: $1,221,159 Committce Recommendation: $1,121,159 Overall Assessment. by Individual Reviewers: Average/Below Average Critique: One of the major concerns of the reviewers was the apparent inability of the region to write a proposal -- to tell their story (at least the current document}. The program staff was considered satisfactory-- "Everyone of the current staff have been in RMP for over four years and they have experience."' The RAG was considered to be in order with appropriate back-up committees. During January 1974, the region polled its RAG, committee members and other health interested groups to re-evaluate the IRMP objectives and priorities. Based on this, the region plans to move ahead utilizing a series of contracts to accomplish some of these objectives. The Indiana RMP envisions an umbrella approach of improving the quality of medical care in the re- maining limited time-frame. The region is extending its sub-regional development by working closely with’ existing (b) agencies. In arriving at the reduced funding level, the committee believed that the support of the continuation of the EMS activity would be low priority or at least open to question -- based on the information presented. JULY /AUGUST REVIEW Estimated Request as of May 1974: $400,000 DRMP/DOD SCOB/6-6-74 MAY REVIEW STAFF SUMMARY ‘ s INDIANA REGIONAL MEDICAL PROGRAM 1300 West Michigan Street Indianapolis, Indiana 46202 Steven Beering, M.D., Coordinator George Lemmson, A.B. Executive Director Current Staff: 5 Full-time Professionals 1 Part-time Professional 3 Full-time Supportive FUNDS REQUESTED: Total Costs - $1,221,159 Program Staff- ($265,775) Contracts Supported From Program Funds- ($616,760) Continuations- ($338,624) Prepared by: Joe Jewell Grant #: RM 00043 On duty part-time since 5/72 On duty full-time as Exec. Director since 11/73 Proposed Staff: 10 Full-time Professionals 2 Part-time Professionals 6 Supportive Target Figure: 1.4m Estimated July Request: $400,000 Period of Time Requested: All Program Staff and Operational activities are scheduled to terminate 6/30/75. ACTIVITIES PROPOSED: See Printout ITEMS FOR REVIEWERS ATTENTION: EMS Project: Project #32 is a request for the continuation of EMS activities in region 7 (6 counties in west central Indiana). The total request of $95,000 is for equipment. During 1974, the state legislature passed the Indiana EMS Act with $75,000 to be initially provided for administrative purposes for a new EMS Commission. The funds requested from IRMP are to be used to establish a demonstration model for the State. The region has requested $616,760 to support contract activities as a part of the program staff component. The area of proposed activities are listed on the last page of the application and are described on the program staff form 15 (page 33). The broad areas are: @ 1. Emergency Medical Services System Development 2. Family Practice Program Development 3. Integration of Comprehensive Health Planning and FRMP Activities 4. Hospital Accessibility 4 a” Page 2 Indiana RMP Summary The IRMP review process has been approved as has its management and administration processes. CHP: This is an application for continuation of presently funded program staff and project activities. The region did not seek formal review and comment by the Comprehensive Health Planning bodies. However, CHP's throughout the state, including the 314 (a) agency and all areawide agencies have participated fully in the reassessment of priorities on which the application is based. Further, they have participated in formal discussions with the IRMP Program Staff of the concepts that are embodied in this application , The CHP (a) Director is a member of the. RAG. DRMP /DOD SCOB/5-16-74 am » INDIANA ITH CENTRAL COM coo | 037 CF COMPONENTS ..-. 035, 038 PROG YR 06 ‘ P wee NO we 2 He Q 024 7 PROGRAM STAFF RENAL ALLOGRAFT “EMS REGION VIT HYPT - SPECIALIZED MED SERV TEL . LISTING COMPONEN Y REGION 06/74 COUNCIL PROG YR 06 COMP COMPONENT TITLE NO _ ee Bo oe. 050 EXPAN MID Sg EYE BANK O51 COMMUNITY HOSP MED AUDIT SYS 052 ~ MULTIPHASIC SCREENING EVAL 053 GIBSON CTY HLTH SERV & MNPWR UTIL 054 ARLINGTON HLTH SERV & MNPWR UTIL “055 MED HELP 056 NEIGHBORHOOD HLTH COUNSELORS EXP NURSG ROLE 057 sYALOBUSHA GRENADA LEFLORE CHRONIC OIS 058 BION HOSP LEARNING CTR : OO 05% HUSP BED UTILIZ REV 066 DIET CONSYLT 061 RUG & TOXICOLOGY INFO CTR 063 PRIM HLTH CARE REG IX 065 HLTH MNPWR EDUC 066 STAFF & SUPPORT TV FUNDS PUB EDUC ——st— RM 00057 MISSISSIPPI REGIONAL MEDICAL PROGRAM 2500 North State Street Jackson, Mississippi 39216 T.D. Lampton, M.D., Coordinator CURRENT STAFF Full-time Professionals -— 9 Full-time Other ~4 Total Staff ----------~ 13 FUNDS REQUESTED: Total Cost - $2,850,409 Continuation - $1,203,463 Program Staff- $491,074 New ~ $1,155,872 On Duty Since: 1970 (100%) PROPOSED STAFF Full-time Professionals - 13 Full-time Other - 5 Total Staff --~--------~-- 18 Target Figure: $1,503,183 Estimated July Request: 3.0m Budget Period: 7/74-6/75 ACTIVITIES PROPOSED: See attached printout ITEMS FOR REVIEWERS ATTENTION: EMS: Project C114-Emergency Medical Service Program,is currently funded (6 months through 6/74) for $17,000. for the year beginning 7/1/74. KIDNEY: This application requests $92,531 Project 17A - Renal Disease & Dialysis Center, is currently funded (6 months through 6/74) for $54,116. for the year beginning 7/1/74. This application requests $151,332 Project 17B - Renal Disease Organ Transplant is currently funded (6 months through 6/74) for $62,130. This application requests $178,400 for the year beginning 7/1/74. Staff notes there are several proposals in this application which have traditionally been supported from other sources examples: C137 - Solid Waste Management Training and C168 - Flouridation of Publicly Owned Water Systems. - 4 * t CHP COMMENTS: t 5 Eleven applications rechumended for disapproval by CHP "a" and subsequently disapproved by RAG, project # C178 - Analysis of Health Care Data, NE Mississipp. was approved by CHP "a'/ agency and disapproved by the CHP "b" agency, MRAG considered the refommendations and approved the application. The CHP "b'' disapproval wah based on the age of the data to be analyzed. j : \ MAY ©. MISS H CENTRAL C162 _ REQUESTED on. COMPCNENTS BY REGION . 06/74 COUNCIL PROG YR 05 come COMPONENT TITLE NO CO00 MISSISSIPPI REGIONAL MEDICAL PROGRAM Clil REGIONAL NEWBORN CARE PROG ""€114 EMERGENCY MED SERV PROGRAM C115 MISS OSTOMY & ED SERV C117 QUALITY ASSURANCE PROGRAM """€126 CONT AND IMPROVEMENT OF LERNG RES LIB C127 AREA WILDE DEVELOPMENT C128 HIGH BLCOD PRES SCREENING. PROG C137 SOLID WASTE MANAGEMENT TRAINING a C140 SPECIAL SERV MASTECTOMY REHAB. C142 CANCER WORKSHGPS FOR NURSES C143 SMOKING WITHDRAWAL CLINICS C144 INDUSTRY EMPLOYEE EDUCATION C145 FGOD SERVICE TRAINING PROGRAM C149 POISON & DRUG INFORMATION CENTER C151 INSERVICE ED FOUR CO AREA | cis3 HOME CARE PROGRAM SIX COUNTIES C1E4 T V NETWORK HEALTH EDUCATICN C158 €ONTINUING ED NURSES FOR AGED C159 QUALITY SERVICE TO MENTALLY RETARDED C161 HOSPITAL COST CONTAINMENT oo PEARL RIVER CO HYP SURVEY DIRECT REQUEST 4254899 118 9842 (809113 16,000 73089 169300 794002 865996 15,269 29700 3500 2700 22500 14,305 52400 28,040 Te153 385030 169200 210267 207716 102000 . INDIRECT REQUEST 65,175 99406 | 129418 60257 0 0 0 ° 29412 o oo 9 6 9 © 0 O 6 6 of ° enn. TOTAL REQUEST 4919074 128,248 929531 229257 73 689 ' 167300 ' 7%, 002 862996 17,681 29700 37500 2700 29500 149305 59400 284040 7siS3 38 3030 16,200 219267 209716 10,000 + » &.... REQUESTED IS LISTING COMPONENTS BY REGION _. _. . 06/74 COUNCIL 7 MISS PROG YR 05 JUTH CENTRAL COMP COMPONENT TITLE meee eNO C163 COMMUNICATION SYSTEM CHOCTAW HLTH SERV : C164 HEALTH SERVICES N CENTRAL MISS e665) MEDICAL FOSTER HOMES | 7 "C166 AFFILIATION PROGRAM IN FAMILY: PRACTICE ~~ e463 FLUORIDATION OF PUBLICLY OKNED WATER SYS eee "C172 QUESTIONAIRE STUDY OBS PED & INTERNISTS : C176 DISTRICT V CHRONIC ILLNESS . 7 ~~” eyayg ANALYSIS OF HLTH CARE OATA N & MISS — C179. PIERRE THE PELICAN O17A RENAL DISEASE & DIALYSIS CENTER o17e RENAL OLSEASE CREAN TRANSPLANT : G21 REGIONAL CANCER PROGRAM 026 REGIONAL RURAL MATERNAL CLO HLTH CARE ° 033 PRECEPTOR TRNG BLACK MEDICAL & DENTAL STUDENTS "924 PATIENT § STAFF ED IN CHRONIC DIS 035 CONT €0 TO HELP HEALTH CARE PROGRAM : 036 ' IMPROVE QUALITY INCREASE HLTH MANPOWER " 939 LTH CARE SYS DEV.AND IMPROVEMENT : 033 LOCAL PLANNING AND COORDINATION Q39 } GF COMPONENTS 42 HEALTH EDUCATION FOR THE PUBLIC REGION TOTALS DIRECT REQUEST . 8,883 25,000 304594 © 429946 50,000 35167 129,671 8825 144029 108 4030 1224256 124,015 824459 20000 589384 374150 150,000 150 4000 150,000 150,000 2.9549 9430 INDIRECT REQUEST 71054 0 475 204329 1,175 19275 43302 569144 579261 0 0 109944 79352 300979 4 wooo: TOTAL REQUEST 8883 25,000 307594 50,000 50,000 39642 150,000 10,000 154304 151,332 1781400 1811276 829459 20%000 699328 44,502 150C00 150,000 150,000 150,000 298509409 Kru UMISSOURT ®@ ols RM 000g9 Po MAY/JUNE 1.974 REVIEW . Request: $3,010,113 ' Committee Recommendation: $2,364,333 Overall assessment by individual reviewers! Average & Superior (The latter is compared with other RMPs) Critique: Continuity of staff is a major strong feature. Program has turned around from heavy bio-engineering, computerized-systems analysis approach to regionalized activities. ; Program is considered overambitious, especially in view of the short time frame. Concerns were expressed regarding staff increases for already well staffed central office, and proposed new staff component activities. Re- viewers found the request for new staff for coordinating health resources ae planning and development of a pilot model, in anticipation of new Federal legislation, unnecessary. The data analysis activities proposed for planning purposes Jack imagination and appear to be routine. Lengthy discussion involved the numerous EMS proposals: continuation of several ongoing activities and 11 new subcomponents, altogether requiring about $600,000. Reviewers expressed concern about the large proportion of funding requested for what appear to be fragmented EMS activities. They stated that the RMP should be certain that there is a State Plan, to assure that components are coordinated as parts of a comprehensive system. JULY/AUGUST REVIEW _ Estimated request as of. May 1974: ° $500,000. MCO 6/4/74 . Bie oe td athe, = Bd QTR OS Teint ty UI py OM tery SAPP Suleese ) FO MAY REY LEW wae Yet marr pegs Pact rs a Oy vhs. ta AO MiSSQurs eco) Obab HeoicAl PROGR. M: RM OG009 COORDIMATCR: Arthur E. Rikli, M.D. - since 1968 STAFF: (FTE) total - 30.3 Acdt'1 Proposed: (FTE) 15 Professional: 21. Professional: 10 Full-ttine 12 Full-tiine 5 Part-time Q Part-time 5 Other: V4 Other: 10 Full-Time 14 Full-time 9 Part-time ] FUNDS REQUESTED: TOTAL $3,010,113 (IDC =349,908) (exceeds est. target of 2,364,333 by 645,000) Program Staff 744,679 Staff Components (26) (includes 7 new planning) 710,880 Total Program Staff & Components 1,455,559 Projects: (46) total 1,554,554 Continuation (16) 692,031 New (19) and (11) EMS subcomponents* 862,523 * 11 subcomponents are extensions and expansions of ongoing EMS activities, to facilitate the implementation of Missouri State Law - Senate, 57 which sets forth standards for vehicles and training requirements. The application identifies the "new" locations. Total requested for these 11 subcomponents =$290,205 CHP COMMENTS Complete application was furnished "A" Agency and appropriate portions to B Agencies; practically all B agencies responded favorably. A Agency responded "no comment", leaving decisions to B Agencies. Questions and issues requiring additional clarification were discussed on the telephone and RAG responded to comments. B Agency comments received for practically all project proposals. ACTIVITIES EMS - Major expansion and additions to implement the State EMS legislation focus on improving EMS services, to meet minimum standards and promote training at various levels. RMP is applying to D/EMS (HSA) but understands that planning funds are limited this year. PSRO - Quality Assurance, continuing ongoing activi' Lies involving criteria development and data evaluation. Kidney - Continuing ongoing; one new project involves training and education oy PO aa yay vr hn TAB PP SUMP Y COP May ov Tew bag Pw , a Ge ‘ wun! MISSOURI Regional Medical Prograis RM 00009 Concerns: Coordinatec planning for health resources - Program staff activity for developinent of model for health resources planning, in antici- pation of legislation; propose a central staff activity and six District liaison officers, to work with CHP and local areawide planning bodies. Total request fcr activities is $306,000 identified for 7 "new" program staff components. Program Staff - Request increase in staff from present 30 (full-time equivalent) to 45 FTE and other expenses, for total program staff funding of $744,679. This is exclusive of the $710,880 requested for the 26 program staff components. Summary of ongoing projects, compared with request: _ The application requests 1,554,554 for 46 projects. Sixteen are continuation, 19 are new and 11 are new subcomponents of: EMS activities, representing expansion and extension of ongoing activities, at different locations. Among other new activities are high risk infant care projects (CPR), education and training of burn center team, improve quality of data (establish criteria and training ~ activities). Several studies and surveys deal with manpower needs and utilization, for “health resources planning" purposes. duly 1 - Expected Request is $500,000. L. Resnick MCO Revised 5/28/74 MAYES, 1974 won _. REQUESTED FONDS LISTING COMPONENTS BY REGION cece ee ee vis nee eo vena ee 06/74 COUNCIL. 2 oo im >. MISSOURI. PROG YR. OT. ‘D CONTINENT COMP” ~~ COMPONENT TITLE oo DIRECT INDIRECT ve eee NO ce cee cnn tune vate ee re cure REQUEST uu... REQUEST... ee COU0 PROGRAM STAFF "581,732. 1625947 _ Cous = PROG EVAL GROUP - 254350 6495 ee “Col4. HLTH PROFILE PLAN STUDY =.” ~ ~~ ° ee" 95000 oe 0 - nnn Cols OEVAL HOSP. SYS) OC 99050 2314 wo" C021 “DIAL ACCESS MED CONSULT - " 24100 $40 C022 STATE RENAL DIS SUPPORT: —~CS eee 479300 LIT ee "C024 «CENT REG CMNC RESOURSE UNIT) ssss—S 93,400" 5997 a "6925 POSTGRAD EDUC PROGRAMMING =” " 179300 607 ee "6028. CAH AUDIT DEVELOP . ~ ~ -3_350_ 892 "C029 «SHARED TRANSP CHRON ILL ISOLATED =i (st—~—s "34750 996 ee eee COs, NURS CLINICAL TEACH PKGS - - 109775 11536 032 INNER CITY CONSUMER HLTH EDUC ===—S™t=<—~S*s*é“‘_ 630005 97700 - | 34550 : : 34 642 ~ a ggg 2ts70—OCOCO—~CS~S 24400 2G 20,00) a 412_850 ~ 139270 0 — ~~ "334900 — "402000 24045 1974 COMP 123 12g as : 126 127 "128 ND. RE PROG YR. O71. ete START UP P T SHARED SERV “GREEN HILLS CMNC REG BURN CARE TEAM DEVEL AND €D HLTH MNPWR SURVEY AND UTILIZ STUDY DETERMINE NURS SUPPLY AND HLTH EO LADDERS MID MO- OO” RURAL AMBULATORY CARE ‘ s ~ - wn os ae oe ~ wee oe 4 aS OG fee Be " 1 nee Dw me ne NRE aR Sm a a fe smo a oe erent ware “ nee ee ’ COMPONENT TITL LISTING REGION Th ooo. QUESTED F COMPONEN .- 06774 —E "DIRECT : "385724 0 : 9,000 : — 345450 | “9 . os” _ DEMAND Se 59775 event ete meena mee me eae vocneee REGION TOTALS ............ 296609205 52,000" “INDIRECT > wes oa ee REQUEST... use. REQUEST REQUEST -. 3499908. a be ee OSM-P. TOTAL 384724 94000 34450 224350 5,775 52,0090 -~» 3,010,113 504000 0-23 , .,,, ii re RMP Mountain States © KM 000_ 32 MAY/ JURE 1974 REVUEM 1974 REVIEW Request: _ $2,409,356 Committee Reconmendation: $2,150,000 Overall assessment by individual reviewers: Above average Critique: MSRMP is. a well-organized well-managed program with a good review process. The region has experienced, stable staff leadership. The Regional Advisory Council is strong and viable and controls program staff direction in terms of goals and. prior- ities for the region. The application proposes continuation and new activities that are in line with program objectives, which are well-thought out and properly reviewed. The RMP has attempted to reach out and provide good service to the four states and appears to have a good working relationship with the State govern- ment and CHPs. 6 The Review Committee questioned the marked increase from 1/6/74 budget allocations to the proposed figures for the Areawide Neo- natal Intensive Care Program (page 105) and for all of the EMS projects except the Wyoming component (see pages 92, 94, 97 Of the application.) Staff requested and has received additional budget information from the region which appears to substantiate the requests. JULY /AUGUST REVIEW Estimated request as of May 1974: $225,000 \ WOB 6/6/74 STAFF SUMMARY FOR MAY 1 REVIEW MOUNTAIN STATES REGIONAL MEDICAL PROGRAM: RM00032 GRANTEE: Western Interstate Commission for Higher Education - Boulder, Colorado REGIONAL DIRECTOR: John W. Gerdes, Ph.D. On duty since 1/1/72 STAFF: (FTE) Total - 29.6 Proposed: 38.6 Professional 18.1 Professional 22.1 Other 11.5 Other 16.5 FUNDS REQUESTED: Total (D.C. and I.D.C.) $2,409,356 Program staff (Administrative) 255,316 Projects: (New) 16 635,440 (Continuation) 11 1,518,600 TOTAL REQUEST 2,409,356 CHP COMMENTS: Comments were received fram all four of the CHP(a) agencies and four of the seven CHP(b) agencies. The Idaho CHP(a) Agency did not endorse Project #313 - New Health Manpower Developmental Activities Physical Assessment Skills for Nurses (see page 232 for CHP comments.) It appears that CHP has misinterpreted the purpose of the project. MSRMP is in the process of clarifying the issues involved. The Clark County CHP(b) Agency commented negatively on four projects; it is difficult to determine the significance of these comments. The MSRMP, however, has responded to all CHP comments. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal programs, such as HMO, PSRO, Kidney and EMS. Mountain States - Page 2, ra a CONTINUATION ACTIVITIES: Of the 27 discrete activities proposed, 11 are continuations, Significant increases in continuation budgets are noted for: PROJECT 6 months 12 months Page 1/74-6/74 7/74-6/75 #112 EMS-Idaho 18,500 240,275 92 #113 EMS-Montana 26,000 144,749 94 #114 EMS-Nevada 17,131 195,760 ‘97 #212 Areawide Neonatal Intensive Care 10,000 234,611 105 #312 New Health Man- power in Mountain States 15,301 96,030 181 WO/DRMP 5/20/74 MAY 1541974 . . . cna. LISTING COMPONENTS BY REGION 06/74 COUNCIL 32. MOUNTAIN PROG YR 06 WESTERN " comp COMPONENT TITLE 7 NO... a COCO PROGRAM STAFF REG OFFICE €001 PROGRAM STAFF IDAHO C002 PROGRAM STAFF MONTANA cee coos | PROGRAM STAFF NEVADA - C004 PROGRAM STAFF WYOMING “po0g AREAWDE NEONATAL TC no poo vy * pog6 = HOME HLTH CARE MT STATES “pons ACCFSSIBILITY DEVELOPMENTAL ACTIVITIES noo SPECIALIZED SERV DEVELOPMENTAL ACTIVITIES boll MECHANISMS DEVELOPMENTAL ACTIVITIES bo12 NEW SKILLS DEVELOPMENTAL ACTIVITIES po13 NEW HLTH MNPWR DEVELOPMENTAL ACTIVITIES 922° NEW HLTH MNPWR MT STATES CO 023. «KEG HLTH TRNG NETWORK "026A EMS IDAHO an = Qo ge” EMS MONTANA oi REG BREAST CA DETECT 034 REG MED AUDIT SYS DEVELCP 0344 MED AUDIT PROG DEVELOP MONTANA 9348 REG NURSG CARE AUDIT PROG 010 CONSUMER PARTICIPATION DEVELOPMENTAL ACTIVITIES , DIRECT REQUEST 65,602 362464 38 7896 347094 39,863 207,969 1839269 349331 489116 32,890 207898 1,955 | 485525 69813 89,074 2599282 2229733 131,071 809676 1779547 199111 689236 INDIRECT REQUEST 129126 69954 79345 62466 79306 | 269642 14,600 . 2419 39780 = 3,023 19603 244 39780 105 69956 209416 179542 139678 " 134011 295858 “4067 7835 os! TOTAL REQUEST 77,928 430418 46,241 40,560 &7e169 | 2340612 195,760 334750 51,898 35,913 229561 24199 524305 6,918 | 96,030 279 5698 2409275 1449749 937687 2072405 23,9178 76,072 w-. . Lo, oo scovesreo QD crsrzn . i D.... COMPONENTS BY REGION . 06/74 COUNCIL a _. & wf L MOUNTAIN... PROG YR 06 STERN == COMP | COMPONENT TITLE 2 sit . DIRECT INDIRECT TOTAL ee ND ee es REQUEST REQUEST .. REQUEST - 034C PHYS OFFICE LAB IMPROVE. a 229529 1,814 249343 : 035 EMS SYS DEV SHERIDAN CO ee — 219296 19663 22,957 "037 HYPT SCREENING WYOMING | ees 369143 = 2987999 022 — " 039 SHARED SERV PROJ - em 349290 29722 375012 040 WYO ACTIVATED PT | 249345 17663 23,008 gat GY DIS CONSULT 7845p BOD 199006 42S DETECT WYOMING re 26974. | 29 268 31,009 O43 CLTH CARE IMPROVE RELATED PSROC a . 539784 = =§»- «9991203 9696 04% CU AND KIDNEY DIS REGISTRIES "395638 sg 6 439014 045 OPERATION SEARCHLIGHT | 50,035 <3 9932 534967 OF COMPONENTS......32.0 2 OREGON TOTALS 291685250 2410106 © 254099356 © | RMP Nassau-Suffolk RM 00066 MAY/JUNE 1974 REVIEW Request: $1,096,910 Committee Recommendation: -0- rN EET ENED Overall assessment by individual reviewers: Poor Critique: This application requesting support for an expanded staff (from 8 to 15 professionals), six ongoing projects and one new project, was discussed at length by Panel B. The reviwers pointed out that this RMP had previously been an RMP-CHP agency under one director with priorities for the two-county area developed jointly by the RAG and CHP Council. The dichotimous arrangement was terminated last Fall, with the RMP concentrating on the non-planning priorities. In the past year the RMP has had three coordinators, but the program appears to represent a holdover from the original coordinator in the grand design of previous activity and programming. The present staff, it was noted, appears weak; no member has an advanced degree, including the coordinator and the backgrounds of the proposed new staff are in @ the fields of social sciences. The reviewers were concerned that staff does not have the leadership qualities and experience that are needed to develop health care programs based on the stated priorities. Furthermore, the reviewers questioned the effective functioning of the Regional Advisory Group and the grantee during the hiatus of staff leadership. The RMP has not complied with the RAG-grantee policy although it is understood by staff that this may be finally near resolution. The problem up to now has been a preponderance of corporate board members on the Regional Advisory Group. After considering the history of this RMP together with an analysis of the current application, Panel B recommended that this RMP grant have an early, orderly termination. The Panel reconsidered the recommendation upon reviewing all its actions, but came to the same conclusion. The Committee concurred. While no funds are recommended, Committee urges that Council and DRMP make available. additional funds that may be needed for appropriate phase-out costs. JULY/AUGUST REVIEW _ Estimated request as of May 1974: $850,000 e , S NASSAU-SUFFOLK Regional Medical Program Coordinator: Rajeshwar Prasad Staff: Full Time Prof. Full Time Other Total Funds Requested: May 1st Total #enreeoeveavovoesepegcese een - 1,096,910 Continuation... (bjececeves ( 682,760 ) NeWssssccscscesqyvseceees (50,000 ) Period of Time Requested: ll RM 00066 On duty since: April 1974 2-1/2 yrs. Proposed: 15 7 ee 22 All projects core staff and activities are within 6/75. Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) RM 00066 Nassau/Suf folk List any continuation project or staff activity for which substantial increase over annualized current funding is requested. Project 21, Nassau County EMS Project requests $288,750 a substantial increase over the 43,015 & 53,308 the project received to date. Also Proj. 22 is requesting $116,516 a request over its 43,014 & 53,306 (See EMS below). HMO project: LS NONE EMS project: Projects 21 & 22 represent’ $405,226 or 55% of the 732,760 dollars N/S RMP is requesting. Of the $405,266 EMS funds, $229,998 or 56% is for equipment. EMS Project 21 requested 208,000 for equipment. The HS consultant in EMS equipment has been asked to look into this request since we received additional information and still cannot make any judgements. The NYS/EMS Department Eeels the Nassau request is to expand the existing gaps. NCR&D comments have not been received as yet. PSRO: . NONE Kidney: The existing kidney projects were reviewed by one outside the region consultant (Arkansas). He indicated both projects were complementary and supplementary but might be brought into a closer working affiliation. CHP commentS: Favorable. CHP comments were received, MAY eo, _ . . REQUESTED @ 2: . So, on. COMPONEN REGION 06/74 COUNCIL ‘ NASSAU SUF PROG YR 04 TERN =——CMCOP COMPONENT TITLE a — * gyRecT INDIRECT) =——«ST'OAAL, a eNO ee ee eee REQUEST =. REQUEST 5. REQUEST “6990 PROGRAM STAFF . B36 HeSO0—=————<“—i~—i‘z 364,150 6904) SUFFOLK CD DATA BASE STUDY FOR AMBULATORY CARE s——=#=t*” 50,000 a) 50,000 001 COMPREHENSIVE HOME CARE PROGRAM me 025312 ~ —"@ -102,.3122 ° ° ~ "009s REGIONAL DRUG INFORMATION NETWORK OF L I gs 0 789615 014 NASSAU SUFFOLK REGIONAL ORGAN DONOR PROGRAM 209303 o) 209303 oeeeen—"""O21« NASSAU COUNTY EMS PROGRAM —(i—i‘é‘“‘™SOCS™S™C;*™*™*;*;*;”;*‘éBBQTSCOXO)06©€™€~« U™~<«;*‘«i BTS tCi«*” 22S © EMS TRAINING PROGRAM oo 1269516 0 —-:126 9516 — "~~" "923s RENAL DISEASE COORDINATION & ED PROJECT , 762264 0 765264 JE COMPONENTS. _—8. oo. _ REGION TOTALS 290969910. 0 . 19096¢910 ¢ RM 000__68 May/June 1974 Review Request: $962,937 Committee Recommendation: —$912,000* Overall assessment by individual reviewers: Above Average Critique: Review Committee considered the Nebraska RMP continuation grant application request of $962,937. Reviewers felt that the goals and objectives are well described and within reasonable capacity of Nebraska to carry out. There is a close relationship between the goals and project activities included in the proposal. For example, the two major program thrusts involve six health service education activities and ten different home health care proposals. On May 22, 1974, DRMP received a letter from the Nebraska RMP which contained copies of three out-of-state Renal Technical Review Committee comments pertaining to project #52 - Statewide Renal Disease Support Plan. All three reviewers had negative comments toward this activity. Program leadership and Program staff were considered satisfactory. July/August Review Estimated request as of May 1974: $150,000 *. Review Committee recommended $912,000 which was $50,000 less than requested. This recommendation was reduced by that amount to comply with the AD HOC Technical Review Committee which in essence disapproved Kidney proposal. ne AR MCO 6/4/74 STAFF SUMMARY FOR MAY REVIEW NEBRASKA REGIONAL MEDICAL PROGRAM: RM 00068 COORDINATOR: Donald Matthews, M.D. On Duty Since 4/5/74 STAFF: (FTE) Total - 11.5 Additional proposed: 0 Professional: 7 F.T.E. 6.5 Other 5 FUNDS REQUESTED: Total (D.C. & I.D.C.) $962,937 Program Staff | 279,780 Staff Components 51,195 Total Program Staff & Components 330,975 Projects (34) total 631,962 Continuation (9) 285,030 New (24) 346 ,932 Target Funding Amount: $840,000 CHP COMMENTS All negative comments from CHP "A" and "B" agencies except for Project #47 have been addressed by Nebraska RMP Regional Advisory Group. A follow-up letter from CHP and the Nebraska RMP's response is in the process of being submitted to DRMP. ITEMS FOR ATTENTION 1 - Kidney - Project #52, Statewide Renal Disease Support Plan is a new project activity requesting $51,920. Nebraska RMP has complied with Federal Regulations for interim approval from S.S.A (see page 456 of application); DRMP Staff recommended out of state technical review for proposal; Dr. Matthews, Coordinator, agreed and project is presently being reviewed by three out of state kidney consultants. 2-- Dr. Matthews provides 50% time and effort. Mr. Buettow, Deputy Coordinator is full-time and has been with the Program since April, 1968. 3 - July 1 expected request - $150,000. @... - Do REQUESTE DS LISTING >.» COMPONE BY REGION i. 06/74 COUNCIL oo . 58 NEBRASKA. PROG YR 03 4ID CONTINENT COMP a COMPONENT TITLE DIRECT INDIRECT TOTAL ee ND . oe oo REQUEST REQUEST . REQUEST : - C000 PROGRAM STAFF - | 235,730 44050 2794780 a ~ CoC2 LEARNING RESOURCE CTR) 7 . 424860 89335 51,195 TT 008)”CONW NEBR HLTH EDUC SERV CTR. a "35300 “9 " 332300 ~~ 909° CENT NEBR COMMUNITY HLTH EDUC CORP ~ 485000 0 48 9000 —_ 015 COMPRE EDUC AND DETECT oTA8 . 27,000 0 274000 920 TEACHING REHAB - , 334000 0 33,000 C22. PYPT ENUC NEBR PHYS - 174730 0 17730 025 NU PLATTE COMMUNITY HLTH EDUC CONSORTIA © 474000. 0 47,000 agg ONE CENT COMMUNITY HLTH EDUC CONSORTIA” . 32,000 oO) 32,000 : 022 «°S WNESR HLTH EDUC SERV. 27,000 o 27,000 b29«§ & NEBR COMMUNITY HLTH EDUC CONSORTIA 204006 Oo - 20,600 034 HOME HLTH SATELLITE FRIEND 0—ists—~S - 5000 : 0 5 4000 : 035° HOME HLTH SATELLITE GENEVA. Be a 5000 0 5,000 036 = HOME HLTH SATELLITE WAHGO oO oo 54000 0 5000 Oe 037 HOME HLTH SATELLITE WEEPING WATER — 6 5000 0 5,000 oo 032 DAY RX SERV ELDERLY AND DISASLED / 194150 ~ 0 19,150 _ C39 HOME HLTH SATELLITE CALLAWAY - a 5 4000 0 5,000 ee eee Ga0””” OHUME HLTH SATELLITE DUNNING . oe 5:000 0 5,000 " "062 HGME HLTH CARE aGY YORK | a 7,500 0 "79500 042 HOME HLTH SATELLITE CRAWFORD 34625 0 39625 O43 HOME HLTH SATELLITE HARRISON 49787 0 49787. o 13,200 044 HOME HLTH CARG DEVELOP 134200 2 NEBRASKA ID CONTINENT com "NO 045 046 047 — o4R 049 050° O51 052 - CF COMPCNENTS - 053 054 O55 056 os7 _ REQUESTE S LISTING COMPON Y REGION _ . 06/74 COUNCIL PROG YR 3 P COMPONENT TITLE - EARLY DETECT CLINICS ELDERLY NURS CLINICIAN SPECIALIST. INNER CITY MATERNAL AND CHILD HLTH OMAHA RESERVATION NEIGHEORHODD OENT SCREENING DENT HLTH EDUC DENT PT MGMT HANCICAPPED : COMPRE NUTRITION EDUC STATEWIDE RENAL DIS SUPPORT SHARED HOSP ASSGC RESOURCES AND EDUC ‘CHILDREN'S HLTH EVAL CTR CRITICAL CARE MED | “CHRONIC RESP DIS AND ALLERGY . INST PHARM: SERV Oo “35 REGION TOTALS DIRECT REQUEST 4,000 334045 129150 114652 54100 15,300 339688 514920 17,300 234695 284500 275200 59120 9105552 INDIRECT REQUEST 0 0 0 0 0 0 0 0 0 o oOo oO Q 529385 >» TOTAL . REQUEST 4,000 339045 129150 119652 53100 15,300 33688 519920 17,300 239695 284500 271200 5120 96249937 *. RMP NEW JERSEY @ Ri 000 42 | MAY /JUE 1974 REVITM Request: $3,970,024 ae nannies raret Conmittee Recommendation: $3,190,000 Superior in all aspects Overall assessment by Sndividual reviewers: cane nonce nani Critique: Panel B considered NJRMP to be a superior region in all respects? strong, effective leadership; an excellent, experienced staff in terms of numbers, skills and competencies; and a RAG, not only representative of the Region, but one whose members have remained interested and active in reviewing the accumulated data to determine needs of the health care delivery system and then charting a programmatic course to meet those needs. Programmatic efforts have been tailored to span the entire set of Goals relating to access, quality assurance, categorical and cost containment as well as a beginning exploration as to how CHP and RMP may prepare for new legislative developments. The Region was commended by Committee for © some of the fascinating areas in which the. program has been involved; particularly new issues such as better access, emergency medical service, quality of care assurance, improvement of health care services to the inner-city poor, setting standards for quality for certificate of need type activities, and for the assistance given to the development of CHP "hb" agencies in N.J. (major support given to development of 3 of 4. existing "bh" agencies in New Jersey). | Relationships with CHP within the State over-all appear to be good; however, one "bh" agency director submitted a ‘scathing letter recommending disapproval of the entire RMP application. It was later determined that this "bh" agency director had held the position for only 4 or 5 months and that after review of the application, the “pn agency board recommended approval. Committee concurred that this was a superior region and would well utilize funds made available to it. . JULY /AUGUST REVIEW Estimated request as of May 1974: $600 ,000 RM 00042 j NEW JERSEY Regional Medical Program Coordinator; Alvin A. Florin, M.D. On duty since: 1967 Staff: Full Time Prof, 16 Proposed: 16 Full Time Other 8 — 10 Total 24 26 Funds Requested: Total @e#ponaoecasvpeestpeecevoes eens 3,970,024 Continuation.sessseseeses ($3,145,024) (project); $825,000 Program Staff e° 0-0" ¢ ) Period of Time Requested: July 1, 1974 to Juhe 30, 1975 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) RM po042- New Jersey List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: NONE EMS project: #28 - Continuation of previously approved activity PSRO; Quality of Care Assurance Project #34 proposes to establish 8 PSRO organizations in the federally designated areas for N.J. by assisting in organization, incorporation, staffing, and enrollment of participating M.D.s. Kidney: Project #33, Renal Dialysis and Transplant Program - Continuation and expansion of previously approved activity. Produced a statewide plan for ESRD for certificate of need. CHP comments: Comments from the CHP agencies are attached. It should be noted the the NJRMP played a major role in establishing three of the four "b" agencies in the state. E0/5/20/74 REQUESTED MAY @& ISTING COMPONEN EGION Ce eee. y 06774 COORCIL NEW JERSEY PROG YR 05 rERN comp - COMPONENT TITLE DIRECT wecteeee eee NOL, So . REQUEST C000 = PROGRAM. STAFF 825,000 : 018° COMMUNITY HLTH IMPR 29048,400 "025 «PRIM RHEUMATIC HT DIS : ” a 254,680 " 028 ~~ EMS "724920 033° REHAL DIAL AND TRANSPLANT "226,080 ” ~ 034A CUAL CARE ASSUR = PSRO 2254000 0348 QUAL CARE ASSUB = SPECIALIZED SERV 1845944 0354 COST COHTAINMENT - HOSP SERV 4824200 "9358 COST CONTAINMENT HOME CARE 2 -1%0 000 036 COMMUNITY BASED HYPT CONTROL 510800 _ COMPONENTS _ 10... oo . REGION TOTALS. _ 399702024 INDIRECT REQUEST _ 6 8 o © o 0 0 0 0 0 °o 0 x... a ‘ 9 TOTAL REQUEST 8254000 1 009482400 254,680 724920 2262080 2254000 1845944 482200 140,000 5105800 - sm 39970 9024 ® MAY/JURE 1974 REVIEW Request: $2,774,838 Committee Recommendation: _ $1,644,754 * Overall assessment by Individual reviewers: AVERAGE . Critique: Review Committee considered the NMRMP continuation grant application request of $2,774,838 to be extremely ambitious. Tne reviewers noted tnat the selection of a staff pnysician as new Program Coordinator will provide a continuity of program leadership. The present program staff seems to be adequate and capable. : In reviewing the criteria of program leadership, the reviewers felt the Programs' Executive Standing Board was too dominant over the Regional Advisory Group in the decision-making process. The RAG Budget Committee needs to be reactivated and more involved in the budget decisions. Reviewers were confused about the relationships between NMRMP Program Staff , and individual project directors. Although several project directors are located in the same quarters as program staff, they operatev independently but complement program staff activities. ‘The requests for project #18 - EMS in Rural Areas and project #25 - Health Education for the Public were too ambitious. The reviewers felt that the project objectives could not be accomplished within one year, Both projects did not adhere to DRMP Principle of Decremental Funding. JULY /AUGUST REVIEW Estimated request as of May 1974: 0 ‘ * Also, project #25 - Health Education for the Public should have a technical review site visit by out-of-state consultants who are familiar with the @ RMP process. ~ ‘ MCO 6/4/74 STAFF SUMMARY FOR MAY REVIEW NEW MEXICO REGIONAL MEDICAL PROGRAM: RM 00034 COORDINATOR: Richard A. Walsh, M.D. (Acting) On Duty: 5/1/74 STAFF:FTE) Total - 24.5 Additional proposed: 5 Professional: 15.5 Professional: 5 Other: 9 Full-time 3 Part-time 2 FUNDS REQUESTED: Total (D.C. & I.D.C.) $2,774,838 Program Staff 653,664 Projects (11) total 2,121,174 Continuation (8) 1,917,366 New (3) 203,808 CHP COMMENTS: CHP "A" and the two official CHP "B" agencies met on April 11, 1974 for a joint CHP Review Committee meeting. Comments are included on pages 62- 72. Dr. James R. Gay's May 1, 1974 cover letter to Dr. Herbert Pahl contains a response from New Mexico RMP RAG which is included as attachment #1. ITEMS FOR ATTENTION: 1. Project #18 - EMS in Rural Areas; $911,106 request for substantial - increase from previous two years of support. 2. Project #25 - Health Education for Public; $302,955 request for. substantial increase from previous two years of support. 3. Richard A. Walsh, M.D. is Acting Coordinator of NMRMP for 5/1/74 to 6/30/74. James R. Gay, M.D. expects to resign 6/30/74 but will Femain as consultant to Dr. Walsh. The NMRMP RAG will forward its recommendation for the permanent appointment of a Coordinator after the May meeting of the NMRMP Executive Board. @: el974 34 NEW MEXICO - MID CONTINENT vnc eee nets eee NOL. NO OF COMPONENTS com coo 018 030 031 033 034 035 PROG e 0 12 "STATEWIDE HLTH NEEDS ASSESS 032 “EMERG HLTH SERV ‘COMMUNITY HLTH RESOURCE DEVELOP REQUEST ' COMPO YR 06 COMPONENT TITLE PROGRAM STAFF SE CHES HLTH EDUC HYPT ” REONATAL INFANT TRANSP STATEWIDE GENETIC CTR ‘HLTH RESOURCES REGISTRY REG HLTH RES PLAN AND DEVEL POISON CONTROL/DRUG INFO CTR OS LISTING BY REGION 06/74 COUNCIL REGION TOTALS DIRECT REQUEST 5654387 842,932 _ 43 9563 275,012 699350 99,060. 299833 502000 1619257 909550 469115 1923608 | 294659677 “INDIRECT REQUEST | 88,277 68,174 49587 | 279943 59737 (129729 19713 109473 27,891 16,862 T9349 - 379426 . 309,161 @...-. TOTAL _... REQUEST 6536546 9117108 | 48,150 3024955 75,097 111,789, 319546 609473 189,148 107,412 534464 2309034 207 74_ 838 » I “yap NEW YORK METRO Rea 00058_ HAY /JUNE 1974 REVIEW Request: $6,417,005 Committee Recommendation: ~ $2,500,000 Overall assessment by individual reviewers: Average Critique: This application requesting $6.4 million for two years, was reviewed in depth by two reviewers, one of whom had only the written word to study and the other who had been on the site visit two years ago. Both reviewers were impressed with the proposed projects that address a real meed in New York--namely, a better network among the clinics and the public and private hospitals. But the reviewer who was a former site visitor was also impressed with the improvements that had accrued in this program despite phase-out and other uncertainties--the change in grantee, the quality of staff leadership and the increased functioning of the Regional Advisory Group. The Committee was concerned about the advisability of initiating projects that meeded at least two years funding which was requested; but they concluded that a number of the projects represented the culmination of several years planning and development, that the projects were needed, and that other sources of funds may be forthcoming if the initial efforts prove effective. The Committee felt that additional staff were needed. In consideration of the population served by this RMP and their health needs, the quality of the proposed projects and the improvement in the management and grantee-RAG relationships, the Committee recommends that this application be approved at.$2.5 million level and that this region be given a high priority for distribution of funds in the July- August review. , JULY /AUGUST REVIEW Estimated request as of: May 1974: °__ $2,000,000 Sa @ NEW Regional Medical Program RM 00058 . Coordinator: Jesse B. Aronson, M.D. ‘On duty since: 42/72 Staff: Full Time Prof. 7 Proposed: 7 Part Time Prof. | | 3 0 Full Time Other 3 2 Part Time Other 0 0 Funds Requested: 7/1/74-6/30/75 7/1/75-6/30/76 Total eoeeeeeeeraeeeeseees 4,330,808 3,033,819 Continuationecccssees sone ( 859 ,430 ) Newsccacccccccecccceseess (2,436,289 ) © Staff-Central Core Activ. (1,035,089 ) Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C . will be placed next to activities which extend beyond June 30, 1975.) RM 00058 List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: Project #37 - Comprehensive Medical and Health Care Service at Maimonides Medical Center - This may or may hot be an HMO, depending on the payment mechanism, . EMS project: Project #62 - Treatment in Municipal Hospital Emergency Rooms ~ This may or may not be an EMSS start up. It certainly is not comprehensive; i.e., it does not purport to establish a system. On the other hand, it does not appear to "tie in" to an overall EMSS activity in the city or the state. Perhaps, it is an excellent, highly needed project; however, it still seems to sit in isolation and is not even (apparently) coordinated with the New York State EMSS effort. PSRO: Kidney: . . CHP comments: The CHP review, although cursory, was acquired and was favorable, Conclusion: This program is on the move and needs encouragement. It is more structured, better managed, and appears capable of making an impact on the complex workings of the New York City health care system in the near future. There is little doubt that money spent in this geographic area would be reasonably well managed and would find itself in areas of critical need; however, it is difficult to visualize the current staff and organization effectively administering nearly 5 million dollars in the next fiscal year. 4 reduced funding level might encourage a consolidation (streamlining) of the multiple hypertension, kedney, manpower and primary care activities. To bring these clusters under some sort of an umbrella would seem to strengthen the overall program and make it more effective with fewer dollars, E0/5/20/74 . M 1974 . : fae mo am OS Bee eee ee ae - . 06 PROG. YR. 04 8. NYC METRO. _ ASTERN C00 034 0414 (044 055 056 062 COMP ~ wa NO coor cooz 037 ~ PLAN REG AFFILIATION EDUC “INST EMERG MED - - REQUEST DOS LISTING comMPO BY REGION OUNCIL COMPONENT TITLE PROGRAM STAFF “HYPT PROG DEVELOP IMPACT NATL HLTH INS ON HLTH PROG MNPUR INFO CLEARING HOUSE COMP MED & HLTH CARE SERV Ame HLTH CARE ELDERLY PEEKSKILL AMRULATORY HLTH CARE CTR “HOSP SATELLITE AMBULATORY CARE NY NJ REG TRANSPLANT EL BARRIO YOUNG PEOPLES CLINIC” HLTH MNPWR COUNSELLING SERV. “DEMO DEL COMP HOME HLTH SERV. “NURS. PRACT “+ HYPT REFERENCE LAB "USE UNION MEMBER COMPLIANCE MECH HYPT CNTRE _ "DIAG MED SONCGRAPHY TRNG ORGAN ACQUISITION “EVAL HYPT DX RX 6 HOSPS IMP CARE PTS SEEK EPISODIC T Rx MUNICIP HOSP EM RM DIRECT REQUEST 371,779 669300 3974500 2949624 191229603 704266 2249926 475 9562 190,804 __ 120693 209241 1924046 183,500 5135257 173725 3549481 1207637 182,332 1074160 969653 947 9632 INDIRECT REQUEST _ . 884514 159978 " 954798 0 O° 0 0 “0 0 0 0 QO o 0 o 0 Q 0 oO 0 oO TOTAL REQUEST 4605293 82,278 4939298 2944624 191222603 705260 2142926 475 4562 “190,804 120,693 209241 192046 183,500 5135257 1735725 354,481 1205637 182,332. 107,160 947 9632 MAY, 974 ; REQUESTED LISTING COMPONE REGION we MAB 06/74 NCIL NYC METRO PROG YR 04. . STERN comp COMPONENT TITLE DIRECT ee NO Co _. . REQUEST OF COMPONENTS 22 REGION TOTALS 6,216,715 > _ , INDIRECT REQUEST. . 2009290 TOTAL REQUEST 6,417,005 BEVEL EEL WARE NORTH CAROLINA REGIONAL MEDICAL PROGRAM RM 00006 MAY /JUNE 1974 REVIEW Request: $3,258,255 Committee Recommendation: $2,375,522 Overall Assessment by Individual Reviewers: Superior Critique: . The reviewers regarde| the NCRMP as a superior program, whose past performance has been outstanding in terms of designing programs to meet the needs and providing services to areas that are deprived of health care. Although there has been a change in leadership, the new Executive Director having been with the program as Deputy Director for five years, was thought to be quite adequate in providing leadership and direction to the program. The Regional Advisory Group's performance is considered good, CHP relationships are good and the program staff though small appears to possess the necessary skills and competence to manage and monitor program activities. The present application, although over-ambitious and some of the activities inappropriate, is believed to be congruent with the region's objectives and priorities. Reduction in recommended level based on the fact that some proposals were considered over-ambitious and some were considered to be inappropriate for DRMP funding. JULY /AUGUST REVIEW Estimated Request as of May 1974: $400,000 DRMP/DOD SCOB/6-6-74 MAY REVIEW STAFF SUMMARY Prepared by: Jeanne Parks Grant # : RM 00006 NORTH CAROLINA REGIONAL MEDICAL PROGRAM 4019 North Roxboro Road P.O. Box 8248 Durham, North Carolina 27704 Ben F. Weaver, Executive Director On Duty As Executive Director Since: 5/1/74 Was Deputy Director 1969-5/74 CURRENT STAFF PROPOSED STAFF Full-time Professionals - 9 Full-time Professionals - 8 Part-time Professionals - 0 Part-time Professionals - 1 Full-time Support Staff - 3 Full-time Support Staff - 3 Part-time Support Staff ~ 1 Part-time Support Staff - 0 FUNDS REQUESTED: Total Costs = $3,258,255 Program Staff - $456,344 Target Figure: $2,702,000 ---- Continuation - $875,378 (7/1/74-6/30/75) New -$1,926,533 Estimated July Request: $400 ,000 Period of Time Requested: ‘Alt projects will terminate as of 6/30/75. CHP COMMENTS: It is the policy of NCRMP to involve CHP agencies in the development of projects at the time a project is being developed. Therefore, the review and comment procedure is a mere formality since the agencies are aware of the project content and have had input from the beginning. This application contains 15 continuation projects which were previously approved for multiple years funding by the appropriate CHP agencies, ‘New activities included in this application were submitted to the appropriate CHP agencies on March 28-29, 1974. In many instances there is no active CHP agency in the area where proposed projects will take place. In other cases projects are statewide training or other type activities of a broad nature which are not applicable to individual CHP "b" areas. However, projects were sent to five of the seven approved CHP agencies within the State. All agencies gave verbal approval of the projects reviewed prior to the RAG meeting, but asked to be given until May 1, to submit formal letters of endorsement to the NCRMP. The letters will be forwarded to DRMP as they become available. The "A" agency is currently in the process of being transferred from the Department of Administration to the Department of Human Resources. The Director of the "A''agency and the Director of the "b" agency (elected by the other "b" agencies) are members of the RAG. -~“~o- 7 North Carolina Regional Medical Program ITEMS FOR REVIEWERS ATTENTION: EMS: No new EMS activities are proposed. Project #49 - Emergency Room Training For Community Hospitals is a continuation activity, which was funded for a total of 24,472 for the period 1/1/74-6/30/74. The region is now requesting $79,848 total costs to continue the project through 6/30/75. KIDNEY DISEASE: Project #28 - Care of Patients with Chronic Uremia, is a continuation activity. It does not invision any large increase in funds, but does propose to expand the capacity for dialysis. PSRO: Project #63 is a continuation proposal which was initiated April 1974, It is designed to develop an educational program for all physicians in the state which promotes the understanding of peer review techniques and increases the capability of physicians to perform such review. Project 67H - Rural Health Clinic Operational and Equipment Assistance, requests $243,100. This activity requests support services for access to primary care tied in with National Health Service Corps appointments. | Project #69 ~ Statewide Network of University-linked Hospital Libraries in North Carolina. This ig a request for $362,993 to develop a network of 59 community hospital libraries, which will be linked to the major health science libraries of the state and to the resources of five schools of health science at the University of North Carolina. DRMP /DOD SCOB/5-20-74 , WT MAY 2551974 N CAROLINA H CENTRAL O66E REQUESTED S$ LISTING COMPON Y REGION 06/ NCIL PROG YR 06 | COMP COMPONENT TITLE DIRECT NO. ' . REQUEST COCO = PROGRAM STAFF . 377,097 | C001 MED AIR OPERATIONS _ . 50,000 028 CHRONIC UREMIA , 489403 031 COMPRE CARDIAC PACEMAKER EDUC 219424 036A RADIATIGN RX PLAN SERV , 839117 “041A ALBEMARLE HUMAN RESOURCES DEVELOP SYS 34,308 041 ARPA HLTH EDUC SYS FGOTHILLS _ "354000 ° 043 OIABETES SHARE YOUR SKILLS : . 539103 046 ALSEMARLE COMPRE SPEECH AND HEARING SERV : 809404 048 WALSTUNAURG COMMUNITY CLINIC . , 545481 049 EMERG RN TRNG COMMUNITY HOSP oe 639725 952 MEASURE QUAL PT oe SO 479742 053 CRAVEN CNTY MOBL HLTH CARE 399397 084 AREA HLTH EDUC SYS REG CODE E . 639381 053 STROKE REHAB . 174998 061 CHILDHOCD CA = "20,000 063 PSsRO 125,215 066A HYPT EDUC REFER ST i 309240 0668 SURHAM HIGH B P EDUC 524,008 d66C MODEL CLINIC AND COMPLIANCE . 334440 066D INDUSTRIAL HYPT . OC 434840 HYPT PHYS EDUC 31,325 INDIRECT REQUEST 799247 0 0 39720 159656 -o C&C 8 9 ° 39665 6303 4053 59313 3797 os ; “oo TOTAL REQUEST 4569344 ” $0,000 (489403 — 259144 989773 34,308 354000 534103 80404 54.481 795848 479 Th2 39,397 63,381 20,179 204000 125,215 334905 58,311 379493 49-153 35,122 ~ MAY 1591974 2 ow. COMPONENTS 06/74 C | CAROLINA _-.. PROG YR 06 | CENTRAL comp COMPONENT TITLE we ce eee eee ND ee ee oe - wet eee ee te BO 066F - HIGH BP PUB Eouc 0666 NURS TRNG Fe 066H. HIGH SCHOOL HYPT EDUC & CNTRL 0661. EDGECOMSE CNTY HYPT CNTRL . 0663 = SHELBY HYPT CNTRL 066K “REG R HYPT CNTRL “066L NCRMP HYP PGM IMPACT MEASURE AND DESCRIPT 067A STAT DATA BASE RURAL PRIM CARE DEVELOP 0678 “Q67C «= DOCUMENTARY FILMY MID LEVEL PRACT RURAL AREAS 06792 PHYS RECRUIT DEMO ""Q67E = PHYS: «STAFFED RURAL HLTH CTR DEMO “ ee O67F «CONT EDUC PHYS EXTENDERS RURAL PRIM CARE 0676 NC RURAL SATELLITE CLINIC WORKSHOP 0672 RURAL HLTH SERV EVAL O67J RESIDENT INCENTIVE 868) CONSUMER / PROVIDER CMNC 069 STATEWIOE NETWORK UNIV LINKED HOSP LIBRARIES 070 PERINATAL NURS SPECIALIST TRNG "O72 0 ELEM SCHOOL HLTH CURRIC - O72 PRGBLEM ORIENT MED RECORD WORKSHOPS ‘C67H -RURAL HLTH CLINIC OPERATIONAL & EQUIP ASSIST | REQUESTED FUNDS LISTING GION DEVELOP GUIDEBOOK & MATERIALS RURAL CLINIC DEVELOP DIRECT .. REQUEST 34,750 5000 ” 649100 | 319985 30,000 144,000 30,000 41,500 90,000 31,155 38,975 319875 58,000 169400 ” 2439100 202000 10,000 542646 3542572 833626 3262540 32,123 INDIRECT REQUEST 4e211l 0 19709 ) ° o 98 o Oo 8 96 o 989 89 @8 080 G6 90 297021 89421 "7,082 89872 w= . - USMerNse TOTAL REQUEST. . 385961 5000 31,985 309000 "144,000 30,000 31,155 389975 162400 20,000 104000 835667 3629993 909707 369540 404995 41,500 | 90,000 "31,875 58,000 243910000 MAY. mh oo _ | REQUESTED Fygillbe LISTING COMPONEN REGION . . Se | ee 06/74 IL N CAROLINA .. PROG YR. 06 ITH CENTRAL «COMP 7 COMPONENT TITLE coe eee NOL ae 073. CONSULT & TECH ASSIST DEVELOP HLTH SERV DEL MODELS worm OME HLTH SERV CRAVEN NORTHAMPTON ONSLOW ROKAN CO CF COMPONENTS 46 . a REGION TOTALS 4 : DIRECT REQUEST 60-981 103 694 3,052,670 INDIRECT REQUEST 69212 0 . 2059585 foe “oO TOTAL ... REQUEST . - 67,193 103 9694 322582255 oe . RMP North Dakota @ 3M 00060 . MAY /JUNE 1974 REVIEW Request: $774,057 Committee Recommendation: $582,517 Overall assessment by individual reviewers; Average_and Below Average Critique: Continuity of program is achieved through a small but well oriented central wu program staff. A full-time deputy director 45 being requested to strengthen i program direction. \ Reviewers considered as unrealistic the request of $400,000 (2/3 of project dollars) for Biomedical Communications System, at each of 4 AHECs (Area Health Education Centers, supported by previous grant from Health Manpower Bureau) » 7 oe huge investment in hardware » computer linkages and other new equipment. The RMP subsequently advised it could reduce the request to about $300,000, and slow down linking facilities with the base centers. Reviewers believed the project overly ambitious,» and recommended considerable scaling down in view of other priorities. Concerns were expressed with regard to data projects (2 later withdrawn) and - a contract for guidance on implementing Certificate of Need Legislation. iy Reviewers recommended more emphasis on improving capability of allied : professional health personnel in delivery of services. The need for a 3-bed unit for kidney dialysis outpatients which was questioned was approved by CHP A and B agencies, a5 well as Social Security Admini The request has been given high priority by RAG and CHP. JULY /AUGUST REVIEW 0 Estimated request as of May 19743 Eee eee a nico 6/4/74 Gitte ee re “ STAFF SUMMARY FOR MAY REVIEW ® NORTH DAKOTA REGIONAL MEDICAL PROGRAM: RM 00060 EXECUTIVE DIRECTOR: Charles Arneson, M.D. ~ since September 1972 STAFF:FTE) Total - 5.6 Additional Proposed: ] Professional: 4 Professional: 1 Full-time 2 * Part-time 2 Other: 2 Full-time 2 * Executive Director and Computer Programmer FUNDS REQUESTED: Total (D.C. & I1.D.C.) $774,057 (exceeds target figure of 582,517 by 191,000) Program Staff (total) $145,940 Projects: (10) total 628,117 (see note) Continuation 0 New (10) ** 628,117 CHP COMMENTS: "A" Agency Executive Committee to meet 5/15 but favorable comments from staff on general review, especially projects related to medical school expansion and further development.** Three active "B" agencies reviewed and commented; approved manpower development projects. Concerns about data collection and forms. RAG considered all comments on review; disapproved some data activities. Identified priorities. (5/20/74 - A agency comments received. } ISSUES: #95 - Biomedical Communications System - establish at each of 4 AHECs and given high priority by all reviewers at all levels. Request.totals $400,000 (about 3/4 for communication equipment and stations). Upon questioning Region, reported that it could consider some modification and reduction of portion of equipment (#95); est. reduction of $104,000. #97 - Kidney: Establish satellite hemodialysis unit (3 beds for outpatients) at United Hospital (under supervision of Minn. Regional Kidney Disease Program) and seeking exception from SSA of freeze. High priority and under study during past grant period (equipment $18,131). Note: RMP advised 5/20/74 that 1 data project and a study proposal (#100 and +x #101) were withdrawn (approx. $28,000) reducing projects to 8 and total project $ to $600,000. @ July 1 - 0 Request expected. L. Resnick - MCO Revised 5/28/74 _ oO” ee 60 _N DAKOTA. PROG YR 04 MID CONTINENT COMP COMPONENT TITLE : oe NO - C000 PROGRAM STAFF 093 FEAS STUDY DEVELOP OF RESIDENCY INT MED 094 STUDY RGF GRAD PROG BEHAVICRAL SCI 095 EIQMED CMNC SYS 096 EVAL APPLICATION COMPUTER IN HLTH CARE 097 EST SATELLITE HEMODIAL UNIT 096 PROJ REVIEW REF N D CERTIFICATE OF NEED “099 —-~ PLAN HUMAN SERV CTR Withdrawn +5 Withdrawn hee “DATA ANAL AREA HLTH PROBLEMS GROUP STUDY IDENTIFY COMMUNITY HLTH PROBLEMS 102 DEVELOP HLTH DATA COLLECT FORMS NO GF COMPONENTS... 11 . Se woe REGION TOTALS REQUEST DS LISTING . cameo BY REGION . . 067 UNCIL . DIRECT - REQUEST 145,940 13,775 99620 " 400,000 362617 48,191 252000 415700 20,072 8 e142 25 3000 7142057 ~~ INDIRECT REQUEST o o o¢ GG a© & G89 GO oO oO @ TOTAL REQUEST oO 0-23 } £ " 1459940 139775 " 99620 400000 36617 485191 25,000 41700 209072 By 142 25,000 T4057 RMP Northern New England © | RM 00003 MAY/JUNE 1974 REVIEW Request: $1,039,670 Committee Recommendation: ($700,000 Overall assessment by individual reviewers: Above average - superior Critique: This application requesting support for staff and seven ongoing projects presents a cohesive program with staff activities and projects clustered around well-defined objectives. The RMP continues to be involved in the evaluation and improvement of the medical care system through the mechanism of disease management committees. The Regional Advisory Group has been actively involved in the development and support of established program priorities. It is a major strength in the program. The relationship with other state agencies also appears strong. The staff is now directed by a new coordinator who has served on the staff for some time. The Committee was concerned about the budget, however, which seemed high, particularly the program staff portion. The Committee recom- mended that this application be approved at a reduced level of © $700,000, but believes the RMP should be in a high priority for * an increase level, pending satisfactory review of the July application. JULY/AUGUST REVIEW Estimated request as of May 1974: $800 ,000 RM 00003 Northern New England Regional Medical Program Coordinator: Edward Francisco, Ph.D. On duty since: 6/30/73 Staff; Full Time Prof. 4 Proposed: 9 Part Time Prof. 0 0 Full Time Other 3 5 Part Time Other 0 0 Total 7 i“ Funds Requested: Total aeoveoeueneoeneoeeveeeeeee 1,039,670 Continuation. sccrccccceses (608,870 ) - 7 Projects* e-0UCC ( None ) Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . *Although all projects in their request are continuations, most are only in their second year of funding. Two projects -- numbers 37 & 38 appear as new projects, but are actually continuations as the first 12 months were funded via the contract mechanism from the "core" budget. ‘ RM 00003_ (NNE) List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: NONE EMS project: This request is for the third and final year of RMP support. The amount requested is higher in the third year as the program can now increase its training capacities and devote greater attention to the development of local ambulance districts. This next year activities build on a long-range EMS plan that Vermont has effectively developed. PSRO; Vermont has long been active with issues surrounding "quality of care." The state has pioneered with the "Problem-Oriented Medical Record" and ways to relate it to measuring quality of care. The NNERMP since its inception has devoted considerable attention to quality of care with heart disease, cancer, respiratory disease, etc., as well as extensive data collection. In addition, the Coordinator is active in the development of a statewide PSRO. ‘ Kidney: This application requests an increased level of support, but it is stated that this will be the last year of RMP support. The increase is primarily to support the kidney program staff and training of personnel to render end-stage renal disease patient care. After this year, the major financial burden associated with meeting initial training needs should be substantiately diminished and the program in a position to function on other funding sources. CHP comments: This application requestd continuation only, of activities previously reviewed and approved by CHP. The "continuation" application was submitted to CHP and CHP has verbally endorsed it. CHP has chosen to devote its attention to new RMP proposals developed for submission on July 1. E0/5/20/74 . MAY eo NO. NEW ENG PROG YR . 05 mo co. RN sCCQMP COMPONENT TITLE DIRECT ee (eee a REQUEST . - C000 © PROGRAM STAFF : 430 9800 ~ 006 REG END-STAGE KIDNEY RX 62,700 morn UNCREASE CAPABILITY RURAL AMBULANCE & ER PERS 897740 =" Qog "REG HIGH RISK INFANT & MOTHER PROG | 1454954 O11 REG RESP DISEASE PROG " 539425 mm AMBULATORY PEDIATRIC CARE ST JOHNSBURY 46,000" oo 937 \ VOL PROBLEM-ORIENT HLTH CARE INFO SyS- 76 200 938 TRNG SERV CTR DISORDERS OF CMNC - 79,068 \F COMPONENTS... a. .... a, REGION TOTALS 983 9887 é . : REQUESTED FU LISTING COMPONENT EGION be ee 06/74 L INDIRECT _ REQUEST 0 99854 29335 15,808 | &y670 0 0 23,116 55,783 . @ TOTAL REQUEST 4301800 725554 "92,075 161s 762 58,095 464000 _ 764200 1027184 -120392670 we ee ee NURIHLANDS KEGLUNAL MBULUAL PKUGKAM RM 00021 MAY/JUNE 1974 REVIEW Request: $1,889,395 Committee Recommendation: $1,700,000 Overall Assessment by Individual Reviewers: Below Average/Average Critique: The past performance for this region has been excellent, with internal management considered to be one of their greatest strengths. Historically Northlands RMP has been using a contract mechanism to increase extramural participation. The region is continuing this approach via the active involvement of the various committees of RAG. These funds have been used for the most part as seed monies of short duration to study and develop new approaches to the delivery of health care for the constituents of NRMP. The region has been successful in the past in finding other sources of funding after termination of DR¥P support. As of June 30, 1973, the Program Coordinator left and the Deputy Director was appointed to his position. The past Coordinator has remained active on a voluntary basis in terms of providing advice and counsel. Prior to the phase-out this program had an adequately experienced program staff. Following the rescinding of the phase-out order, the Board decided to retain a small nucleus of program staff personnel and purchase by contract the various consultants that would be needed. This created concern with the reviewers as to the adequacy of staff in terms of fiscal and program monitoring of the various activities proposed. In spite of the past record on local support, concern was expressed by the reviewers relative to the generation of local support for the proposed AHEC's. The reviewers felt that good work had been done in terms of the development of a program call the Foundation for Health Care Evaluation, but expressed concern as to whether existing staff could properly guide and monitor such a program, and (expressed concern) as to the need for further information on this program. The reviewers generally expressed a concern for the lack of specificity in the programs presented. To reiterate, the reviewers expressed concern relative to staffing, lack of activity in primary care, possible funding in the PSRO area. ‘The above concerns were considered in arriving at a recommendation by the Committee. In this application the region has requested funds to support the initial staffing of two CHP "'b'' agencies. JULY/AUGUST REVIEW Estimated Request as of May 1974: $600,000 SCOB/DRMP 6/6/74 ee MAY STAFF SUMMAKY KEVILEW Prepared By: Joe Jewell Grant. # : RM 00021 NORTHLANDS REGIONAL MEDICAL PROGRAM, INC. 375 Jackson Street St. Paul, Minnesota 55101 Robert Wilkins, Coordinator On Duty As Coordinator Since: 7/73 Deputy Director Since: 1/68 Current Staff: Proposed Staff: 3 Full-time Professionals 5 Full-time Professionals 3 Full-time Other 4 Full-time Other FUNDS REQUESTED: Total Cost - $1,889,395 Program Staff - 200,223 Centinuation -(1,463,022) Target Figure: $2,116,240 (7/1/74-6/30/75) New ~( 226,150) Estimated July Request: $600,000 Period of Time Requested: All activities to terminate as of 6/30/75 ITEMS FOR REVIEWERS ATTENTION: Excluding the amount requested for Program Staff (CORE) support, the region is requesting $1,689,172 for operational activities via contracts. The percentage of the proposed program to be beamed at the following health care areas or systems are: Percentage of Activity Total Costs Total Request Community~based Health $674,618 39 Education and Manpower Training Quality Assurance $326,676 20 Hypertension $191,985 11 Emergency Medical Services $281,506 17 Kidney Disease $149,777 9 CHP Regional Agency Support $ 64,610 4 The plans for these activities are described in the program report section (orange) portion of the application. The requests for EMS and Kidney proposal are for the continuation and expansion of currently funded activities. _ Page 2 Northlands RMP Summary Last year the region allocated $25,000 to develop a State EMS Plan. The requests in this application are to begin to implement the plan. The Quality Assurance Requests are for the development of standards to complement the Professional Service Review Organization(s) when this is settled in Minnesota. CHP: The region outlines its procedures and expectations for the involvement and support of health planning agencies in the May Ist cover letter to Dr. Pahl as well as throughout the application. An April 25, 1974 letter from the Executive Director of the Southeastern Minnesota Health Planning Council (Rochester) is included in the application. This was not received in time for consideration when the RAG reviewed this submission. The (b) agency recommended "disapproval, approval with conditions and denial" on three of the five requests it reviewed. The region has assured DRMP Staff that the concerns expressed by the planning agency will be solved or satisfied before the proposals are presented to RAG for funding considerations. The region is requesting funds ($64,610) to support two unstaffed CHP (b) agencies in South-Central and Southwestern Minnesota. DRMP / DOD SCOB/5-16-74 REQUESTED FU MAY @ . oo” oe, a 06/74 COUNCIL COMPONENTS EGION ORTHLANOS . PROG YR O05 CENTRAL come COMPONENT TITLE ee — NO . a ee ws cooo PROG STAFF 103. KIDNEY DONOR RECOV & TRANSPL LOSS. AV ~TECHNIQUES 106 | QUAL. ASSUR OUTCOME 106S UAL ASSUR OUTCOME 107 «ASSIST GUAL CARE EVAL _ 107S ASSIST CUAL ASSUR MECHANISM “1088 SUPERV MGMT TRNG . “113 HLTH CARE S W MINN 114. CLINICAL PASTORAL MINISTRY EDUC 1145 CRITICAL CARE NURSING “415 E & TRNG NM MINN | 116 «SE MINN PROGRAM IMPLEMENATION 117 CONTINUING EDUC HLTH PERS S C MINN “418 WEST CENTRAL MINN CHEC PROGRAM 118S NURSE AID CURRICULM 119 CURRICULUM OFFERINGS IN HLTH OCCUPATIONS “\ze | MAYO-COMMUNITY-BASED HLTH EDUC , 121 HLTH SCI COMMUNITY HLTH EDUC 1215 MANAGEMENT TRAINING REG LEARNING CTRS woes "423 AGASSIZ HLTH PLAN EMERGENCY 12358 DEVELOP PUBLIC INFORMATION PROGRAMS ESTING . OIRECT REQUE ST 200 4223 279500 475480 207000 739135 30,000 1589926 1299628 259000 10,000 249339 25,000 25,000 25,000 25,000 25,953 25,000 © 10,000 10,006 794396 10,006 1749294 INDIRECT . REQUEST 0 0 “1ne410 0 249615 0 ° ‘92 © 0 23800 Qo oOo G6 10199 0 0 0 182419 osx ru: TOTAL REQUEST 200,223 274500 58 890 20,000 97750 30,000 1589926 “1299628 254000 102000 279139 25,000 25,000 25,000 "25,000 365152 254000 10,000 10,000 979815 107000 179294 21 @.: BC REQUES . 06/74 COUNCIL NORTHLANDS. . SOUTH CENTRAL C OF COMPONENTS COMPON PROG YR . 05 - coMP COMPONENT TITLE NO. 124 MIN-DAK CHP EMS 125. METRO AREA EMERG SERV STUDY 125S METRG AREA EMERG SERV STUDY 126 INTERSTATE EMS 127. PLAN FOR COMPRE EMS 127S PLANNING COMPRE EMS 128 STRENGTHEN LOCAL QUAL ASSURANCE 1298 MODEL HYPT DETECTION MGMT 131$ COMPRE ORGAN RECOVERY PROG 1358 IMPROVE COMMUNITY BASED MNPWR DEV 13g SE MINN EMS PLAN & HOSP DESIGNATION 139 - REG IX CHP SO CENTRAL oo 140 COMPRE HLTH PLAN Sw | 141 METRO AREA CHEC : 142. RESOURCE CTR REHAB ILL 143. PLAN EMS PERS 144 AUDIO VISUAL PT EDUC ON HYPT “Y45 9 MINN GOPT OF HLTH HYPT 146¢ SOUTH CENTRAL EMS 147 SW EMS REGION ‘>: LISTING BY REGION DIRECT REQUEST 10000 10,000 15,000 10,000 10,000 1189428 20-000 119,135 1229277. 959165 10,000 349842 29,768 250900 195254 287650 7035 507000 10,000 10,000 TOTALS 19778 9448 INDIRECT REQUEST 17%823 0 14,080 0 o oo 8. eo 6 5.555 42311 1,735 1109947 o 9 oOo 8 oO TOTAL REQUEST 10,000 10,000 154000 — 10,000 10,000 1367251 20,000 133,215 1229277 954185 107000 (34,842 294768 254000 24,809 32+961 85770 50,000 10,000 16,000 198895395 VALU VAD BROULUNAB Iu DINU “ 0 RM 00048 MAY/JUNE 1974 REVIEW Request: $2,820,536 Committee Recommendation: $2,205,636 plus 100,000 for Project 27(d) to fund Toledo, Lima, Dayton, Ohio activity. Overall Assessment by Individual Reviewers: Below Average/Average Critique: This region was reviewed in depth by two reviewers neither of which had ever site visited the region. This region has had a change in Coordinators, as of July 1973. The new Coordinator has been a member of program staff since 1969. Program staff is considered to be adequate. Regional Advisory Council relationships are excellent, and all program activities are congruent with the goals, objectives and priorities established by the Regional Advisory Council. This RAC has a long history of being one of the better ones in terms of decision-making. This region historically covers parts of Indiana, West Virginia, Ohio and Kentucky, with input from the medical schools in Kentucky, Louisville and Cincinnati. The region is entering its third triennial year and has been considered to be in the upper quartile of regions within the country. The Ohio Valley Regional Medical Program at the request of Division of Regional Medical Programs had agreed to accept applications from the three phased-out Ohio regions. This meant accepting fiscal responsibilities as the Grantee and staff responsibilities for monitoring and evaluating any activities submitted. Assurances were made by DRMP that should such activities fit within the region's program priorities and objectives this would not effect their funding level. This region's past performance and accomplishments and their relationships with CHP, Appalachia and other agencies, including surrounding RMP's are considered to be excellent. In arriving at a reduced funding recommendation, criticism was leveled relative to the tripartite nature of certain projects as it relates to the three medical schools. Concerns were expressed relative to the length of funding of certain demonstration projects that had been receiving RMP support beyond a three year period. Another concern was expressed relative to financial stimulation of the Home Care Programs under third party payees. Such coverage has not yet been too successful. (CONTINUED ON PAGE 2) «~ : PAGE 2 - OHIO VALLEY REGIONAL MEDICAL PROGRAM RM 00048 JULY/AUGUST REVIEW Estimated Request ‘as of May 1974: None DRMP SCOB/DOD 6/6/74 MAY REVIEW STAFF SUMMARY OHIO VALLEY REGIONAL MEDICAL PROGRAM Prepared by: Jeanne L. Parks 1733 Harrodsbury Road P.O. Box 4098 Lexington, Kentucky 40504 E.L. Angie Hebbeler, Director On Duty Since: 7/1/73 Former member of Program Development staff since 1969 CURRENT STAFF Total proposed: 15 0 Total proposed: 16 6 Full-time Professional staff: Part-time Professional staff: Full-time Other : Part-time Other FUNDS REQUESTED: (Target figure: $2,294,728) OFF Total Costs : $2,820,536 Period of time requested: All Program Staff: 503,710 projects are scheduled to terminate Continuation : 2,150,303 6/30/75 New : 166,523 This region does not anticipate submitting a request for funds for July 1, 1974. CHP COMMENTS: No problems noted. All proposals were reviewed by the CHP(a) and (b) agencies prior to the RAC review. Page 87 of the application lists each project and the CHP(a) and (b) agency reviewing the project. ITEMS FOR REVIEWERS ATTENTION: EMS - No new EMS activities are requested. Project #36 - Advanced EMT is a continuation activity and currently funded through 6730/75 for a total of $14,585. The region is now requesting $44,239 for the period 7/1/74-6/30/75. Project #37C - Area EMS Development - Kentuckiana is a continuation activity and is currently funded through 6/30/75 for a total of $16,769. The region is now requesting $26,159 to complete the development of coordinated emergency medical services plans for a 17-county area of Kentucky and Indiana. a Page 2 - OHIO VALLEY REGIONAL MEDICAL PROGRAM Kidney: Project #44 - Computerized Time-Oriented Data Base Implementation Renal Failure This is a new activity directed at the creation and computerization of a time-oriented data base for end-stage renal failure. uw &- OHIO VAL H CENTRAL COMPONENT TITLE HLTH MNPWA SURVEY DEMO REQUESTED F COMPONENT ISTING EGION 06/74 COUNCIL DEL SYS NEEDS & EVAL STUDY: EDUC RESOURCES EDUC RESOURCES» EDUC RESOURCES EpUC RES ~ MULTI-SPONSOR: DANVILLE KY GEORGETOWN OHIO DEVELOPMENTAL AWARDS MAYSVILLE KY LEXINGTON KY ASHLAND KY EFFECT DE PARRIERS IMP NURS COORD DIS PLAN ELDERLY HLTH SUPERVISOR — LOUISVILLE KY “REG PEDIATRIC HT CLINICS REG PEDIATRIC HT CLINIC " PROG YR 05 COMP NO .. C000 PROGRAM STAFF £004 coos. tt Coos = HLTH 005A UNIV CONT 005B UNIV CONT 005¢ | UNIV CONT. 0050 UNIV CONT OLLA HOME CARE ‘O1IB HOME CARE — O110 «HOME CARE = “GLIF HOME CARE - O1LH HOME CARE — OL1I HOME CARE ~ OLLJ HOME CARE - OL1XK 015 ‘CLINICAL ASSOC 020 DIALYSIS TECHNCLUGIST G21A. 0218 “O21C. REG PEDIATRIC HT CLINICS RURAL PRIM CARE OIRECT REQUEST 4179550. "15,000 6,000 1,500 44,557 295976 129695 15,000 385253 254000 359512 200,000 ' 33,210 105 597 55,860 459405 62 691 "369865 20 9283 © 224965 202547 15,077 INDIRECT REQUEST 869160 0 0 0 18,862 149798 69347 8,217 } we 11,133 on TOTAL REQUEST we 503710 154000 6000 1,500 635418 “bag TT4 19 9042 154000 "464470 254000 469645 "200,000 334210 1059697 55,880 45,405 919662 529515 264503 33140 299296 15,077 JHIO VAL... 4 CENTRAL STING GION REQUESTED FU COMPONENTS 06/74 COU L PROG YR. 05 comp - COMPONENT TITLE ONO _ 024 STUDY CLINICAL RESOURCES NURSG STUDENTS “oz6A. UNIV AMBULATORY CARE ss - 0268 UNIV AMBULATORY CARE 026C UNTV AMBULATORY CARE 027A AREA HLTH ECUC SYS | mo 0278 AREA HLTH EDUC SYS . ) O27C AREA HLTH EDUC SYS 6270 SMHMET — DEVELGPMENTAL COMPONENT O27 SOHMET — PENNYRILE O27F SOHMET - SE KY C276 SGHMET - LAKE CUMBERLAND O27H | SOHMET - SW OHIO. 020 PHYS ASSIST UTILIZATION 031 . PROBLEM-ORIENTED MED RECORDS 035 4 AMGULATORY CARE — DEVELOPMENTAL COMPONENT : 036 ADVANCED EMT . 937C AREA EMS DEVELOP ~ KENTUCKIANA 0424. REG DOSIMETRY STANDARDS DEVELOP 9428 REG DOSIMETRY STANDARDS DEVELO 0420 REG DOSIMETRY STANDARDS DEVELOP “043 CHILDRENS HOSP EVENING MED CLINIC C44 COMPUTERIZED TIME GRIENT DATA BASE RENTAL FAILURE DIRECT REQUEST , 299900 34,251 “G4y241 41750 27,005 829657 784963 150,000 529426 371456 229650 31,975 14,000 105,000 _ 150 4000 449239 264159 © 9150 9 9662 8,850 219778 72,575 INDIRECT REQUEST 0 169134 209224 20,125 12,211 372343 | 379357 0 . 145045 9 - 27500 14,293 39491 “1,800 | 3-162 1,050 224170 . OSK-PH TOTAL REQUEST 299900 50385 649465 | 619875 392216 "120,000 1164320 150,000 669471 379456 255150 465268 "14-000 1054000 156,000 47,730 26,159 59950 125824 9,900 21,778 94,745 @ x . MAY @& - - . . REQUESTED us . oe . - OSM-PwW COMPONENTS GION . - -. 5 06/74 COUNCIL . . }HIO VAL - PROG YR 05 4 CENTRAL COMP — COMPONENT TITLE oO ss oTRECT INDIRECT TOTAL ae NO... cee oo a . REQUEST REQUEST .. REQUEST. : 045 CONT EDUC EXPANDED FUNCTIONS—DENT AUXIL $0,000 0 ———- 50,000 = COMPONENTS .. 450 0 2 ee REGION TOTALS. 293999350... 4229186 . 29820,536... s _ ’ _ ye - ; RM 00023 @ ovo. 1974 REVIEW Request: $1,382,243 Committee Recommendation: $1,062,237 Overall assessment by individual reviewers: Average and below average; the latter was based on review of the application, before the-opportunity to study a comprehensive statement regarding the RHDAP concept and objectives. Critique: Reviewers noted that the program had turned around from a heavily oriented , continuing professional medical education emphasis to health care delivery, promotion of areawide institutional participation and regionalization, with primary emphasis on quality of care improvement, sharing of services, and cost containment. Concerns were expressed regarding the additional staff requested (7 new positions) and the vagueness of staff component activities. Questions were raised as to consumer and community involvement. Staff pointed out that the © RHDAP concept stems from the Health Services Education activities, tnitiated through community-wide institutional consortia, beginning with the coronary care monitoring program and the telelecture conferences, with emphasis on manpower development. These activities involve community hospitals, local health institutions and organizations. Reviewers observed the strengths which result from the furthering of community hospital and educational institution consortia, with outreach to rural areas with limited resources. JULY/AUGUST REVIEW Estimated request as of May 1974: $448 ,000 MCO 6/4/74 STAFF SUMMARY FOR MAY REVIEW © OKLAHOMA REGIONAL MEDICAL PROGRAM: RM 00023 PROGRAM DIRECTOR: Mr. A. Donnell (Hospital Admin.) - since January 1973 (formerly Pl. CHP) STAFF: (FTE) Total -*10 Additional Proposed: 7 Professional: 7 Professional: 4 Full-time 6 ; Full-time 4 Part-time 1 (50%) * to be full-time July 1 Other: 3 Other: 3 Full-time 3 Full-time 3 FUNDS REQUESTED: Total (D.C. & I1.D.C.) $1,382,243 (IDC = $96,635) (exceeds estimated target of $1,062,237 by 320,000 ) Program Staff $800,372 Staff Components (3) 83,315 Total Program Staff & Components 483,682 Projects: (9) total 898 ,556 Continuation (6) 727 ,356 New (3) 171,200 CHP COMMENTS: @ Oklahoma Planning Commission ("A" Agency) commented on each project separately; generally concurred, but noted concern about possible duplication in pending EMS application to new EMS Division, under PL 94-153. (Similarly questioned EMS aspects of RHDA, area program proposals, but so far no approvals from D/EMS). An overall statement from "A" agency will be furnished DRMP.* Four "B" agencies confirmed approval of individual proposals and also noted approval of total program proposal. * Was furnished 5/23/74 Activities: . EMS - training expanded; communications expansion through RHDA programs; requesting 1/3 more than 12 month base and reaching other locations. ~ RHDA - Regional Health Development Area Programs - 4 locations; area-wide multiple county programs of cost containment activities, sharing services, joint personnel utilization, in rural areas; (non-profit hospital organi- zations - manpower development, education activities). #34 ~ Strengthen regionalization through expansion of areawide planning support for 4 locations in Western Oklahoma. (Two had been initiated by Core with unexpended funds. ) “ also education and training to improve manpower resources, and - #43,45 & 46 - These three new activities involve primary care and referral services; © focus on rural area needs. July 1 - expect to request $448,030 L. Resnick -MCO - Revised 5/28/74 : ‘eo oe 3. OKLAHOMA ID CONTINENT 3 OF COMPGNENTS .... REQUESTED, S LISTING COMPON REGION 06/7 NCIL PROG YR 05 . come COMPONENT TITLE NO. - - Ce . C000 PROGRAM STAFF 025 EMS TRNG & SYS DEVELOP 032A REG HLTH DEVELOP ADA . 0328 REG HLTH DEVELOP ARDMORE 033 REG HLTH DEVELOP BARTLESVILLE 034A CONT AREAWIDE HLTH PLAN NW OKLA - (03458 CONT AREAWIDE HLTH PLAN SW OKLA ; . 039 REG HLTH DEVELOP ENID - 041 REG HLTH DEVELOP LAWTON 043“ UPDATING KNOWLEDGE & SKILLS-RN®S & LPNYS: 045 MNBL EYE DIS SCREENING SERV (046 PT REFER & TRANSP SYS s—tS 120 ee _ REGION TOTALS. DIRECT _ REQUEST 387,062 1019622 86,035 959419 862913 629130. 629130 126 9352 1069755 91,000 47500 32700 142857618 INDIRECT REQUEST 969625 0 6 8 0 0 8 0 0 0 0 0 969625 - “oo” TOTAL . . -. REQUEST 4839687 101;622 864035 954419 869913 629130 624130 126352 106,755 91000 479500 329700 193824243 ed BN I BW RMP Oregon @ - RM 00012 MAY /JUNE 1974 REVIEW Request: $ 1,201,357 Commi tte Recomncndation: $ 1, 201,357 Overall assessment by individual revicweors: Superior Critigue: As in the past, Oregon has continued to be an exemplary, well- managed program with strong leadership. The Region has a viable Regional Advisory Board with a good review process. The relationships with CHPs are good. These agencies are apparently involved in program planning. New staff has and is being recruited to fill existing vacancies. The ongoing and proposed activities are well-developed and in line with program objectives. @ The Committee recommends that this application be approved at roe the requested level. JULY /AUGUST REVIEW Estimated request as of. May 1974: $200,000 WOB 6/6/74 STAFF SUMMARY FOR MAY 1 REVIEW OREGON REGIONAL MEDICAL PROGRAM: RM00012 University of Oregon Medical School, Portland, Oregon COORDINATOR: Julian S. Reinschmidt, M.D. Since- 12/1/70 STAFF: (FTE) Total - 15.35 Proposed: 15.35 Professional 10.35 Professional 10,35 Other 5,00 Other 5.00 FUNDS REQUESTED: Total (D.C. & i.d.c.) $1,201,357 Program Staff (Administration) 633,330 Staff Components (9) ~- 3 new activities 356,995 Total Program Staff & Components 990,325 Projects (8) total 211,032 $ 1,201,357 CHP COMMENTS: As a matter of procedure, all project applications are reviewed by the ORMP-CHP Subcommittee composed of representatives from each of the CHP agencies in the state, Further, applications were sent to 14 area-wide CHP groups, of these nine did not respond formally. Of the five CHP Agencies which did not respond only one critized one activity, the Family and Self Help Education Program (COOK). This criticism was addressed and reflected in the conditions on which ORMP approved the activity. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal grant programs--such as, HMO, PSRO, KIDNEY, and EMS. CONTINUATION ACTIVITIES: Of the 17 discrete activities proposed 12 are continuations. Only significant increase in continuation budget is noted for EMS Consultation (C006) which goes from $48,593 for six months to $158,910 for 12 months. (See p. 66). NEW ACTIVITIES: CHP Agency Priorities (COOJ), Family and Self Help Education Program (COOK), Chicano Health Task Force (COOM), Oregon Cryopreservation Eye Bank (#31) and Management Training Program for Hospital Personnel. DRMP/DOD @ WOB-5/17/74 MAY 15,1974 sisi . a REQUES come wee el ee 0 12 OREGON. . PROG YR 06 WESTERN COMP : ‘COMPONENT TITLE NO OF. COMPONENTS JNO 2 ee ~ Lee C000 = PROGRAM STAFF “COLA PT ORIGIN STUDY “Cole RENAL DIS “CO1LF OREGON COMPRE CA ColG STATE EMERG MED CONSULT SERV “CO1H) = QUAL ASSUR) “CO1J . STATEWIDE CHP AGY PRIORITIES COIK FAMILY AND SELF HELP EDUC COIL PEER REVIEW QUAL ASSUR COIM - NW CHICANO HLTH TASK FORCE 018 OPER SERV REMOTE C C MONTTORING 022 EMERG 4£D TECHN TRNG RURAL 025 COMMUNITY STROKE REHAB 028 GROUP PURCHASING 929. AREAWIDE COURO HLTH DATA INFO “031 OREGON CRYOPRESERVATION EYE BANK 033 EM § DIST ORGANIZ 035. MGMT TRNG HOSP PERS 18g T UNDS LISTING BY REGION 6 OUNCIL REGION TOTALS DIRECT REQUEST . 4699390 33,988 22800 112780 158,910 21,9358 100,000 92550 137509 5,000 239409 359169 220796 77600 18,620 165523 23610 245334 998 5346 INDIRECT - REQUEST 163,946 49299 12,907 6,900 203,011 eo oOo C90 6&© 8 8& 8 08. 6 oOo TOTAL REQUEST 633 9330 33,988 29800 132780 158,910 219358 100,000 99650 13,509 5,000 27-9708 48,076 299696 79500 18,620 229823 329275 (240334 19201,357. 4 WEL PUR AU feraest + St ECLPUCSI oP RE Committee Pecommendation: — $695,862 Overall assesswent by individual reviewers: Above average Critique: Previous concerns of reviewers had brought future funding of this program into serious question. A site visit was conducted in January 1974 to deal with the previous concerns in anticipation of this application. The primary reviewer, having participated in the January site visit, expressed complete satisfaction with the findings and indicated that previous concerns stemmed more from problems of communication than from programmatic inadequacies. On the strength of the site visit experience plus his review of this application, he recommended funding in the full amount requested. This recommendation was concurred in by the secondary reviewer and unanimously adopted by Panel B. ‘ JULY /AUGUST REVIEW Estimated request as of May 1974: $300,000 RM 0005 PUERTO RICO Regional Medical Program Rafael A. Rivera-Castano, M.D. On duty since: Sept, 1973 Coordinator: (Previously Asgoc. Coord.) Full Time Prof. Proposed: 11.25 Staff: Full Time Other aa Total "12 : 20.24 Funds Requested: Total enoeoveoereeoeaeeenoee 695,862 ! Continuation... cessesesese | (570,491 ) 390,137 Prof. 180,354 Program Staff eC" (125,371 ) Period of Time Requested: None later than June 1975 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) RM 00065 @... any continuation project or staff activity for which substantial increase ‘over annualized current funding is requested. HMO project: EMS project: #3 - Health Planning Assistance - This is a program staff activity. It will be devoted this year to planning for EMS thoughout the island. #20 - Cardiac Pulmonary Center (new) - has long range implications relative to planning transportation needs for trauma patients. psro: #18 - Promote and Strengthen Integration of Health Services in Humacao - (staff planning assistance for establishment of a PSRO was given last year). The development of integrated services on a community wide basis is the long range goal, but PSRO concerns will almost surely arise as those services are planned and developed. Kidney: Staff assistance was given to the Board of Health last year to plan a program for the island . Further assistance plans are not indicated Cd CHP comments: «a jetter of general approval is contained in the application E0/5/20/74 MAY 1541974 we REQUESTED FUMDS LISTING COMPONE REGION ceca ve 06/7 cI PUERTO RIC... PROG YR. .04.. STERN comp ‘COMPONENT TITLE ve eee NOL. . a CO0O = PROGRAM STAFF SUPPORT 6901 ACTIVITY NO 1 e902 ACTIVITY NO2. — -€003 ACTIVITY NO 3 / 018 § PROMOTE AND STRENGTHEN THE INTEG OF HLTH SERV IN H ~ 020 ESTAB CARDIAC PULMONARY RESUCITATION TRNG CTR : 021 TRNG PROG TREAT CHILD LANGUAGE AND HEARING DISABIL OF COMPONENTS... . 7... - REGION TOTALS DIRECT REQUEST 153355. 77,907 339755 1335224 108,136 71,386. 439366. 621-129 INOIRECT REQUEST... 265999 139716 "59943 10,779 6,677 &9203 42416 . TH,T33 TOTAL REQUEST 180-354 91,623 399698 144,003 1147813 772589 | | 47,782 695 9862 RMP ROCHESTER . cee v--e ee = RM 00025 _ BAY AMEE 19/4 RENTES Request: _ $361,437 0 Comni ttee Recommendation: $361,437 ee Overall assessment by individual. reviewers: | Superior. ______- . Critigue: The reviewers were very impressed with this application which requests continued support for staff and two on-going projects. (Two year funding is requested for one project.) The display of goals, activities, priorities and funding was especially noted as reflecting a well-ordered program based on identified areas of need. The staff, Regional Advisory. Group and review process appear outstanding. The CHP(b) is supportive., ° In recommending approval as requested of this application, the Committee expressed anticipation at. seeing the new proposals in the July application. JULY /AUGUST_REVIEW Rstimated request as of May 1974: $1,080,000 \ C @ _ - ROCHESTER Regional Medical Program Coordinator: Peter D. Mott, M.D. On duty since: Apr, 1972. Staff: Full Time Prof. 5.75 Proposed: 6,75 Other 3 3 Total 8.75 9.75 Funds Requested: Total eevee eerereeeeeeenese $ 361,437 Continuatlon.ccrsecesases ( 88,652 ) (projects); 272,785 program staff eo CCC ( ) Period of Time Requested: July 1, 1974 to June 30, 1975 Activities Proposed: Refer to Management Information Systems (41S) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . ‘ , RM 00025 ° Rochester List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: EMS project: #43¢ - Continuation of a previously approved project. PSRO: Kidney: CHP comments: The Genesee Region Healfh Planning Council recommended approval of this application. E0/5/20/74 MAY 1531974 ROCHESTER. _.. PROG YR. 06 "ERN COMP we NO C000 PROGRAM STAFF "6001 RURAL PRIM CARE EVAL STUDY COMPONENT TITLE REQUESTED FU LISTING COMPONENT EGION 06/74 L 043C EMS PLAN AND DEVELOP _ F COMPONENTS. 3... ...... , : REGION TOTALS . , - - “ * # OIRECT REQUEST 2249324 25,000 472845 2979169 “INDIRECT _. REQUEST _ my “oO . ae cnet - - 1 ‘ - ‘ REQUEST 485461 - 59425 10,382 64,248 TOTAL | 2725785 302425 «58,227. CC . 3619437 ‘ Oo es SUULH GAKULIINA RGULUI tae Ur 4 terse ee RM 00035 MAY/JUNE 1974 REVIEW Request: $3,000,000 Committee Recommendation: $2,200,000 Overall Assessment by Individual Reviewers: Average/Above -Average Critique: Members of the Review Committee agreed that this was one of the better applications from an obviously matured program. The region has established goals and objectives with priorities carefully spelled outs They are making a real attempt, in their cooperation with the CHP and other agencies, to solve the health authority problem. During the last 18 months the region has made good progress in restructuring its RAC by disciplines of members as well as geographic representation. South Carolina RMP is considered to have an excellent local review process. They were considered to have an experienced program staff under strong leadership. There are many divergent political forces at work in the region at the present time, both medical and administrative, that affects the future of the health care agencies in this area.. The Regional Medical Program may emerge as the agency to provide a platform to the resolution of the health care problems in the delivery system. ~ In arriving at the reduced fumding level, members of the Committee were not convinced that the rather large amounts requested for activities had not had time to be completely reviewed under the local review process. For example, escrowed funds were requested for: regionalization of services; for health manpower development and improvement ; for strengthening of quality assurance efforts and several other activities which the region was interested in to accomplish its objectives. In arriving at the reduced funding level, the reviewers also did not believe that these particular activities were sufficiently developed at this time to allow for proper review by this Committee. JULY/AUGUST REVIEW Estimated Request as of May 1974: $500,000 SCOB/DOD 6/6/74 MAY REVIEW STAFF SUMMARY SOUTH CAROLINA REGIONAL MEDICAL PROGRAM Prepared by: Lorraine Kyttle 80 Barre Street RM# : 00035 Charleston, South Carolina 29401 Vince Moseley, M.D., Coordinator On duty since: 1969 Current Staff: Proposed Staff: | 6 Full-time Professionals 9 Full-time Professionals 0 Part-time Professionals 0 Part-time Professionals 11 Full-time Other 11 Full-time Other 0 Part-time Other : 0 Part-time Other Funds Requested: (Target Figure - $2,444,287) Total: $3,000,000 Program Staff - $ 497,380 Continuation - $ 983,512 (23 activities) New - $1,519,108 ( 2 activities plus 6 targeted thrusts) Activities Proposed: Continuations Of the 23 "continuations" 8 are components initiated with October 1973. awards and the remaining 15 were started with January 1974 6-month awards. The law country EMS activity (#88) is a CHP "b" sponsored assessment of needs and resources study. Component #71 continues an _ activity which designed curriculum and procedures for advanced training for EMI's and which has ongoing enrolled students. Component #75 does not propose to increase renal services but rather to share consultant back-up. New On March 1, 1974, SCRMP issued an invitation for contract proposals to its constituency. It outlined five areas of activity in which SCRMP was interested in extending its objectives: Regional development of Planning and Services Regional Health Manpower Development Strengthening Quality Assurance Regional Programs in Categorical Diseases Improvements in Primary Care These areas all directly reflect SCRMP goals and objectives set by RAG in April 1972 to guide the program in its triennium. One hundred seven letters of intent were received. Pages 79-82 list the 48 formal applica- tions which have been developed through this response and which have entered the formal review system. They were discussed at the Annual uh, Page: 2 South Carolina Regional Medical Progran Conference with CHP on April 15 and will emerge from the complete local review in late May. Final CHP comments are anticipated in mid-June. In late June, final RAG discussions, priority ranking and contract award will be made and the activities will begin July 1. These activities are grouped on the printout under the heading 032A through 032F. The specific activity addressed in 032F, Advanced Health Resources Planning, is an advanced planning group to develop realistic responses to emerging legislation in health resources planning. It proposes the establishment of a body of participants with a balanced and objective structure to logically build upon what South Carolina already has learned and done in health resources planning rather than to discard it and start over again. CHP Comments: Components #89 and #90 seek initial funding in this application. The proposer of #89 is a CHP "b" agency. Number 90 is an activity that was submitted for local "b'’ comment in the last review cycle and the comment was favorable. With respect to the initiative 032F, Advanced Health Resources Planning, it was submitted to all "b's" and the replies ranged from "premature" to ''characteristic foresight" and "timely proposal." Items for Reviewers Attention: The responses of the "b's"! to SCRMP's proposal for an advanced planning body, mirror the divergent currents prevailing in South Carolina in matters medical. It is difficult at this point to forecast whether the existing divergencies are healthy disagreements that are good checks and balances or if they are forces that may prove to be counterproductive. DRMP/DOD 5/20/74 MAY. Te REQUESTED LISTING ; COMPONEN REGION — 08074 IL S CARQGLINA TH CENTRAL PROG YR 06 “COMP ‘COMPONENT TITLE _ NS . mo , C000 = PROGRAM STAFF O32A Ooé 067 068 069 070 O71 O72 _ G72 074 075 O76 O78 079 580 “HLTH MNPWR DEVEL IMPROV. REGIONALIZATION OF SER STRENGTHEN QUAL ASSUR EFFORTS - SPECIAL CATEGORICAL INTERESTS PRIM HLTH CARE SO ADVANCED HLTH RESOURCE PLAN SCREENING HYPT CHILDREN QUAL ASSUR DIABETICS PERINATAL QUAL ASSUR RURAL MOGL HLTH SHARED MNPWR CEVELOP PEE DEE HOSP BASED MNPWR DEVEL AOVANCED TRNG EMTS CRITERIA IMPROVE HOSP AND AMBULATORY SERV IMPROV CMNC QUAL ASSUR UPPER. SAVANNAH QUAL ASSUR "COMPUTERIZED CARE RENAL DIS * COMMUNITY HYPT CNTREL SCREENING UROPATHIES ANDO HYPT CHILDREN HOSP MED CARE EVAL SYS INTENSIVE COURSE NEGNATAL CARE NURSG DIRECT REQUEST 3539398 539499 899916 ” 1049903 4049624. 194,819 1649847 439750 554500 48,750 125000 22,700 139412 18,450 20,000 32,000 19,950. 14,250 554000 372000 55,000 339154 INDIRECT REQUEST . 143,982 a) ° 0 0 0 0 169250 19,500 164250 13,000 0 0 0 13,000 0 169846 o oOo @ 9 9 oSM-P TOTAL REQUEST 4975380 539,499 899916 104903 404,624 ” 1949819 164, 847 601000 75,000 65,000 125,000 ' 224700 139412 189450 20,000 454000 195950 14,250 _ 554000 50000 "$5000 50,000 —23 ™ LOTS . . . REQUESTE S$ LISTING COMPON Y REGION bo eee De . .. 06/7 NCIL 5. § CAROLINA PROG YR 06 OUTH CENTRAL COMP” COMPONENT TITLE NO te 081 CATAWBA AREAWIDE HLTH DATA BASE 082. HYPT STUDY BLACK MALES CHARLESTON CNTY 083. DEMO HYPT CNTRL 084. QUEING METHODS IMPROV AMBULATORY CARE 085 OCONOLUGY RADIATION DOSIMETRY = 086 QUAL ASSUR LAB PERS a 087 WACCAMAW DIS HLTH. PLAN “088 LQW COUNTRY E M S_STUDY “689. UPPER SAVANNAK HLTH PLAN 090. NURSE MIDWIFERY QO OF COMPONENTS. . ...32 0... .----.- coo ee ee es we REGION TOTALS... DIRECT REQUEST . 323000 659452 53,495 32,000 259250 17000 15,000 39500 5,500 15,000 297103119 INDIRECT _ REQUEST 0 214798 69505 134000 9,750 0 0 0 0 6 289,881 “@~ * TOTAL REQUEST 32000 875250 60,000 45000 35000 172000 15,000 34500 5,500 15,000 320002000 wy Pl wrt © . RM 000__¢7 MAY/JUNE 1974 REVIEW Request: $729,417 Committee Recommendation: $729,417 Overall assessment by individual reviewers: SUPERIOR Its goals and objectives appear to be achievable. Critique: The joint RAG and CHP Advisory Council provide primary strength in leadership and in support of a small, capable staff. Program proposals are considered well defined and priorities well meshed. With regard to Indian invo}vement, several staff activities conducted on Indian Reservations, were proposed by Indian RAG members. Cooperation is commendable, as is the participation of the Grantee institution in program implementation. : : Quality assurance activities are continuations of two program staff initiatives directed at developing guidelines for use in establishing PSRO criteria and the identification of continuing medical education needs of MDs. These are proposed to be assumed by the SD Med. Care Foundation which will be the State PSRO when funds are available. The Medical Genetics service began as a developmental activity under program staff funding, and will be the only one in the State. Its focus is on identification of birth defects, , to improve diagnoses and establish referral systems. It would be managed in conjunction with training in chromosome analysis, while other sources of support are being sought. JULY /AUGUST REVIEW Estimated request as of May 1974: $150,000 MCO 6/4/74 STAFF SUMMARY FOR MAY REVIEW SOUTH DAKOTA REGIONAL MEDICAL PROGRAM: RM 00067 PROGRAM DIRECTOR: Mr. Donald Brekke (full-time) on Duty since Nov. 1972 (Prior to appt. had been deputy director) STAFF: (FTE) Total - 6 Additional Proposed: None Professional: 4 Expect to use increasing number Other: 2 of consultants and University technical advisors, without reimbursement. FUNDS REQUESTED: Total (D.C. & I.D.C.) $729,417 (exceeds est. target of 571,095 by 158,909) * Program Staff 210,921 Staff Components (8) 76,252 Total Program Staff & Components 287 173 Projects: (11) total 442,244 Continuation (6) 252 ,568 New (5) 189,676 * Funding base reflected program in planning status. Program approved for operational status January 1974 by NAC. CHP COMMENTS: RAG and CHP Council one and same; members of various technical and review committees, represented on Executive Committee and actively participate. Goals and priorities coordinated and integrated in a dual matrix - care levels and functional objectives. Priorities are manpower development. and resources to improve quality care. ACTIVITIES: #3 - EMS - continuing at only slightly high level for expansion of training and for advance program in development of a total system (EMS) CATTAC. #6 - PSRO - Quality assurance activities; emphasis on improved data base, medical record quality, base for continuing education of MDs and other health professionals in preparation of a PSRO; assist SD Medical Research Foundation . | Most activities requesting the same, less or only small increases above current program (annualized). Exceptions are the PSRO activity and the development of the Sioux Falls CHES (presently a core component until project director appointed - site selection has been made and will be converted to project. This activity will complete the Statewide CHES program and enhance the total manpower resources development activity. July 1.- expected to request $150,000 L. Resnick - MCO -Revised 5/28/74 @” Loe REQUESTE $ LISTING COMPON Y REGION ee Ne ee 06/74 COUNCIL 7 S$ DAKOTA PROG YR 03°. ID CONTINENT comp COMPONENT TITLE " : COOU PROGRAM STAFF "6004 = SAMA INDIAN RESERVATION PRECEPTORSHIP "C006 NURSE RESOURCE LISRARY . eo “C007 ACUTELY POISONED PTS 6008) MGT HYPT PHARM PINE RIDGE RESERVATION —"egag ” PT ORIENTED MED RECORDS © oe €O10 ROSEBUD INDIAN HLTH HLTH OCCUPATIONS ~ "" Cohh COUNCIL AFFILIATED HOSP oo C012 SIOUX FALLS AREA CHES , : “902s LEWIS AND CLARK HLTH ED AND SERV CTR mo 003 EMERG HLTH SERV 004 ”C GAME COMMUNITY HLTH EDUC SYS " a "005 " HYPT EDUC PREV DET REFER ~ 006. PSRO . eee 009 = CMNC PISORDERS GERIATRIC PTS. oe : : 010 = MED GENETICS «OAL «EST CONT ED RECOGNITION ~ . "972 ORGANIZ AWARENESS DEVELOP IN SERV TRNG O13 ST LUKE®S RESP OUTREACH _ 014 WESTERN HLTH SYSTEMS CHES CF COMPCNENTS 20 REGION TOTALS OIRECT REQUEST 1499568 29250 32000 3500 64400 179262 3,200 19140 399500 609350 472301 59200 — ~ 309800 43,000 329956 » 469354 109300 224000 30,7000 48,066 6425147 INDIRECT _ REQUEST... 619353 “149407 42730 69780 872270 © © © © © © Ce «6 © 6© © @©@ © 0 oo o n@- ’ TOTAL REQUEST 210,921 24250 39000 "3,500 69400 174262 3200 12140 395500 7142757 52,031 51,980 302500 | 432620 325956 46 9354 10300 ” 22,000 304000 48066 729 2417 et ews @ RMP _ SUSQUEHANNA VALLEY... RM 00059 __ May LIUNE L9OTA ENTE Request $721,606 Committee Recommendation: $400,000_.. Overall assessment by individual revicwers! Below average Critique: The Committee expressed concern over the lack of planning for present and future activities. The application appeared to be essentially a rebuilding of their budget. The request was primarily for staff support, and a request to fill :10 vacant positions, plus support for 2 projects. Committee recommended $250,000 in program staff support, $60,000, for grantee costs and $95,000 for ongoing projects. This would in effect give SVRMP some room for expansion as well as keep the remaining 14 positions. Further hiring © should cease until a definite program can be identified. Committee recommended a site visit to this region prior to Council meeting or if this could not be arranged, to have key representation i of the program visit DRMP to provide additional information regarding : future plans for the program. JULY /AUGUST REVIEW Estimated request as of May 1974: $705,860 \ @ RM 00029 SUSQUEHANNA VALLEY Regional Medical Program Coordinator: Chad Combs, T.hm On duty since: 5/74 As Coordinator with RMP Full Time Prof.: 9 2 yrs. 16 Staff: ** Proposed: Part Time Prof.: "3 4 Full Time Other: 2 3 Part Time Other: 0 0 Total 14 23 Funds Requested: May ist Total eeoereereceneenseeeeneee 721,606 Continuation... G2becceees ( 32,634 ) or ( 63,000 ) Period of Time Requested: Request is for program staff 6/75 continuation of three previously funded sas for July and August 1974, and one new health planning initiative Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) , in RM 00059 (Susquehanna Valley) List any continuation project or staff activity for which substantial increase over annualized current funding is requested. The FY 73 annualized level-for program staff was $599,435 d.c. HMO project: NONE EMS project: NONE PSRO: NONE da : Kidney NONE CHP comments: One CHP will forward comments to Associate Director, Health Resource Planning since they found it impossible to complete their review by 5/1/74. MAY 1521974. re REQUESTED F LISTING oe _ OSM=P 23 COMPONEN REGION Co cee ce 06/74 IL. . - I 5 SUSQUE VAL... .. PROG YR 05. RN (i ts:t=“‘«é«~C cowpoNENT TITLE DIRECT INDIRECT =~ TOTAL Coe ND ee REQUEST REQUEST _. . REQUEST : C000 PROGRAM STAFF oe "4984124 - 1272848 6254972 ~ €001 AMBULANT PATIENT DATA ANALYSIS — 5,000 19300 = 69 300 on ECO15 FACILITATING DEV REG HLTH PLAN = =—s—‘“—«‘“=;i<‘=~=‘“‘sé™*~;:””C*«SO GOOD ~C*«iVDCOCs—“(tsté«‘té«a CCD a 04 SO CENTRAL PENNSYLVANIA HLTH ED CONSORTIUM B94 72 39195 si OT : 041 NORTHCENTRAL PENN HLTH ED SYSTEM 135530 15137 144667 en ne ce Co . . F COMPONENTS... 5.0 2 08 _ 7... REGION TOTALS 5759126 1465480 «7214606 TENNESSEE MID-SOUTH] REGIONAL MEDICAL PROGRAM RM 00018 ~ MAY/JUNE 1974 REVIEW Request: $2,283,972 Committee Recommendation: $2,133,972 Overall Assessment by Individual Reviewers: Average Critique: This proposal was reviewed in depth by two reviewers and the consensus was that this region although it has a new coordinator, does have adequate leadership and staffing. The new RAG is good and assuming a proper role as decision-maker. Past performance and accomplishments were considered good, with activities properly addressing their priorities. The proposed application had 49% budgeted for continuation activities, 37% for new activities and 14% for staff and staff activities. CHP relationships have been good with proper coordination and participation. One of the reviewers, who had formerly site visited this region, complimented the region for beginning to move into outreach programs where the needs are so great. In arriving at the recommendation, two projects were considered to be of low priority and the region may want to consider purchasing films on dialysis rather than producing new ones. It was felt that the cancer activity proposed, in view of time-frame, should be funded from other funds. JULY/ AUGUST REVIEW Estimated Request as of May 1974: $850,000 DRMP/DOD SCOB/6-6-74 e . MAY REVIEW STAFF SUMMARY Prepared by: Lorraine Kyttle TENNESSEE MID-SOUTH RM 00018 REGIONAL MEDICAL PROGRAM 1110 Baker Building 110 2ist Avenue, South Nashville, Tennessee 37203 Richard 0. Cannon, M.D., Coordinator On Duty Since: 9/73 Current Staff: Proposed Staff: 6 Full-time Professionals 8 Full-time Professionals (1 of whom is located as full-time . professional outside RMP office) 1 Part-time Professional ( at 50% ] Part-time Professional effort of a consultant located outside RMP office) 3 Full-time Support Staff 7 Full-time Support Staff (1 hired , since application was prepared) 2 Part-time Support Staff 2 Part-time Support Staff (1 hired since application was prepared) 12. Total Staff 18 Total Staff FUNDS REQUESTED: Target Figure: $3,118,179 Total Costs - $2,283,972 Program Staff - $370,866 Continuation - $1,094,490 (18 activities) New - $818,616 (19 activities) PERIOD OF TIME REQUESTED: 7/1/74-6/30/75 ACTIVITIES PROPOSED: Continuation - Although these activities are classified "continuation" most were activated as an operational component approximately November 1973, and some were activated within the past four months. Component #72, is the logical extension of a pilot project seeking to develop a telemetry link from patients in the field to coronary units for emergency purposes. Component #82 concerns the treatment of renal disease. However, the proposal does not seek to fund the expansion of existing chronic dialysis units. The equipment purchases are not dialysis machines. Page 2° T™S/RMP Summary ©... Activities: #98, Upper East Tennessee Dialysis Project, represents an expansion of chronic renal dialysis services. CHP need certification has been received; interim approval from SSA has been applied for but not yet received. CHP Comments: All projects were submitted to appropriate "pb" agencies. Written comments submitted on 10 of the 19 new activities (all favorable). Verbal approval has been received on all new activities from appropriate "bts" with promise of written follow-up. Mr. Boris Georgiff, Director of the "a" agency is a member of the Regional Advisory Group and attended the meeting at which this application was discussed. Irems for Reviewers’ Attention: .During the last year this region has faced some provocative issues and has emerged with the following strengths and weaknesses: - A revitalized RAG (operating with new by-laws) which in very short order assumed the proper role of decision-maker. - A small (one-third its former size) central staff that is spread a little too thin but mobilizes itself totally and without friction. - Improving relationships with a grantee which has assumed a more proper role in the tripartite aspects of RMP structure (RAG - Coordinator ~- Grantee) DRMP /DOD @ SCOB/5-16/74 @ REQUESTED > COMPONENTS STING GION 06/74 COUNCIL TENN MID S_ PROG YR 06 1 CENTRAL COMP COMPONENT TITLE Cee NG . " ¢060 = PROGRAM STAFF - "6007 RURAL STUDENT HLTH COALITION E TENN "C025 STUDENT APPRENTICESHIP FAMILY COMMUNITY HLTH : 057 HYPERTENSIVE FOLLOW UP 061 = SE HLTH SERV EDUC ~ "962. «MID EAST HLTH SERV EDUC : ” 064 COORD PEDIATRIC EDUC SERV SYS 065 REGIONALIZATION HIGH RISK NEWBORN CARE : 067 CAYCE HOMES COMMUNITY CLINIC . 068 NURSE CLINICIAN PRCVID PRIM HLTH CARE 069 HIGH RISK OB | " "072 «UPPER E TENN EMS : ” : 074 WYNN HABERSHAM CLINIC 078 APPALACHIAN NURSE MIDWIFERY CHILD PROJ - ~ 0979 ORGAN DONOR EDUC : ~ 980 UTILIZ REG TEACH PERS STRENGTHEN PUB HLTH ED 082 CHRONIC KIDNEY OIS PT CARE SYS)” 084 “HYPERTENSION SCREENING _— 085 COORD SYS APPRCACH COST REDUCTION of8 FIRST TENN REG GENT PROJ ~ """ 9€9 «MEIGS CNTY PRIM CARE . : 090 PRIM CARE STONEY FORK TENN OIRECT REQUEST 309,177 50,000 15,400 82,119 122,082 159158 "2014737 1259131 90,042 149442 33132 242900 349764 199420 55915 46620 1252056 12,000 249923 522600 761544 125820 INDIRECT REQUEST | 619689 22110 | 1,232 13302 0 62484 ‘309189 293927 0 ~ 19242 69218 39923 7,022 59602. oso TOTAL REQUEST . 3709866 529110 162632 95 e421 1225082 219642 1319926 " 155,058 90042 159684 39,350 247900 34,764 23 9343 §5915 53642 125,056 12,000 249923 52,000 829146 12,820 a wv &. REQUESTED FU STING COMPONENTS EGION 06/74 COUNCIL TENN MID S.. PROG YR C6 H CENTRAL COMP COMPONENT TITLE we eee ND eee a . . gy ph MOBL CLINIC SERV - oO 092. LIFE ADJUSTMENT SERV CA PTS sa BAN LUNG CA DETECT oe, MYPERTENSION MGMT CTR oo “995” pNEUMOCONTOSIS SURVEIL AND MGMT : ST INFO CTR : - (097 | SE REG REHAS THERAPY pea UpPER E OTALYSIS : ea HOSP ENGINEERING & SAFETY —— 100 COORD MNOWR DEVELOP 1GL RAP HOUSE COMMUNITY CLINIC - Lz HLTH STATUS & MED MNPHR oe “403 ARCHA HLTH SERV PLAN . 104 TRNG NUKS PRACT CHRONIC CARE ==" CppceR LADDERS ALLIED HLTH PERS 106 «DENT AUXILIARY MODULAR EDUC REGION TOTALS - DIRECT REQUEST... 5,006 © 244620 "432900 1856 429498 20610 484714 25 y700 371800 52,004 699928 249453 T4225 244656 $0,000 220722122 "129770 “a INDIRECT | REQUEST... 49510 8,856 2115850 og TOTAL REQUEST "$4006 299130 529756 71:856 424498 20,610 554388 254700 37,8600 527004 69,928 18,695 249453 91,170 247656 50,000 222835972 on RMP rw 000 _07 . ve ~ MAY/JUNE 1974 REVIEW Request: $2333 ,55] Committee Recommendation: _ $1,100,000 Overall assessment by individual reviewers? Average - Below-Average Critique: Committee recommended that the RMPT submit the RAG-CHP reviewed contract proposals in July for a detailed review by the Review Committee. Permission would be extended to the next scheduled Review Committee by the June National Advisory Council allowing the Committee to review and extend final approval of the contracts with their accompanying funding requests. The procedure would allow the contracts to initiate in July, rather than September, and would preclude the necessity of a Council review in August. This expediency measure has been considered important from a management standpoint. @ The RMPT has been most effectively managed by an able Director, Mr. David Ferguson, and a talented staff of very limited size. Reviewers did express concern regarding the capability of the staff to effectively manage and monitor the very ambitious program set forth in the application. Mr. Ferguson, through the select contract mechanism, is expected to follow through most competently by DRMP staff. Concern was expressed regarding the Requests for Proposals, the contract language employed and the sameness in the language used to describe the activities. The submission on July 1 of the form 15 s (narrative) and 16 s (budget) should further alleviate the concerns raised. The relation- ship between the new activities, the expected outcomes and the prospect of future funding for the new activities should be clearly discernible from -.the: July submission. Estimated request as of May 1974: _ $1,298,599 for contracts not approved for funding in May application. McO. 6/4/74 7 eo @ “= mS . . Sh ke ’ STAFF SUMMARY FOR MAY REVIEW © Prepared by: M.E. Murphy REGIONAL MEDICAL PROGRAM OF TEXAS: RMP #07 COORDINATOR: David K. Ferguson - since 8/73 Deputy Director - since 6/71. STAFF: (FTE) Total - 12 Professional: 8 1/2 Clerical: 3 1/2 Requested Positions: 5 (3 prof.; 2 clerical) FUNDS REQUESTED: Total (D.C. & 1.D.C.): $2,333,551 Program Staff: 319,111 Staff Developmental: 210,000 Staff TOTAL: 529,111 Projects: 1,804,440 ““Continuation (6): 348 ,000 Hew (5) 1,456,440 CHP comments: Received from all funded and appropriate 'B' agencies (5) and the 'A' agency. Comments good and responded to by RAG. Included in application. Reference on page 2\. CONCERNS: 1) Project #91A: EMS Manual Implementation is a continuation activity. 2) Project #106: Renal Program of Texas. Expansion of ongoing project. Activities consistent with the statewide coordinated comprehensive Renal Program of Texas. RMPT application request is equal to target figure (140% annualized amt. )- $2,333,551. Provided application is funded, AS REQUESTED, no July 1 application request will be made. * Will include approximately 35 contracts in 5 areas of emphasis: 1) Health Education; 2) Health Economics and Systems Demonstration; 3) Health Manpower; 4) Health Care Quality; and 5) Management of Major Diseases. Status as of 5/15/74: 25 requests for proposals (RFP) distributed to 500 bidders {select universities, organizations, individuals, etc.) Received 130 proposals and anticipate 70-80 proposals will receive full review. - Mid-Continent Operations Staff Analysis: Mary E. Murphy Texas RMP: #07 The application requests funding for the period of July 1, 1974 through June 30, 1975 for the following activities: Program Staff $319,111 Staff Developmental 210,000 Projects/Contracts Expansion and Continuation Activities O91A EMS Manual Implementation 30,000 094A Community Health Nursing 32,000 100A APACHE 50,000 102B Hospital Patient Education Program 35,000 1048 Planning a Community Hypertension Control Program 60,000 106 Renal Program Support Project 141,000 New Activities 108 Health Education Project 286,400 109 Health Economics and Systems Demonstration Project 636,340 110 Health Manpower 160,000 111. Health Care Quality Program 308,700 112 Regional Disease Management Program 65,000 Total Application Request $2,333,551 Application Philosophy The new activities, to be funded as contracts, are in the developmental stage within each area of emphasis, 1) health education, 2)health economics and systems demonstration, 3) health manpower, 4) health care quality, and 5) management of major diseases, 25 requests for proposals have been developed and widely circulated (See Appendix). Letters of intent are now being received by RMPT and the full proposal is due May 15. The designated Program Committee consisting of Regional Advisory Group member(s) and related specialists will give the proposals an in-depth technical review. At the next scheduled RAG meeting on June 28, 1974. Action will be taken on the proposals selected for funding by the six Program Committees. Form 15 & 16s will be prepared immediately, and submitted to DRMP. By requesting funding for the new activities at this time, rather than in the July 1 application, it will allow the contracts to operate for a full 12 month period. Mr. Ferguson strongly feels that an operational period of less than 12 months hinders the activity. If reviewers have marked reservations regarding funding of activities which do not present Form 15 and 16s, a consideration could be given to hold the award until the forms are received after June 28, 1974. Funds could then be released to cover Program Staff, continuation and new activities, covered by 15 and 16s. Therefore, the new activity operational period of 12 months would remain unaffected. If reviewers find funding at this time totally unacceptable, then the approved contracts will be submitted ina July 1 application which would give the contracts less than the desired 12 months operational period. -2- The RMPT submitted an Arthritis Proposal for funding in the amount of $356,559. Performance sites included Dallas, San Antonio, Houston, Galveston, | Lubboch and Austin, Texas. The proposal was to be critiqued by an assigned body of reviewers. Summary of the Regional Medical Program of Texas The RMPT is in the second year of its triennium. Present funding (1/1/74 ~ 6/30/74) is in the amount of $775,832. Project Activities number 14 at a cost of $340,127. Program staff numbers 12 full time, consisting of 8 1/2 professional and 3 1/2 clerical members. Pre-phaseout staff numbered 35. The Program Director is Mr. David Ferguson who succeeded Dr. Charles McCall. Mr. Ferguson served as Deputy Director from June, 1971 until August, 1973 when he became Acting Director. The Regional Advisory Group recommended the appointment of Mr. Ferguson as Director which became effective November 1, 1973. As a manager of the Regional Medical Program of Texas, Mr. Ferguson has exhibited strong leadership capabilities. No major organizational changes have taken place since the last NAC review in November 1973. The grantee for the Program is a non-profit corporation, Texas Regional Medical Program, Inc. The Board of Trustees numbers six members. The Grantee/RAG relationship is most satisfactory. The 1974 - 75 program is designed to utilize the contract award mechanism. Experience in 1972 and 1973, as well as during the 1973-74 period attest to the value of the contract as a management tool especially for activities of short duration. Experience with the contract mechanism is most positive in Texas and it is the intention of the Regional Advisory Group that it be continued. In order for a project activity to develop community involvement, carry out its specific objectives, evaluate its effectiveness, and present usable results for general distribution is at least a one-year takk. The application appears acceptable for funding in its present form. M 1974 -... REQUESTE DS LISTING . os 10-23 come Y REGION a ol -06/ UNCIL | 37 TEXAS PROG YR . 06 4ID CONTINENT COMP” © COMPONENT TITLE , DIRECT INDIRECT TOTAL ee ND Se oo. -_ REQUEST . REQUEST _ REQUEST COCO PROGRAM STAFF, . ; 319,112 0. 319,111 _ “" €003 PROGRAM STAFF DEVELOPMENT == 210,000 0 210,000 veer OO1A EMS MANUAL IMPLE = SOO™~=CS~S~SsSiCSsee gi sis BCT : OO 0944 COMMUNITY HLTH NURSG 7 254960 69040 322000 TOOA OAPACHE ees - 334250 164 750 50,000 TT Og HOSP PT EDUC 354000 0 354000 oe 1044 PLAN COMMUNITY: HYPT CNTRL 52,000 9,000 604000 | : “106 * RENAL SUPPORT OO 1319337 ss 663 141,000 a “303 HLTH EDUC ee oo a 2862400 0 , 286 9400 ~ "199° METH ECONOMICS AND SYS DEMD . 6369340 = 0 6364340 LO HELTH MNP WR , a . 1607000 oO 160,000 ee yay ~~ “HLTA CAKE QUAL. ~ — 6 ea oo 308,700 , . a 6 a 308,700 : - 112. REG DIS MGMT Br 659000 o 651000 IO'OE. COMPONENTS. .. 13 2222 eee ee ee REGION TOTALS =. 292857098 © 48945302 93339551 , . ie TRI-STATE 2. jot 900762, wavy (UNE Vad BEMIS peoguest: $1,886,907 Comittee Recommendations $800,000. nee individual reviewers: _Below_ average to-average Overall assessment by Critique: The Tri-State RMP request for $1,886,907 which was for the Massachusetts and Rhode Island portions only, generated considerable concern for the Review Committee especially with regard to certain projects which appeared to be over-budgeted. The reviewers in general were concerned with the Rhode Island portion since there appeared to be a lack of linkages of projects to an overall program. A minimal interim funding level of , $800,000 was recommended. In addition, a site visit prior to June Council was felt necessary in order to obtain additional facts not found in the application. It was hoped that the site visit findings would aid Council in their deliberations. JULY /AUGUST_REVIEW Estimated request as of May 1974: $800,000 \ © RM 000 62 TRI-STATE Regional Medical Program Coordinator: Mr. Robert Murphy, M,PaH. On duty since: June 1972 Staff: Full Time Prof. 6 Proposed: 7 Part Time Prof. 5 , 4 Full Time Other 3 4 Part Time Other 2 3 Total 15 18 Funds Requested; May Ist Total seer eet ee ooeeoey a8 1,886,907 Continuation (Q)....66. 6. ( 324,779 ) eo ee ( 891,568 ) Period of Time Reque: :ed: The program and all b:: one project requests support until June '75. Project 19 requests support u.c il June '76, a fourth year of support. Also, the Region requests 210,0''} in its core budget to contract out fiscal monitoring of its proy.am after June 1975. Activities Proposed: Refer to Management Ir! rmation Systems (%IS) printout. (Also, note symbol C will be placed next tc ictivities which extend beyond June 30, 1975.) RM 00062 (Tri-State) t any continuation project or staff activity for which substantial increase r annualized current funding is requested. nt a substantial increase over the 1972 Although Project 19 does not in no evidence of declining funding for the Ley supplemental appropriation, there fourth year. HMO project: EMS project: Project 50 Organization & Standardization of a Cardiopulmonary Resusitation Program R.I. ‘This project requests $40,160 and appears separate from the EMS Project 16 Org vizgation, which has been found to be in a state of confusion. (See CHF Co is also) PSRO? . NOWE Kidney: NONE CHP comments: The CHP A & B comments only refer to Mass. and R.I. since N.H. will send in their activities July lst. R.I. Project 50 EMS, CPR ~ this project was felt to be highly ambitious and has a ‘dubious organization arrangement. TRAG executive board, however, approved this with pressure from the R.I. members with the condition that the EMS Advisory Board of Project 18 approved this request. Mass. Project 49 Regionalization of Maternity & Newborn Care, was denied by one fa agency. However, the WA agency gave it the highest priority. ass. Project 46 Hypertension Screening in Low Income Areas ~ The "B" agency commended this project not be funded. More information as to why the Tri-State ecutive Board Committee approved this is forthcoming. However, we were told the New Bedford portion of this project would be deleted. All other "B" agency comments appear favorable and constructive. TRAG will incorporate B comments and the NAC advice before funding. MAT boga7ett GF COMPONENTS. 2.014 2-20-2020 25 eee SS COMPONEN Lae Y REGION _ _. . _ . 06/7 CIt TRI STA PROG YR . 05 STERN COMP COMPONENT TITLE ce ND Z ee C000 = PROGRAM STAFF 018 EMSS : 019 OR CT HLTH SCI EDUC COUNCIL oO : ~ "943 STUDY HLTH POLICY IN MASS - 044 STUDY AMBULATORY SERV GREATER BOSTON ee 045 IMPROV CUAL CARE NURSING HOMES : 046 « HYPT SCREENING LOW INCOME COMMUNITIES — 047 SNC ACCESS CARE MODEL CITIES RES - : 948 COOP FAMILY HLTH CTR DATA SYS” : - 049 REGIONALIZATION MATERNITY AND NEWBORN CARE “950 ORG AND STAND CP RI e952. «PREV. ENVIRONMENTAL DIS : : 052 HLTH SERV TIME OF ECONOMIC TRANSITION 053 FAMILY PRACTICE RESIDENCY TRNG PROG STUDY REGION .TOTALS DIRECT _ REQUEST ” 654,560 1239474 2019305 186300 359486 439345 § 824990 31,500 * 139960 81,057 404160 349322 2507000 179500 19795 959 INDIRECT REQUEST 16,000 0 6 Si+706 6 19505 ° 905948 . TOTAL REQUEST 670 2560 1239474 201,305 238000 359486 “624850 $2,990 31.509 © 43,960 842800 409160 349322 2507000 17500 13886 9907 INL Vo RERW eat aae RM 000 49 @ MAY/JUNE 1974 REVIEW Request: . $1,290,482 Committee Recommendation:, $1,000,000 Overall assessment by individual reviewers: Average Critique: Reviewed by Panel B, this application was considered "average" and reflective of an "average" program by two assigned reviewers. Concern was expressed about the proportion of vacant staff positions, the proporticn . of hypertension related projects and a tendency by the region to "parrot" national initiatives as a funding strategy. Objectives and priorities were considered consistent with national puide- lines and leadership was considered adequate. Notice was taken that planning is closely coordinated with a "Governor's Committee" but in reality that applies to EMS planning rather than total program planning. A problem with one CHP(b) agency was discussed but not considered to be of critical importance. A motion to fund at $1,000,000 was unanimously carried. JULY/AUGUST REVIEW Estimated request as of May 1974: $1,362,894 RM 000 49 VIRGINIA Regional Medical Program Coordinator: Eugene ~. Perez, M.D. On duty since: _7/67 Staff: Full Time Prof. 9 Proposed: Q Full Time Other 2 . 5 Funds Requested: Total «ecoreuceesvcecevses 1,290,482 Continuation. w-secrcoecres (1,290,482 ) 581,602 projects; 708,880 program staff Ne@weecscccevssceneacnsoevens ( none ) Period of Time Requested: None later than June 1975 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C @ will be placed next to activities which extend beyond June 30, 1975.) RM 00049 List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: EMS project: The region has a contract with Tidewater EMS to employ a training supervisor and a clerk; using previously unexpended contract funds. Project CO11L proposes regionalization of the state to tie into rescue squad patterns "for transport of newborns with emergency problems." Project C028 will contract for instruction of qualified EMTs and certify them as lay instructors. All EMS planning has been closely correlated with the Governor's Advisory Committee. PSRO: Project C004 has 10 physicians (others being invited) involved in an outcome audit of ambulatory care rendered relative to present criterias; and to develop new criteria for at least 18 diseases and problems as a result. Project C031 will make services of a Quality of Care Assurance Committee and a Utilization Review Committee available to all EVIMEC as well as any others interested in joining. Project C033 whll support workshops aimed at effective self analysis of quality of dental care rendered. Kidney: 7 CHP comments! Not solicited because all projects are continuations which have previously been reviewed by CHP ISTING MAY 15 seat REQUESTED FUND COMPONENTS GION — Ce a . . 06/74 €C IRGINIA PROG YR 05 RN coMP COMPONENT TITLE DIRECT ee ee = NO REQUEST COCO © PROGRAM STAFF 7085880 a 6006 GSUAL MED CARE REV — PRIM CARE PHYS 30 »000 omg DTETICIAN TNG PROG - RENAL DIS & HYPT ~ 129900 7 ~ COlL EMERG PERINATAL MED 399400 CO12 FAMILY NURS PRACT ING © $4,000 om CO1S «BP SCREENING ~ VA HT ASSN - 20,000 COlS PRIM CARE NURS PRACT HYPT 25,000 : CozaA COMPRE COMMUNITY BASED HYPT CONTROL 739645 Oe SCREENING HYPT DENT OFFICE ” 224608 COZC PHARM ORUG MGMT ED HYPT PT BY PHARM 539969 Coo? PUB SCH CURRIC HYPT — CIRCULATORY SYS 32,000 i ‘C028 | EMS TRNG TRAINERS a 10,000 C029 COST CONTAINMENT RATE REV "40,000 6036. ADOLESCENT HYPT SCREENING | 12 9850 : momma QUAL MEO CARE ASSUR — NORFOLK CONSORTIUM HOSPS — 442930 C032. EDUC PROG CHILD ABUSE PREV 28 000 C023. QUAL DENT HLTH CARE ASSESS 501000 ~ “copa _ NURS“IN-RESIDENCE we - 10 »000 “"C08B PHYS-IN~RESIDENCE - 12,000 COBC PHARM—IN“-RESIDENCE 117200 COMPONENTS . 20 192909482 REGION TOTALS INDIRECT REQUEST °o°. a °O S ° o o 8: 9 °o o © Cc Oo TOTAL REQUEST "708,880 "30,000 12,000 39400 544000 20, 000 25,000 | 73,645 © 224608 535969 32 4000 10,000 40,000 12,850 4nd 9 930 28,000 50000 102000 12,000 11,200 192902482 new ew WER DLL LAV Baty saben rup Washington/Alaska @ ru 000_38 MAY /JUSE 1974 REVIEW Request: 2,077,311 Committee Recommendation: $2,077,311 Overall assessment by individual reviewers: Superior Critique: Washington/Alaska is a superior, well-managed program. The RAG is forceful and active in determining program policy and direction based on'the needs of the area. The technical review committee structure appears well-designed and active. Staff was reduced from 52 to 35 during phase-out. ‘However, recruitment of new staff is in process. Staff direction is superior. There appears to be close collaboration with the CHP agencies in the area. The proposed program, as well as current activities, represent a good balance both programmati- cally and geographically. The Committee recommends that this application be approved at the requested level. JULY /AUGUST REVIEW Estimated ‘request as of May 1974: $500,000 \ WOB 6/6/74 I ‘STAPF SUMMARY FOR MAY REVIEW WASHINGTON/ALASKA REGIONAL MEDICAL PROGRAM: RM00038 University of Washington, Seattle _ COORDINATOR: Donal R. Sparkman, M.D. Since - 1966 STAFF: (FTE) 30.85 . Proposed: 38.85 Professional 20,60 Professional 24,60 Other 10,25 14.25 FUNDS REQUESTED: Total (D.C. i.d.c.) $2,077,311 Program Staff 1,053,131 7 Continuation Projects 521,948 12 New Projects 502 ,232 $2,077,311 CHP COMMENTS: Comments were received from the two CHP (a) agencies and five of the eight CHP (b) agencies, The Alaska CHP (a) agency questioned the need for Alaska Health Manpower Corporation's project, Physician Extender Placement Program (#70 - page 89). The Spokane County CHP (b) agency in commenting on the projects, noted that "it was apparent that none of them would directly impact our area. If at all, their impact would be indirect", (See page 45) The Spokane group also expressed concern about the Gynecorps Training Program and a Clinical Laboratory Services project. Both of these projects, however, were not approved by W/ARMP. The Puget Sound Health Planning Council's Special Regional Project Review Committee did not complete its review of the W/ARMP application. The staff of the Puget Sound Health Planning Council commented on 19 projects. Between the Council and its staff concerns were (see Pp. 55-63) expressed ae follows: #47 Stroke Nurses Training --"difficult to assess need for additional practioners"; #77 Patient Care Appraisal--"program an unnecessary duplication of effort, especially in light of the up- coming PSRO program’; #81 Education of Nurses to treat Hypertension-- Specialized training in hypertension should be included in the nursing continuation education process", Other projects for which the Council had concerns were not approved by W/ARMP. On May 22 all CHP comments will be further reviewed by the W/ARMP Executive Committee and each significant negative comment will be addressed. W/ARMP will submit minutes of this meeting to DRMP. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal programs -- such ag HMO, PSRO, Kidney and EMS. WASHINGTON/ALASKA REGIONAL MEDICAL PROGRAM: RM00038 University of Washington, Seattle ¥ _ COORDINATOR: Donal R. Sparkman, M.D. Since = 1966 STAFF: (FTE) 30.85 | Proposed: 38.85 Professional 20.60 . Professional 24,60 Other 10,25 14,25 FUNDS REQUESTED: Total (D.C.- i.d.c.) $2,077,311 Program Staff , 1,053,131 7 Continuation Projects 521,948 12 New Projects 502,232 $2,077,311 CHP COMMENTS: Comments were received from the two CHP (a) agencies and five of the eight CHP (b) agencies. The Alaska CHP (a) agency questioned the need for Alaska Health Manpower Corporation's project, Physician Extender Placement Program (#70 - page 89). The Spokane County CHP (b) agency in commenting on the projects, noted that "it was apparent that none of them would directly impact our area. If at all, their impact would be indirect". (See page 45) The Spokane group also expressed concern about the Gynecorps Training Program and 4 Clinical Laboratory Services project. Both of these projects, however, were not approved by W/ARMP. The Puget Sound Health Planning Council's Special Regional Project Review Committee did not complete its review of the W/ARMP application. The staff of the Puget Sound Health Planning Council commented on 19 projects. Between the Council and its staff concerns were (see Pp. 55-63) expressed as follows: #47 Stroke Nurses Training --"difficult to assess need for additional practioners"; #77 Patient Care Appraisal--"program an unnecessary duplication of effort, especially in light of the up- coming PSRO program’; #81 Education of Nurses to treat Hypertension-- Specialized training in hypertension should be included in the nursing continuation education process". Other projects for which the Council had concerns were not approved by W/ARMP. On May 22 all CHP comments will be further reviewed by the W/ARMP Executive Committee and each significant negative comment will be addressed. W/ARMP will submit minutes of this meeting to DRMP. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal programs -- such as HMO, PSRO, Kidney and EMS. WASHINGTON/ALASKA Summary Page 2 © CONTINUATION ACTIVITIES: Of the 19 projects, seven are continuations, six of these continuations are projects which were initially funded as Functional Program Activities (FPA). The FPA is an application to utilize funds for an "immediate purpose" and for which specific evaluation questions have been developed to assess its value. There does not appear to be any significant budget increases in any of the continuation activities. DRMP/DOD WOB 5/21/74 eee ve eee . REQUESTE S LISTING _ - . Qs 10-23 cOMPC! BY REGION . _ ee 06/ WCIL Dee oo . 38. WASH ALASK . = PROG YR _ 06 oo, _ eat eee ee ee ee a n . . ~ ~ re . - * WESTERN comp COMPONENT TITLE DIRECT INDIRECT TOTAL oe ND De Do, - ... REQUEST REQUEST . REQUEST .. ... — COOO PROGRAM STAFE a 7 9305255 1229876 . 190539131 «047s STROKE NURS CLINICIAN — a 699171 O 699172 <7” «PHYS EXTENDER PLACEMENT a / a 369793 i t”*~ TOTAL REQUEST 620,675 13,829 ” 289628 663,132 @ oe RMP Western Pennsylvania RM 00041 MAY/JUNE 1974 REVIEW Request: _ $1,985,273 Ohio Project: $170,285 Committee recommendation: $1,370,285 includes Ohio Project: $170,285 Overall assessment by individual reviewers: _ Average Critique: This application includes continuation funding for staff and 16 ongoing projects in Western Pennsylvania area and one ongoing. project in Ohio which had been developed under the former Northeast Ohio RMP. Two-year funding is requested for two of the Western Pennsylvania projects. The objectives of the program appear well throughout and the projects well designed. The community involvement throughout the areas was noteworthy but the review process with area committees appeared somewhat cumbersome. Three issues concerned the Committee: the fact that the coordinator is still the University Vice-President for Health Affairs, the kidney © project and the request for two years support for the kidney project, and a nursing education project. Staff was asked to clarify several. questions about the kidney projects, The Committee was informed that the coordinator-director issue would probably be resolved this summer with the retirement of the coordinator. The RMP has always had a full-time director and the coordinator has not received support from the grant. The Committee did not believe the two-year funding was warranted. The Committee recommends that this application be approved at a reduced level of $1,200,000 pending clarification of the kidney project issues. In addition, the Committee recommends continuation funding at the requested level of the Mahoning-Shenango Area Health Education Center in chlo. The latter project will be monitored by Western Pennsylvania staff. . JULY/AUGUST REVIEW Estimated request as of May 1974: $650,000 RM 00041 qe iareneerenameaneeraitisstnr amet etn WESTERN PENNSYLVANIA Regional Medical Program Coordinator: David E. Reed, M.D. On duty since: _5 years Staff; Full Time Prof. 16 Proposed: 5 vacant Part Time Prof. 2 positions listed Full Time Other 5 and asked for Part Time Other 0 Total 25 Funds Requested: Total acoevevevesen ses ewve sees 1,985,873 Continuation. .crccrescsece (1,814,588 ) Newsssseccccccescsssesees (€ 170,285 ) Mahoning Shenango Area Health Education Network Inc. (044)* Period of Time Requested: July 1, 1974 to June 30, 1975 *044 - WP/RMP has included in the consultant category of this budget funds to allow for WP/RMP administrative, monitoring and evaluation activities. Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) Project #25 Adult Nurse Proc. Educ. Nurse Adult Ambulatory Care is requesting support through 6/76. $419,305 Project #26 Regional Renal is requesting support through 6/76. $312, 348. ° RMOOO41 W. Pa. List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: NONE | { i EMS project: (903 Emergency Medical Services - This activity was initiated 7/73. The overall objective of this activity is to develop a pool of competent instructors for training the three areas of life support: cardiopulmonary resuscitation and basic and advanced medical care. PSRO: NONE Kidney: Project #26 Regional Renal is requesting support through 6/76. $312,348. Increase the following activities on a regional basis: to increase dialysis capability in Region; to expand the transplantation capabilities of the H.C.; to train the required manpower for dialysis and transplantation; to develop a communications and unfform record system. CHP comments: It is my understanding that the two CHP "b" agencies have recommended approval of this application. The Southwest Pa. CHP "b" agency did provide a representative to be present at the RAG meeting. Comments from both "b" agencies will be forwarded upon receipt. E£0/5/20/74 1 WPA... PROG YR 05 ASTERN COMP a " COMPONENT TITLE ee eee oe NO a C000 PROGRAM STAFF COOL EVAL/RES ACTIV Cag ppg LIAISON ACTIV C003 EMS TANG CCO4 = =REG QUAL ASSUR ACTIV 017A BEAVER CNTY LIPID SCREENING 0178 BEAVER CNTY LIPID SCREENING 019 = BUCKTAIL RHEUMATIC FEVER 023° W PENN REG NEONATAL 025 ADULT NURSE PRAC EDUC NURS ADULT AMBULATORY CARE (026 = - REG RENAL 030 GUAL ASSUR SELECT ALLEGHENY CNTY HOSP 031 © WESTMORELAND. CNTY QUAL ASSUR 037 LAUREL MT QUAL ASSUR 038° «PT AUDIT 040 BUCKTAIL NURS AUDIT 041 © BEAVER VALLEY HOME HLTH NURSG AUDIT 044 MAHONING SHENANGO AREA HLTH EDUC NETWORK INC IF COMPONENTS 128 . . REGION TOTALS MA 1974 ce, . . . REQUESTE S LISTING COMPON Y REGION ao - to. . wo 06/74 COUNCIL a OIRECT REQUEST 2655583 55,075 63,891 602654 90,028 35,079 219643 29,189 679512 293 9362 253038 53,320 27630 16856 18090 "194160 12,853 170,285 195534248 INDIRECT REQUEST T4599 242990 _ 289990 277522 414387 92138 92469 71648 232629 1259943 TOTAL REQUEST 340,182 80065 924881 884176 131,415 445217 31,112 36,837 919141 4194305 3125348 539320 272630 169856 18,090 199160 12,853 170,285 199855873 ; WISCONSIN REGIONAL MEDICAL PROGRAM RM 00037 MAY/JUNE 1974 REVIEW Request: $4,577,325 Committee Recommendation: $2,000,000 Overall Assessment by Individual Reviewers: Average Critique: The reviewers noted that this region having had a very illustrious past history, is now in a crisis of leadership. With the exception of the Program Coordinator, most of the present program staff members are new. The reviewers found little evidence that the RAG has accomplished much during the past year, although past performance had been quite good. CHP relationships as in the past are still good overall objectives and priorities are vague. The proposal represents a series of poorly conceived, fragmented project activities, some research in nature, others (such as mental health, etc.) not in keeping with the usual DRMP goals and may be inappropriate for funding. Except for the evidence of past performance ,there is little evaluation of what is currently going on in the region. JULY/AUGUST REVIEW Estimated Request as of May 1974: $2,500,000 DRMP/DOD SCOB/6-6-74 MAY REVIEW STAFF SUMMARY WISCONSIN REGIONAL MEDICAL PROGRAM, INC. Prepared by: Jeanne Parks 5721 Odana Road RM # : 00037 Madision, Wisconsin 53719 Mr. Charles W. Lemke, Coordinator On duty since: 2/74 Current Staff: Proposed Staff: 8 Full-time Professionals 23 Full-time Professionals 17 Part-time Professionals 3 Part-time Professionals 5 Full-time Other 6 Full-time Other 9 Part-time Other 1 Part-time Other Staff - Contractural services not included in Program Staff Budget: 1 Full-time Professional 2 Part-time Professionals 1 Full-time Other 3 Part-time Other Funds Requested: Total - $4,577,325 Continuation - 1,517,322 Target Figure - $2,490,701 New - 2,239,203 Estimated July Request - $2,500,000 Program Staff - 820,800 Budget Period: 7/74 - 6/75 Period of time Requested: All activities will terminate 6/30/75. Activities Proposed: See MIS printout. Items for the Reviewers Attention: The region is requesting a total of $156,413 for the following proposals which are in the Mental Health area: Project # 84 - Self Administered Sex Therapy Program $ 18,263 Project #112 - Evaluation of Mental Health Outcome 59,513 Developing Program Project #113 - Reducing Suicides in Wisconsin 39,862 De-Institutuionalization Implementation 38,775 Project #120 Methodology TOTAL $156,413 Page 2 Wisconsin Regtonal Medical Program While there may be a need for work in this area, it raises several questions: (1) the appropriateness of DRMP funds to support these activities; and(2) how do the proposals tie in with the goals and objectives of WRMP. The following activities are flagged because they are either research oriented, continuing education activities or activities which are believed not to be in line with DRMP initiatives: Project #47 - Health Line $100 ,147 Project #56 - Comparative Evaluation of Diabetics 128,590 Project #53 - Crisis Intervention in an Emergency 22,196 Room Project #70 - Development of Seriodiagnostic 59,548 Procedures for Gonorrhea in Wisc. Project #77 - Reprod. Info. §& Data Collection System 51,360 Project#111 - Quantitation of the Cytotoxic Assay 35,750 Project #95 - Hodgkin's Disease in Wisconsin 41,625 EMS: The region received approval for a three year period for the establishment of a Statewide EMS Program. Funds were provided in the amount of $1,265,816 for two years only, beginning June 1972. In addition, the region was awarded $118,850 additional funds for the period January 1, 1974-June 30, 1974 for two components of the EMS program, The region is now requesting $938,198 for the third and final year of the EMS activity. CHP Comments: Copies of the WRMP application were forwarded to each of the eight CHP ''b'' agencies for review and comment. Letters from two of the (b) agencies (pages 66 and 69) indicated that the application was not received in time for consideration when the WRAG reviewed the application to submission to DRMP. One negative comment which dealt with the technical aspects of a project. DRMP/DOD 5/20/74 } 1974 . 37 WISCONSIN SOUTH CENTRAL 063 REQUEST 06/74 COUNCIL. COMPON PROG YR .07 coMP COMPONENT TITLE NC... a. Coo0 «= PROGRAM STAFF COOL DEVELOP PLAN STANDARDS : €003 QUAL ASSUR FEAS STUDY 026 NURSE ASSOC PHYS TEAM 632 STUDY UTILIZ FINANCE & QUAL MED CARE 034T VOL FGR STROKE ; 036A ST CROIX VAL SHARED SERV INC 0368 SHARED HLTH SERV INC 040 EMS O44 CENT RYPT SCREENING 0444 HYOT SCREENING RX - Oana SCH HYPT SCREENING =” 646 PT HLTH OUTCOME CRITERIA NURS PEERS 047 9 HLTH LINE 051 ALLIED HLTH EDUC COORD COUNCIL 052. IMPROV UTILIZ NURS AMBULATORY CARE 653 CRISIS INTERVEN EMERG RM 036 5SIAB TEACH APPROACH EVAL 052 HYPT COMPUTER ASSIST SCREEN AND MGMT 061 DEVELOP NURS HOME CARE APPRAIS 062 COCKD DENT CARE QUAL ASSUR WISC FACIL ST/WIDE HYPT SCREEN RX DS LISTING DIRECT . REQUEST 820,800 52,800 50,000 287368 539268 11,665 164000 56,538 8379314 262035 1454040 149160 74,557 84,189 40,041 789141 224196 894910 244295 149 7300 354050 55,700 INDIRECT . REQUEST 0 6 : ° a 12,320 179942 0 0 0 "100,884 49632 13,618 | 29495 30,016 15958 } . 29 9454 Qo 38,680 92128 T1266 > TOTAL ... REQUEST 820 ¥800 "522800 50,000 " 409688 715210 117665 16,000 56 9538 938,198 309667 1585658 169655 104,573 1005147 — | 40,042 1077595 229196 "1284590 334423 ” 1494300 354050 629826 ‘qi REQUESTED F LISTING COMPONENTS REGION 06/74 COUNCIL WISCONSIN .. _. PROG.YR 07 | H CENTRAL COMP COMPONENT TITLE - ee ee NO ee oe | on. 064 «EDUC PERS BIO EEFECTS RADIATION. HS 965 CO EDUC DENT WISC 067 MOTIVAT CONSUMERS MEET HLTH RESPONSIBIL : "969: DEVEL ALT CARE W WIS - 07s: DEVELG SERTO DX PROCEDURES GONORRHEA WIS O71 CONT EDUC G2 FAMILY PRACT "O73. ~~ PHYSICAL ACTIV PROG AGED : "974 | PREV MAINT CVA pIs "976 COMMUNITY NURSG SERV ELDERLY - : “077 EPROM INFO & MATA COLLECT SYS DEV IMPLE : 078 CCMP HLTH SYST INNOV MTHDS PRIM HLTH CARE DEL "084 ~~ SSELF ADMINIST SEX THRPY Oe "987 so MEVELGP TRANSITIONAL NURSG COURSE RN*S) --682)~=—ssC# HOME «CARE DEVELOP SE WISC 094 ~~» PREV COR HT DIS SCH CHILDREN t—(“‘i‘itét~™S , "995 —« HODGKIN®S DIS WISC — (697 «FOX VAL SHARED SERV EDUC ASSOC "098° CUAL CNTRL DX RADIOLOGY _ noe ~ - : 404 OBT EDUC 105 ASSESS EXPECT GUTCOMES & PT SATISFACT "106 RURAL CLASSROOM PRACT — IMMUNOLGG MICRO-CYTOTOXIC ASSAY DIRECT . REQUEST 99380 394500 739927 314800 50,560 (219777 165861 149200 45 9842 514360 49730 13,783 207204 449400 53,698 _ 339365 92500 277836 503550 51,380 155,181 354500 - INDIRECT .-. REQUEST 750 316 239186 169362 8 ¥260 0 109836 — 159382 235435 | 679536 0 19616 sen o- . TOTAL .- REQUEST - 109130 39-816 97,113 31,800 599548 29,197 225501 ; 143200 © 459842 51,360 494730 184263 "21,820 44,400 "709059 4149625 92,500 ” 389672 654932 T4_,815 2229717 354500 @.... a " WESCONSIN. UTH CENTRAL 12 REQUES NOS LISTING . coMPo BY REGION ee ee .. . . 06/74 COUNCIL . PROG YR 07 comp : COMPONENT TITLE 2 —™ DIRECT NO Oe REQUEST DEVELOP MENTAL HLTH OUTCOME MEASUREMENTS 246 92- 113 REDUCING ‘SUICIDES WISC . - , 329491 115 IMPROV "MEASUREMENT PHYS PERFORM'HOSP 2 t—<“i‘“SCS™S "625748 “116 STATEWIDE HOSP DISCHARGE SURVEY _ 4069 118 NURS EDUC HIGH RISK PERINATAL DIS 12,000 120 DE=INSTITUTIONALIZ IMPLE METHCDOL ~—~> : : | 389775 - \ . a ewe . . : . 50 . ou. ..... REGION TOTALS 490689476 INDIRECT REQUEST 169821 75372 6,765 19433 0 0 508 9 849 . ®@....... TOTAL REQUEST 599513 395862 599513 142,502 12,000 389775 405779325