AREA ns MOL. I= RO; 3 November 26, 1969 EXPECTATTONS MET AND UNMET om "gen he : . . Donald W. Petit, M.D., Area Coordinator | yvAtea V California Regional Medical Programs Bach Area Coordinator in‘ California hasbeen asked to write for.the Statewide Conference a ‘brief paper on the directions. in which he thinks his Area is heading and how it may be ‘affeeted by. new national. priorities... Inasmuch as I am not sure what the national priorities are, I would like to raise some questions which I think are central to Regional Medical Pro- grams at this‘time. “No matter what happens to them in the future, these have to do with the rather familiar procesa that: takes place when expectations are raised and then are not met. - One might summarize this process by saying "Unmet expectations lead to frustration which, in turn, leada:-to amelety which,’ in turn, “leade‘to hostility and/or apathy and impotence." If Regional Medical. Programs are to avoid either of these two unfortunate states of mind, ex- Pectations raised by the Program must. be met. - : “Tn a general. way, “the unique’ arratigenents that Regional Medical Programs have with pro-~ viders. of care: assembled together, to discuss common problems must be continued and any _ alteration which would affect the support we now have would be bad. Regional Medical Pro~- ‘grams, through the cooperative arrangements and through linkages between educational insti- tutions and purveyors of care,-offer a very real opportunity to demonstrate better ways to deliver. care;.to place better. products in the delivery system; to define major health needs in communities; to determine. posible solutions to these needs and to lock into ways to ; {mplement. then... Ie is in this latter. aspect of our activities that the process of “expectations unmet" {s leading to trouble! Any Area Coordinator. can give a long list of meetings, of hours spent, of thousends of dollars of staff time involved in the development of worthwhile projects, which somewherealong the line have been negated by one or another of the review bodies. These projects have been developed.in a financial vacuum,. with no idea about _possible fund- ing or attitudes. of review bodies. This whole process should be reversed; there should be some. form, of: block. grants. to regions, for general purposes; these regions might then notify various Area Coordinators and District Coordinators of the types of projects which will be looked upon favorably, of.the constraints upon these projects, and of the very real potential for, funding if.a project: {s:drawn up appropriately; then the expensive, time-consuming process "of project development can be started. (All of this after local, particular community needs have been, identified, as the basis for such development.) ., . I do not think there should be. a “cessation of program-project activity in the various dis- eases states--this has a great. deal to offer to many sick patients, however, along with thie activity there should be waye in which other health needs can be met and worked with by Regional Medical Programs. thy There should ‘be ‘authority, with, suitable accountability, given to appropriately representative ‘advisory groups to make decisions in respect to direct allocation of funds aimed at the detec- tion and definition of major health needs and that can be used as seed money to start imple- mentation processes toward the alleviation of these needa. There should be a mechanism de- veloped within each Area.or Region by which alternate sources of funding can be readily avallable to the Regional Medical Program apparatus; thus, there is needed a central clear- ing house, which shows the most appropriate way to go for various types of funding, voluntary, private, governmental, etc, . “Area Vv has developed a well balanced, decision-making apparatua and a good core administra- tive staff representing many of the major disciplines involved in health care. The utiliza-~ tion of. this apparatus and of these staff members for community involvement and determination of community health needs is obvious and will be of great practical value in the future, however, this should be accompanied by a machaniam which will allow the Area a reasonable expectation of what: funding will be available. _ Tr ‘would sugges “furthermore, that serious consideration be given to incorporation of ‘advisory “ groups -as non-profit bodies so that funds from other sources then Regional Medical Programs may be accepted, and’ used through the very, decision-making ability that these advisory’ groups represent. eR EL, STAFF MEETINGS ARE SUBJECT TO SUDDEN CHANGES--PLEASE CHECK WITH OFFICE FOR LATEST INFORMATION tanta CCRMP “age gets Malet ttee on Re ALL MEETINGS ARE IN CONFERENCE ROOM UNLESS OTHERWISE INDICATED ton Inn Hilton Inn tee on Heart ley coy |. ‘The Health, Transportation Study will be presented to AREA V Peek Committee Chairmen and Staff.on December 5 by Misa Shirley, _Walders, ACSW (SOCIAL WORKERS ADVISORY COMMITTEE) and by . Project Consultanta Mrs. Florence Goldy, ACSW and Dr. Helen Olander, .ACSW. Y-MINUTE NEWS was not yet in existence in Novembér, 1968 so some readers may not be aware of the five-day course entitled "Dis- semination and Utilization.of New Knowledge | and Skills in Cardiovascular, Stroke and Chronic Illness" which was"presented at that’ | time on a demonstration basia by the L. A. County Heart Association.” “It was attended by about eighty. social workers, most. of whom were employed in supervisory or consultant positions in social agencies that were not primarily medical’ or health care agencies. An in-depth evaluation, financed jointly by | Area IV. (UCLA and AREA Vand conducted by the Division. of Research in Medical Education, USC, found that this course’ did tranemit needed new médical. knowledge‘which has, been utilized to” provide. improved sécial services ‘to patients and their. families. ;The postgraduate level | course’was highly successful and‘consider- * 7 ation. is “being given to the expansion and extension of the course to enable more social workers to participate. ’, The course materials was subsequently, published’ in 4 Social Work Course Guide, which, with the permiasion of | the County Heart Association, has been re- printed by AREA V for distribution to the other Regional Medical Programs in the U.S. Seventy-four’ coples’ were mailed last week to RMP social. work consultants, social workers advisory committee chairmen or to area co~ ordinators with a covering letter over the aignatures of BERNICE.C, HARPER, ACSW, GHATRMAN: AREA V. SOCIAL WORKERS ADVISORY COM- MITTEE and by DONALD W. PETIT, MD, AREA CO- ORDINATOR... An exchange of information about _ other RMP experiences and plana regarding continuing education progrems for social . workers hasbeen invited. 9. |. : GEORGE C; GRIFFITH, MD," (Chairman AREA V ‘CARDIAC COMMITTEER) “has been appointed a member.of a special. advisory group charged with advising HEW on conditiona under which . (thetuse of. cyclamates would. be. justified, by ‘medical needs 0!) , November 21 - The "Conference on Community Health Resources and the’ Consumer" presented “by the Continuity of Care Committee of the San Fernando Valley drew a gathering of ‘approximately 300, report AREA 'V-represent- community. ° “ atives CLYDE E, MADDEN, ACSW and DOROTHY E. ANDERSON, MPH. primarily on San Fernando Valley activities; This meeting was focused KAY D. FULLER, RN, has been named Chairman of a Continuity of Care Committee which is studying ways to improve continuity of care for patients in-the San Gabriel Valley An exchange of information on an inter- regional level took place November 21 when _& group from Inter-Mountain RMP (Salt Lake “Gity) met with the CCRMP CCU Coordinating “ Committee and some members of RAND CORPO- "RATION. ‘of the Regional Coordinator Cs Hilman The Inter-Mountain group consisted Castle, MD; Miss Marilyn Ford, RN, David Noonan, and Dietrich XK. Gehmlich, Ph.D. Present from AREA V were MILFORD G. WYMAN, MD (Project Coordinator, CCU) and JOHN S. “LLOYD, Ph.D. (Asst. Coordinator, Evalua- tion). The agenda included comparison of CCU data systems in the two regions and a ‘“@fscussion of the possibility of ‘future information exchanges. The Statewide CRMP Conference, conducted on November 24. at the Airport Marina, Inter- national Airport in Los Angeles was well attended by AREA V members. CHESTER A. RUDE, Chairman of the AREA ADVISORY GROUP; FRANK F, AGUILERA; DOROTHY E. ANDERSON, MPH; “KAY D. PULLER, RN; JOHN S. LLOYD, Ph.D.3 CLYDE E. MADDEN, ACSW; ELSIE McGUFF; TONT MOORS; LEWIS W. GUISS, MD (Chairman of "AREA V_ CANCER: COMMITTEE). Report to follow. he Over 250 people were in attendance af the East Los Angeles Health Conference, report~ FRANK F. AGUILERA (Asst. Coordinator, Com munity Programs). This conference, held Nov, 22 at LAC-USC Medical Center, repre- gents 8 months of work and che beginning of better things for the ELA Community. Details will be reported in a later issue.