I anh hb rs V minute news vo2 no! Be May 13, 1970. THE NEW. ACT ING DIRECTOR'S VIEW OF RMP *Kilied health personnel are more likely to bring ebout much néeded: changes t in ‘the present system of medical care than other members of the health team." This was the theme of an address by newly appointed Acting Director of RMP Harold Margulies, MD before the second RMP National Allied Health Conference April 26-29. RMP. was . perceived by him s an actiontoriented, policy-making force which should question, attack, even be disruptive if necessary, to bring about changes which will improve quatity of care. -Schools of medicine were criticized as "rigid and not relevant to the health and social needs of today” and national professional organizations such as AMA, ANA, etc. were described as unsuited to bring about change. Dr. Margulies called for RMP involvement with activities that will improve the present health man- power situation and achieve better distribution of health care. and felt that the Pro- grams could be effective in this area because of their political freedom. According to Dr. Margulies, RMP should be regarded as a programatic thrust rather than a granting agency and one function should be to relate the medical care system to other agencies; RMP should make use of other funding sources: as well as its own and should have greater outonomy in the field; there should be greater dialogue with other health problems in (tion to those of heart, stroke and cancer; there must be equal opportunities for all, and good minority group representation; evaluation must be a significant factor i In solv- ing problems. The Conference, a follow-up to the fi it < one held at Asilomar in 1969, was hosted by - Nirginia RMP at Airlie House, Warrenton, Virginia and was attended by 163 rep- reséntatives from 55 RMP's. The group included [5 program coordinators and repre- -.._ sented 14 different health professions. Attending for AREA V were DOROTHY E. “ek ANDERSON, FRANK F, AGUILERA, ond. DONALD Ww. PETIT, MD. eae Another speaker. who urged RMP to rerorient and restructure. the current health ¢ care system was Mr, Ray Brown, Executive Vice President, Northwestern University Medi- | cal Center, who spoke on "Changing Perspectives in the Delivery 0 of Health Care," © Mr. Irving Lewis, anticipating the national health scene for the 70's, predicted the cost of health care will reach between $70-$100 billion and felt that, RMP's role should be to influence the areas of comprehensive. services and continuity of care. Ten mul’> discipline Task Forces which met throughout the Conference, enumerated on the fina day some of the major concerns of the conferees: a cr . * The need for better communication among health professionals, and between ~ health workers and consumers; that direction should be given to a single ~ standard of health care and access to primary care should be broadened; there should be more effective use of present. funds and RMP should tap - _other sources; there should be relevant programs of consumer education; _all health manpower needs to be expanded and extended with greater util-_ ization; and continuous education; RMP should-be involved in changing - ~ patterns of health care and the ‘development of new models of community. : health centers; RMP should include consumers as well as officials of federal, state and local health agencies in planning, coordinating and implementing programs; RMP should develop better acceptance of allied health and a better . understanding of their role; there should be more equal distribution of pro- : ~ fessions at conferences and better representation of allied health professionals ~ on committees; there should be.-more emphasis on strategy-~the health profession should learn and plan together--there should be increased consumer input; the _review process should take greater cognizance of local differences and should move more rapidly; RMP should encourage interdisciplinary approach to health problems, should facilitate incentives to deploy people to areas of greatest need; fomily members should be utilized in determining health care; curricu- lum development should be accelerated and there should be more imaginative _ use of personnel; that the recommendations of the Asilomar Conference regard- . ing the inclusion of allied health in national, regional and local planning be implemented immediately and that the report of the current conference be pub- lished and distributed to all RMP. Coordinators within.a month; that DRMP be active inhelping the Regions implement the recommendations of the second ve DOROTHY E. ANDERSON reports: “In presenting a Program:Coordinator's View of. Allied Health, Dr. Petit was very generous in his recognition of the role of allied health in AREA V's structure, organization.and programs, and in the community © aspects of our programs. ..In summary, this was a very exciting conference which: - we left with a feeling of security and dynamic action ahead for RMP." s.25° 0 7 ~ ‘Conférence of RMP Coordinators, held May 6-8, 1970 at Airlie House, Virginia. By William A. Markey, Deputy Coordinator T Conference was called to permit RMP Coordinators from all over the country to meet Dr. Harry Margulies, the new Acting Director of RMP Service, to update themselves on the current status, focus, and scope of RMP and-HSMHA, and be introduced to the Annual Review method of Program and fiscal reporting to s become effective over the | next year. I osed legislative direction was discussed and Coordinators authorized Dre ‘H. Gordon Barrow (Georgia RMP) to speak for the Coordinators in hearings of Congress. Mrs. Martha Phillips, Associate Director for Grant and Contract Policy, RMP Service described Annual Review as a system of operational management which should simplify fiscal and program reporting and allow evaluation of progress in an orderly way. An-_ niversary review will allow for more decisions to be made by RMP Regional Advisory — Groups in determination of program directions. DRMP staff will visit all Regions within the next few months to assist with implementation of the new accounting and Annual _ Review program. Dr. Harry Margulies spoke of the special role of RMP in the evolving national strategy ‘and the need to relate effectiveness of programs to the financial outlay, He was en- thusiastic about the importance of RMP's potential impact on the delivery of health - care. The task at hand, he said, is how to translate the potential to reality, how to manage the payment mechanisms, and how to achieve change in the system. RMP centralization versus decentralization studies in HEW were outlined, and the strength- - ening of HEW Regional Offices described. Of 60 programs reviewed by a streamlin- _ task force, Il have been recommended for decentralization to regional offi ices. The Coordinators were assured of Dr. Marguties' own strong'belief in RMP, in its special role as a source of talent, resources, providers, and iin the technical com- petence of RMP staffs in the many health professions. The question now is, with RMP's limited dollar resources and its strengths in access and staff, which things should bk ione first. The chief i issues were summarized as-being: costs, lack of access, and quality. New standards are needed, methods to evaluate quality must be developed, and there is increasing concern with quality of health care. * Stress was placed on use of funds from other sources and in ‘enabling the various providers and payment agencies to work together i in new combinations. Focus is on the quality of medical and health 5 care, and on increasing the effectiveness of health manpower-~better t use rather than just increasing numbers. As RMP's can work as a "broker" to achieve HEW's goals ' the’ use of various sources would become more available. : AREA V REGIONAL MEDICAL PROGRAMS Monday, May 18 AREAV Tuesday, May 19 - AREA V- : Wednesday, May 20. — “AREA V - AREA V AREA V ~ CCRMP Watts-Willowbrook Thursday, May 21 CCRMP “Friday, Moy 22 AREA V : _ CALENDAR May 1970 American Indian Free Clinic © Area Advisory Group Special Meeting Social Workers Advisory Committee - Staff Meeting | Continuing Education Meeting Data & Evaluation . Advisory Committee Staff Consultants ; Seminar ~ Family Wellness Center 7:30 pam. Compton _ 7 p.m. ; RMP Conference Room 8 to 9:30 a.m. ~ RMP Conference Room 930a.m. 12 noon - LAC-USC |. . Medical Center . -— 2to5 p.m. _ L.A. Airport 7:30 p.m. Los Angeles | 2 to 5 p.m -L. A. Airport. Hasms tolpame : RMP Conference Room : AREA ADVISORY GROUP:-MEETINGS FOR-1970 July 14 ‘September 8 ‘November 10 _ COMMITTEE CHAIRMEN'S MEETINGS FOR MAY AND JUNE, , May 15 ; . dune 5. June 19 STAFF MEETINGS SUBJECT TO CHANGES--CHECK WITH OFFICE FOR LATEST INFORMATION | ; First Annual Conference on the Phystcian and the Hospital ~ at Monte Corona Conference Genter, April 23-25, 1970 “This Conference for medical staff leaders of community hospitals was highly rated by the majority of 225 participants -and, according to evaluation of sheets turned in by the conferees on. the last day, a second conference, perhaps somewhat larger, will be in order for late 1970 or early i971. [ _ co Henry B. Dunlap, Chairman of the AREA V Ad Hoe. Steering Committee which initi- - gated the Conference and cooperated in its presentation with the Postgraduate Division of USC School of Medicine, dubbed the meeting a "potato chip" conference and said, in his summary: "You have already decided whether this was a limp or a crisp one and have indicated that you want another! . . . In the early part of the conference, Dr. Boyle touched on some of the current challenges that are being made about our abil- ity to make effective use of health manpower, facilities and resources. Some elements of this challenge have been exposed and discussed. We have expressed ourselves as believing that there are internal conflicts that drain our energies, interfere with effec- tive joint effort and tend to confirm the suspicions of those who claim the present sys~ tem can't work. Dr. Delbecq taught us some procedures for looking at some of our conflicts and problems and | think we discovered where some of them are. The public is questioning whether hospitals are well managed and 1 think we have been doing a pretty good job of saying, 'No, they are not." We defined some of the reasons why they are not, with key words like mutual distrust, different value systems, inability to communicate, incompatibilities of point of view and objectives, and soon. I. believe we cannot afford the luxury of these barriers and suggest that medical staff. - > Jeadership and managerial representatives, with the insistence of the trustees, open -" yp these problems os they exist and deal with them. The voluntary health care and hospital system has enough problems with external challenges--it cannot endure in- ternal dissension.” C, Wesley Eisele, M.D. Assoctate Dean for Postgraduate. Medical Education, Uni~ “versity of Colorado and Director of the Hospital. Medical Staff Conference which | ~ has been held for the post seven years at Estes Park, ~commented: "As one who has been’ engaged in over 300 conferences over many years, rls ‘want to congratulate you on this very successful, controversial conference. It was well balanced, stimulat- ~ ing, provocative--even a little abrasive and threatening--and that. is good. You have to be a little abrasive if the status quo is going to be changed. |! have been: trying to get other regions to have similar conferences because there is a great need and great interest--certainly more than we can satisfy in Colorado. | hope that this will be a real competitor to our Colorado Conference." ne Area V Staff Meet Donald W. Petit, M.D. Mea Coordinator a William A. Markey, MS. Deputy Coordinator ne "Russell D. Tyler, M.D. Operations Division Frank F. Aguilera, M.P.A. Community Programs Gladys Ancrum, Dr. P.H. Cotonaty Care Program -— Dorothy E. Anderson, M.P.H. Community Programs Kay D. Fuller, R.N. _ Nursing. ~~ “Leon C. Hauck, W.P.H. Health Data — Robbie W. Jones Administration "> John $. Lloyd, Ph.D. Evaluation ~ Elsie M. McGuff’ —=~=S«Communications Clyde E. Madden, ACSW. Social Work Toni Mois, B.A. : ~ Community Programs Luis A. Pingatron East Los Angeles: Vivien E, Wart, R.N. Coronary Care Programs | 7 ae Committee Chairmen | Area Advisory Group «=> Chester A. Rude Cancer Lewis W. Guiss, M.D. = oe Chronic Disease —-.——=Russell D. Tyler, M.D. | B & Cadac George C. Griffith, M.D. - “ = £ | o Continuing Education Phil R. Manning, M.D. | > 806s Sz Ess 3. Hospital Adninistatos ~ Henry B. Dunlap, MPH. | 7 2 S . aS w Cae 2 “Library Services . John M. Connor, A. Su ul “ 226 Ee 5838 2 Nursing - ; , , Fotine O'Conner, R.N. mo e 3 = 2 3,8 ays ee Stoke © Robert H. Pudenz, M.D. | cp 5 - s : os $ Z &§ Systems & Computers . Lee‘D. Cady, M.D. vt & = Bo ” - _. Social Workers ©. = Bernice W. Harper, A.C.S.W.