3

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UNITED STATES GOVERNMENT DEPARTMENT OF HEALTH, epuch ON. AND WELFARE

Memorandum

FROM

SUBJECT :

PUBLIC HEALTH SERVICE

See Below DATE: December 8, 1967

Martha L. Phillips, Chief, Grants Review Branch
Division of Regional Medical Programs

"Purple Sheets”

The attached copies of "Purple Sheets" reflect the actions taken
on applications considered at the November 20-21 meeting of the
National Advisory Council.

The award of the two new operational applications (Tennessee Mid=
South and Washington/ Alaska) will be made only after negotiation
which may rearrange the level of recommended funding of some
individual projects. You are also reminded that the award to the
Western New York (Buffalo) region is to be negotiated following a
Council site visit. -

Distribution of this memorandum to:

Dr. Marston/Mr. Yordy « 1

Mr. Odoroff = 1

Dr. Sloan - 1 ;

Mr. Friedlander « 1 .

Miss Abrams (for Planning & Evaluation) « 4

Dr. Stephenson (Yor Operations Staff) « 2

Mr. Beattie (for Grants Management) = 2

Dr. Manegold (for Program Development & Research) = 3

 

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UNITED STATES GOVERNMENT DEPARTMENT OF HEALTH, EDUGATIONAAND WELFARE

Momorandium

TO

FROM

SUBJECT :

PUBLIC TIEALTEH SERVICE

THE RECORD DATE: November 27, 1967

Public Health Advisor
Grants Review Branch

Recommendation on the Operational Supplement submitted by the
Missouri Regional Medical Program, 3 GO3 RM 00009-0152, National
Advisory Council Meeting, November 20-21, 1967

MOTION: Disapproval. (#5)

Council was in essential agreement with the Review Committee that this is
a thinly disguised request for immediate financial assistance for support
of continued operation of the Kansas City General Hospital as a center of
training and as a continuing education resource for the Kansas City area.
Although it is certainly possible under Public Law 89-239 to support the

_cost of patient care under certain special circumstances and in direct

relationship to heart disease, cancer, stroke and related diseases, the
use of Regional Medical Program funds to perpetuate the existance of a
traditional large open-ward general hospital is inappropriate, principally
for two reasons: (1) the plight of such hospitals in cities throughout
the Nation is essentially the same and Regional Medical Program funds
cannot and should not be used to bridge the gap created by delays in
Medicare and Medicaid reimbursement, or provide basic support which has
not been forthcoming from local funding mechanisms; (2) relevance of

this project and others which might be designed upon the same lines to the
goals of Regional Medical Programs has not bcen shown.

Council expressed great confidence in the staff of the Missouri Regional
Medical Program and its performance to date. It scems evident that had

the planning for this project been less hasty and less dominated by fiscal
urgency, the project could have been almost classic in its appropriateness
as an approach to improved care in an urban setting. Although there was
unanimous agreement with the recommendation for disapproval, it was apparent
that Council would be willing at any. time to look at another proposal from
this region for a project for urban Kansas City and involving Kansas City
General Hospital and related "Hospital Hill" activity which would clearly
demonstrate its relevance to Regional Medical Programs.

? .
Peter A. Clepper « -~ -~

“&

 

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UNITED STATES GOVERNMENT DEPARTMENT OF FIFALTIL, EDUC: OON, and weaver

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ER OROVERLUM

TO

FROM

SUBJECT :

PUBLIC TRALEE SERVICE

THE RECORD DATE: November 24, 1967

Public Health Advisor
Grants Review Branch

Recommendation on the Supplemental Planning Grant Application submitted
by the Western New York (Buffalo) Regional Medical Program,

3 GO2 RM 00013-0281, National Advisory Council Meeting on November 20-21,
1967

MOTION: Conditional approval (#2) in principle, of all three components
of this application subject to a Council site visit to (a) identify
fundable planning aspects of each activity and (b) determine the
amount to ba awarded.

The Council was cognizant of the apparent Operational facets of the proposed
communications network and coronary care training activities, and concern

‘was expressed as to the appropriateness of outright or partial approval of

these two proposals as additional planning without further delineation
between the planning and operational phases. The Council considered the
third activity in pulmonary care as a straightforward six-month planning
request but with the recognition that an operational request in this areca
could be substantial. The proposed methods to evaluate the results of cach
activity were not felt to be a strength of this application.

In discussing the communications network proposal, it was noted that it

will be based in part upon the success of another medical communications
program (Albany) which has already been demonstrated as feasible. This

fact together with the proposed magnitude (both content and goographic

area to be covered), the projected three-year budget at approximately the
same annual level of expenditure, and the obvious high degree of planning
already accomplished, tend to support this as an operational rather than

a planning project. It was suggested that the applicant may want to consider
building a communications network upon a more modest but functional base.

Although the coronary care training program requests only one year of
support, Lt was described by Council as an operat Llonal project. ‘This is
not a unique eheathonal demonstration but rather a proposal in an areca
where similar programs have been tried, tested and proven. ‘lhe degree of
planning accomplished prior to the writing of this project and the acknowl-
edged involvement of peripheral as well as nearby medical and nursing
resources give further evidence of the readiness of this activity to enter
its operational phase.

 
 
 

 

 

HELP ELIMINATE WASTE

 

 

 

COST REDUCTION PROGRAM

 

 
 

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2.

Since this application had been submitted as a planning supplement, the
applicant had not submitted specific information usually required in ~

support of an operational request. Accordingly, and in keeping with the
wishes of the applicant, the Council did not consider the communications

network and the coronary care training program as a two-part operational
request.

The Council fFelt that all the proposals presented in this application are
worthy of support. lowever, after full and thorough discussion of this
application, the questions raised and the appropriate use of planning and
and operational funds, it was determined that a Council site visit would
be necessary so as to identify those facets which could be fundad.

-
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Robert Ew ' Jones
 

°

Jay Bll

* UNITED STATES GOVERNMENT . DEPARTMENT OF HEALTH, EDUCATION, AND/WELFARE

Memorandum

FROM :

SUBJECT ;

PUBLIC HEALTH SERVICE

: THE RECORD DATE: November 24, 1967

Public Health Advisor
Grants Review Branch

Recommendation on the Operational Supplement submitted by the
Intermountain Regional Medical Program, 3 G03 RM 00015-0182, ~
National Advisory Council Meeting, November 20-21, 1967

MOTION: _ Project #1 - The Control of Chronic Renal Disease - DISAPPROVED

Project #2.- Endocrine Metabolic Laboratory - APPROVED in
time and amount requested

Project #1

The discussion centered mainly on the policy and precedent-setting issues in
a very broad and general sense. There was agreement that this project is
primarily a service function with very little research and training involved.
The interesting social-cthical aspects are obvious and calls for discussion
both inside and outside medicine. However, there was agreement that, even
though the homotransplantation project has relevance as a "related" disease
to Regional Medical Programs, it 1s not within the purview of the program.

It was also pointed out that if similar projects, likewise service in function,
were extended throughout the United States, could require support in excess
of the entire Regional Medical Program funds. The Council also agreed that
implementation of any such projects should await the results of special
studies now underway by the PHS and the BOB.

Project #2

Council was divided in approach to the support of the project, albeit in
agreement as to its significance to Regional Medical Programs. On the one
hand, Council believed support of such a laboratory is of unquestionable
value in early detection of hypertension, and some forms of heart disease
and in the diagnosis of some cancers. The idea is meritorious also from -
an educational standpoint, as it will increase interest and improvement in
the management of hypertension - a disease which is being appropriately
managed in only a small fraction of the 17 million estimated cases.

On the other hand, the precedent-setting aspects are obvious; a relatively
small percentage of hypertensives will be seen from screening procedures in
a laboratory established for general endocrine diagnostic purposes; and also,

  
 

 

 
 

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COST REDUCTION PROGRAM

 

 
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2.

it was believed that the phasing is inverted, i.e., education of physicians
and ancillary personnel should precede setting up the screening process,
the latter establishment of such a laboratory facility.

Although a majority decision resulted, there were two negative votes
recorded, with seven in favor of recommendation for approval.

Jessic TF. Salazar

 

 

 

 
 

"ED § ‘ES G SRNMENT DEPARTMENT OF HEALTH, EDUCATION
ee et PUBLIC HEALTH SERVICE
< yp y-
Memorandum
TO THE RECORD DATE: December

é ?
q.
Peter Clepper irc
FROM ;: Public Health Advisor
Grants Review Branch

SUBJECT: Recommendation on the operational grant application submitted by

kaye

ND WELFARE

'

1, 1967

the Tennessee Mid-South Regional Medical Program, 1 G03 RM 00018-01,

National Advisory Council Meeting - November 20-21, 1967

MOTION: Approval in the amount of $1,500,000 in direct costs for
the first year, and at the same level, less nonrecurring
costs, for the remaining year of the program period.

<4.

The Council was satisfied that the Region has the mechanisms available for
an operational program. Special mention was made of the intercommunity and

interracial cooperation evident in the application. Shortcomings

in the

program are the absence of stroke projects and lack of full acceptance of

the program on the part of the State Medical Society, which was apparent to
the site visitors. Specific strengths of the program are its leadership;
the degree of developed and developing cooperative arrangements among the

7". health care facilities in the Region; and the personal commitment,
widely representative health professionals. !

of

The final decision on the recommended dollar amount was based, not only
on the total of the "approved" projects, but on a general agreement that
the $1.5 million will provide for an adequate program base upon which the

Region may build,

The recommendation affects the individual projects as follows:

 

 

Requested Approved

Project No. Project Description Amount Amount
1 Continuing Medical Education (Meharry) $ 51,802 $ 51,802

Approval based on site-visitor and .

Review Committee recommendations, as

an interesting approach to the special

problem of the Negro physician in the

Region,
2,3,4,5 Continuing Education (Vanderbilt), 358,189 ~0-

 

Education Centers (Hopkinsville &

Chattanooga), Radiologist Education

(Vanderbilt) These projects should be

deferred for additional planning and

rene tings for reasons set forth by the
o

alte vis rs ng Phe Review Committee.
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HELP ELIMINATE WASTE V Ve REDUCTION PROGRAM \

 

 

 

 
 

 

 

 

 

2
~ . . Requested Approved
Project No. Project Description Amount Amount
6 Cardiac Nurse Training Program $ 59,695 $ 59,695
Approval is recommended.
7 School of X-ray Technology (Mcharry) 22,702 22,702
Approval based on recommendation of
Committee and site visitors as contri-
buting to regional activities. .
8,9,10 Radiology Technology (Vanderbilt), 113,400 __ «100,000.

 

Nuclear Medicine Training (Vanderbilt),
Medical Technology School (Chattanooga)
Approval based on recommendation of site
visitors and Review Committee, at ‘a
slightly reduced amount.

11-21 , Coronary Care Units * 511,659 300,000

“ Approval based on site visitors and
Review Committee's recommendations which
were for support at a more reduced budget .
level.

22,23, 24 Computer-Linked Program to Improve Super- 119,351 ~O-
voltage Thera
As mentioned at the Review Committee
meeting, the console equipment proposed
in the application is not yet available '
for general use. However, other methods !
of promoting a communications system for
central calculation and relay of dosimetry
levels are now in use and are generally
far less expensive than equipment proposed
here. Council recommends that the present
proposals not be supported as outlined, but
that the Region be encouraged to investi-
gate other systems to meet this real need.
Hence, Council agreed with the Committee's
recommendation that these projects not be
funded, but altered its recommendation on
forbidding use of RMP funds.

25 Supervoltage Therapy (Meharry) | 73,021 73,021
Approval based on Review Committee's
recommendation (in turn based on the
recommendation of the expert site visit
team) as a facility appropriate for the
school.

 

 
 

Project No.
26

27

28

TL. |
(ay

Requested Approved
Project Description Amount Amount

Rehabilitation Center (Vanderbilt) $ 151,038 -0-
Disapproval, as recommended by Review

Committee. Council agreed that the

project is for a single institution

with limited application to the Region

as a whole ard without sufficient _

demonstration of categorical relevance.

Consequently, it was further recommend-

ed that RMP funds not be used for this

project.

 

Patient Care {n a Remote Mountain 10,560 10,560
Community

‘' Approval based on site visitors and

Review Committee's recommendations as a
modest request which will draw upon local
manpower for filling necessary hospital
positions.

Multiphasic Screening Center (Meharry) 747 , 043 747 ,043
Approval up to the amount requested, as

a necessary and worthy project which is

particularly suitable to the purposes of -
Regional Medical Programs. This is a '
project directly related to patient i
welfare and offers a promising approach

to bringing diagnostic services and con-

sequent treatment to a large group of
underprivileged who would not otherwise

have opportunities for this type of care.

The members of the Council agreed that

there are weaknesses in the planning for

the Center, but this approach to patient

treatment has been tried elsewhere; there

is a large and growing body of expert

opinion which can be drawn upon, especially

that now supported by the Public Health

Service. :

 

Accordingly, the Council approved the
project in principle and recommended
that it be funded up to the amount re-
quested with the condition that the
staff consult with the applicant about
expertise available, and that the
applicant accepts the help needed to
develop a workable project.

 
 

 

Project No.
29,30,31

32

33

34

feajtite

 

Requested Approved
Project Description Amount Amount
Patient Care Models ' $100,646 §$ 100,646

Approval as innovative projects with
high potential for achieving the
goals stated, and provided with lead-
ership of unusually high character,
Council decided that the projects are “oe
relevant to Regional Medical Programs
as useful experiments in patterns of

patient care, role definition, and

social engineering for discovering

optimal care patterns.

Nurse Specialist Graduate -Program 25,620 -O-
Disapproval as recommended by the site

visitors and the Review Committee... The

program is not essential to patient

study and is eligible for support under

a program of the PHS Division of

Nursing. ~

 

Biomedical Science Summer Program

(Meharry) ~ 150,540 _ 20+
Disapproval as recommended by the Review
Committee. The project is commendable,

but since it involves prebaccalaureate i
students who are not even committed to ‘
careers in the health field, Council

decided that it is beyond the scope of

Regional Medical Program objectives.

Medical Data Processing (Vanderbilt) 112,362 -0-
Disapproval as recommended by the Review

Committee as being unsuitable for use

of RMP funds. This is a general research

project into one hospital data system

without demonstrable relevance to regional

objectives. Use of RMP funds should be

excluded until such time as the project

can be re-developed- the methodology and

plan for regional relevance can be
presented in more specific detail. §

Ase amen tm sommes ov awe ee rete etna

 

TOTAL $2,607 ,628 $1,465,469

 

 

 
 

UNITED STATES GOVERNMENT DEPARTMENT OF HEALTH, EDUCATION,

_ Memorandum

FROM

SUBJECT :

ND WELFARE
PUBLIC HEALTH SERVICE

: THE RECORD DATE: November 27, 1967

Public Health Advisor

: Grants Review Branch °

Recommendation on Supplemental Planning Grant Application ~
submitted by Oklahoma Regional Medical Program, 3 G02 RM 00023-02s1,
National Advisory Council Meeting, November 20-21, 1967

MOTION: Approval in the time and amount requested. (#1)

Council expressed great interest in this application which will provide
funds for supplementary planning activities for this Regional Medical
Program. It defines needs which were not anticipated originally and
proposes an imaginative approach’ to their solution. It also, provides
for the extension of the committed program period for one additional

"year.

Some concern was expressed relative to the region's slowness in recruiting
a permanent full-time coordinator, It was felt that although the present
coordinator is devoting his full attention to the program, it is unlikely
that the region will move smoothly into a -full-fledged operational program

until a permanent person is found.

‘o
-

/ AO “ .
{Peter A. Clepper

 

| HELP ELIMINATE WASTE COST REDUCTION PROGRAM

 

 
 

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‘Ey TR

- UNITED STATES GOVERNMENT DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Memorandum

TO

FROM

SUBJECT :

PUBLIC HEALTH SERVICE

; THE RECORD DATE: November 27, 1967

‘Public Health Advisor

Grants Review Branch

Recommendation on the Operational Grant Application submitted by
the Rochester (N.Y.) Regional Medical Program, 1 GO3 RM 00025-01,
National Advisory Council Meeting on November 20-21, 1967

MOTION: Approval (#1) in the time and amounts requested for components
one through four descttbed below; disapproval (#5) of component
five described below, with further recommendation that no DRMP
funds be used to support this activity.

A joint Committee-Council site visit was made to this regional medical
program on November 15, 1967, as suggested by the Review Committee last
month. The results of this visit were reported to Council, and it was

evident the findings of the site visit group substantiated the fact that

this regional medical program is well established and ready to Lnaugurate
an operational program. Accordingly, the Council concurred in general
with the conclusion of the Review Comnitteac.

The Council was cognizant that the components of this application ‘represent
a cohesive initial approach to the problems of cardiovascular disease and
that a significant number of cardiologists will be available to provide
necessary support. It was indicated, however, that appropriate attention
needs to be given the development of a balanced program in all three of

the major categorical diseases as time, manpower and resources permit.

The active participation of nurses both in the planning as well as opera-
tional phases was especially noted by the Council.

A summary of the recommendations made by the National Advisory Council on
each of the five component projects contained in this application follows.
Dollar amounts are given for first-year direct costs only.

: Requested Recommended
. Support Support
1. Support for reconstruction and equipping of $ 26,400 $ 26,400

facilitics for use as a learning center for

projected training programs talated to heart

disease, cancer, and stroke = The Council

concurred with the Committee as to approval

of this modest request. It was evident from

the site visit that educational services will

  
 

 

 
 

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COST REDUCTION PROGRAM

 
 

/

 

2.
Requested Recommended
(cont'd.) Support Support
1. radiate out from this resource to

peripheral facilities. The work already

accomplished in the planning of the

coronary care nurse training program is

illustrative of the way in which this

heart, cancer, and stroke learning center

will be utilized for the benefit of the ~
entire region.

Postgraduate training program for physicians $ 83,857 $ 83,857
in the Rochester ten county region - In
approving this proposal, the Council gave :
particular attention to the respdénse of

this training program to expressed peri-
pheral needs, the depth of medical specialty
manpower. available to carry out this program,
and the thoroughness with which this project
has been planned,

Registry of patients with acute myocardial  $ 21,180 $ 21,180
infarction in the Rochester regional

hospitals - It was noted that the form to

be used in this registry had been developed

by the State Department of Health and the

State Heart Assembly, and that goals: for

its use go beyond that of data gathering.

Proposal for the establishment and support $ 69,420 $ 69,420
of a regional laboratory for the education
and training in the care of patients with
thrombotic and hemorrhagic disorders - The
Council concurred with the Review Committee
as to the appropriateness of this request.
It was indicated that this laboratory can
make a major contribution in providing a
needed consultation-education resource, and
gives assurance that efforts to stimulate
cooperative quality control will have the
necessary support in manpower and equipment.
 

Requested Recommended
Support Support

4. Study of the cardiac output by electrical $ 17,121 none
impedance plethysmography - It was noted
that this was the only project in which
the Committee had expressed concern. Based
upon the findings of the site team, the
Council concluded that the proposed method | -
would require additional laboratory investi-
gation before results would be applicable
to patients. In recommending disapproval
of this project, the Council further
recommended that no DRMP funds be used to *
pursue this activity.

 

 

 

 

TOTAL _ $217,978 $200,857

~

HATE ne

Robert E.° «Jones

 
Cy ttle

UNITED STATES GOVERNMENT , DEPARTMENT OF HEALTH, EDUCATION,AND WELFARE

Menorandum ,

TO

FROM

PUBLIC HEALTH SERVICE

THE RECORD DATE: November 27, 1967

Public Health Advisor
Grants Review Branch

SUBJECT: Recommendation on South Carolina Regional Medical Program, - .

2 G02 RM 00035-02, National Advisory Council Meeting,
November 20-21, 1967

MOTION: The Council recommended a grant for the time and in the
amount requested (#1).

 

This is a competing application for a second year planning grant. The
initial planning award was made for one year only. Discussion of the
application was brief. Major concern was expressed about the absence
of a permanent director. Reluctance of practicing physicians in the
Region to cooperate was also mentioned. The possibility was suggested

“that the Regional Program has realized more progress than is evident
in this application.

Ldn he

Patricia McDonald

 

 

 

HELP ELIMINATE WASTE COST REDUCTION PROGRAM

 
 

 

UNITED STATES GOVERNMENT DEPARTMENT OF HEALTH, spuewrion, WELFARE

Memorandum

TO

FROM

SUBJECT :

PUBLIC HEAL TEL SERVICE

, THE RECORD DATE: November 28, 1967

Public Health Advisor

, Grants Review Branch

Recommendation on the Operational Grant Application submitted by the
Washington-Alaska Regional Medical Program, 1 GO3 RM 00038-O1R,
National Advisory Council Meeting on November 20-21, 1967

MOTION: Conditional approval (#2) for two years, direct costs of which
shall not exceed $969,904 in the first year and an equal amount
in the second year, exclusive of nonrecurring costs, to continue
allowable activities presented in the application.

The Council concurred in the Review Committee's finding as to the viability
of this regional medical program and its readiness to mount an operational
program.. Final approval of this operational grant request -is contingent
upon the applicant's submission of an acceptable revised budget to the
Division of Regional Medical Programs which reflects projected activities
within the intent of the Council's recommendation. Dr. Hogness was not
present during the discussion of this application.

A summary of the recommendations made by the National Advisory Council on
each of the eighteen component projects contained in this application
follows. Dollar amounts shown are for first-year direct costs only.i/

Section I: Education and Training
—_ :
Requested Recommended
Support Support

1. Central Washington - This project was $ 18,181 $ 18,181
considered responsive to the expressed
needs of practicing physicians for
continuing education so as to improve
their capabilities to provide quality
medical service to patients. :

2. Southeastern Alaska - This proposal was $ 27,062 $ 27,062
viewed as similar in many ways to the
first project and also worthy of support.
It was felt that this initial effort might
be expected to develop into a broader
Operational program in Alaska.

 

| HELP ELIMINATE WASTE COST REDUCTION PROGRAM

 
 

iy elt

Requested Recommended
Support Support

Preceptorships - The Council concluded $ 17,610 $ 17,610
this was another worthwhile and logical

approach leading toward the delivery
of improved health services.

Telephone-Radio Conferences = There was $ 8,445- § 8,445
agreement with the findings of the Review

Committee to support this project. The

relatively modest first-year request was

noted but with the recognition that supple~

mental funds may be requested to expand thia -

pilot program.

Educational Support Unit - The Council was $522,304 $522,304
cognizant of the considerable amount of
planning that had gone into this project.

It also expressed confidence in the staff
thus far selected to man this activity. A
primary concern had to do with a balanced
approach to the education and informational
needs in all three major categorical
diseases; accordingly, it was indicated

that adequate attention should be given the
area of stroke and that this might be -
accomplished through the active participation
of the proposed Professional Advisory
Committee as well as other means.. Other
concerns had to do with (a) the amount of
time to be expended by key professional
staff although it is possible that the
estimates given are in reality conservative,
and (b) the ability of the WARMP to recruit
required staff and go fully operational in
the first year.

In discussing this proposal, the Council made
reference to the emerging need to give appropriate
attention to the broader issues inherent in the
support of comprehensive audio-visual resources
such as this. DRMP staff indicated that this
whole area was receiving active attention, and
that policies in this regard would be formulated.

Coronary Care Unit Coordination =~ In $ 70,285 $ 70,285
recommending full support for this project,

the Council stressed the growing need for

this type of program in view of the increasing

 

 
 

(cont'd)
interest in and activation of coronary care
units. The involvement of both physicians
and nurses was felt to be commendable.

6.

10.

ll.

12.

Continuing Education of Technicians - There
was agreement that this project will help
strengthen Laboratory services which benefit

patients.

One Council member concurred in the

Review Committee's concern as to the need for
negotiation with the applicant in regard to
the training fees to be paid cooperating
laboratories.

Cardio-Pulmonary Technician Training - The
Council wasdn agreement with the Review
Committee's finding to support this project.

Alaska Medical Library - The Council agreed’
that this was a modest request and worthy

of support. At least one Council member
suggested that a higher initial amount would’
have been justified.

Section IT:

Patient Study and Service

Anchorage Cancer Program - The need for this

program in Alaska was felt to be evident and

the Council unanimously recommended approval.
The Council had the benefit of review of this
proposal by the NCI which also recommends

support.

The suggestion was made that this

project might more appropriately be referred
to as the Alaska Cancer Program.

Children with Cancer Study - The Council
expressed the belief that this study could
produce meaningful information which could
be utilized in improving the care of
children with cancer. The NCI did not
submit a technical review of this project.

Radiation Physicist = The Council concurred
with the recommendation of the Review
Committee as to the approval of this project.
The Council had the benefit of a review by
the NCI which also recommended support as

requested.

4

 

3.

Requested Recommended
Support Support

$ 53,446 $ 53,446

$ 41,554 § 41,554
$ 21,754 $ 21,754
$ 51,450 $ 51,450
$ 28,030 $ 28,030
$ 56,393 $ 56,393

 
13.

Ma

15.

16.

17.

18.

Section IIT: Developmental

Laboratory Evaluation of Renal and Adrenal
Hypertension - In recommending disapproval
of this project, it was suggested that
preliminary studies need to be conducted
before reapplication is made to pursue

this as an operational activity.

Ocular Plethysmography = The Council concurred
in the recommendation of the Review Committee
to disapprove this project with the stipula-
tion that no DRMP funds be used to pursue -
this research activity.

Early Detection of Ischemic Heart Disease = It
was the consensus of the Council that this
proposal not be supported as submitted but
that the applicant be encouraged to develop

a more definitive protocol. Of primary
concern was the lack of methodology to

support this proposal as either a teaching

or epidemiologic activity, or both.

Laboratory Data Systems - The Council did not
recommend support of this project. One

Council member suggested further planning

of this program with the possible implementation
of a more Limited pilot program, —

Standards of Nursing Care - It was not felt that
the proposed methodology gave reasonable assur-

ance that valid and meaningful results would be

obtained in this study. Recommendation was for

disapproval.

Computer-Aided Instruction - The Council
concurred in the Committee's recommendations
to support this proposal.

- TOTAL

 

Ll
Kall

 

4,
Requested Recommended
Support Support
$ 51,875 none

$ 27,935 none

$ 56,163 none

$ 42,431 none

$ 32,408 none

$ 53,390 $53,390

 

 

$1,180,716 $969,904

1/Final computation based on individually approved projects will

need to take into account the minor adjustments described in
Mr. Kornfeld's letter of October 5, 1967.

DP ese
ee Le ME Le
‘Robert E. Jonés
_-/

 

 
 

 

 

UNTTED STATES GOVERNMENT DEPARTMENT OF HEALTH, EDUCATION, A Gy WELFARE

Memorandum

TO

FROM

SUBJECT :

PUBLIC HEALTH SERVICE

THE RECORD DATE: November 27, 1967

Public Health Advisor
Grants Review Branch

Recommendation on Initial Planning Grant Application from
Northwestern Ohio Regional Medical Program at Toledo,

1 GO2 RM 00063-01, National Advisory Council Meeting,
November 20-21, 1967

MOTION: Council recommended awarding a planning grant for the time
and amount requested.

Council was satisfied that a vast amount of planning had preceded this
application, The high level of cooperation achieved in the region was
noted, with special mention that financial assistance had been provided

. by the Heart Association. Since the medical college with which the

Region will be affiliated is a developing one, Council stated that this
is a unique opportunity for the medical college and regional program to
develop together. Information was provided that Dr. Robert Tittle, the
Program Coordinator, has recently arranged to work with the Program on
a full time basis. With that problem resolved, the Council was favorably

impressed with the proposal.
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Patricia McDonald

 

 

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UNITED STATES GOVERNMENT DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Memorandum

TO

FROM

SUBJECT :

PUBLIC HEALTH SERVICE

THE RECORD DATE: November 24, 1967

Public Health Advisor
Grants Review Branch.

Recommendation on the Planning Grant Application submitted by

the Northeastern Ohio (Cleveland) Regional Medical Program,

1 G02 RM 00064-01, National Advisory Council Meeting, November 20-21,
1967

MOTION: Approval in time and. amount requested,

There was consensus that this planning proposal is reasonable in scope,
size and socio-economic characteristics, with the to be expected encumbent
urban complexities. It shows great promise of success in that pre~planning
has been underway for sufficient time to allow for the formulation of a

. well-organized plan, and also it comes from a region rich in talent and

medical resources,

The organizational framework leaves some minor questions as to relation-
ships of the Program Coordinator and the Chairmen of the three categorical
committees. Does he, for example, have the necessary "line" authority to
make coordination of planning effective?

The evidence of ‘involvement of urban and suburban peripheral interests to
the Cleveland area could be stronger, but it was recognized that this is

a common weakness of most planning applications. A strengthening of lay

participation from the outlying areas would improve this aspect.

The overlapping in state licensing practices was felt to be a potential -
strength for inter-regional cooperative efforts.

Jessie F. Salazar

 

 

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