NL February 10, 1971 “FISCAL CUTBACKS, SHIFT IN EMPHASIS FOR RMP REVEALED > "Some of the responsibilities that have been assigned to.us are new and different but I.” don't think they were unexpected,” stated CCRMP. Executive Director Paul D. Ward, , addressing the Staff Consultants at their Feb. 4 meeting. The subject.was the Federal 1972 budget request for RMP, prepared by the Office of Management and Budget, . . - which states; RECS an en SER otiy So "The 1972 budget introduces a stronger discriminatory policy whi ch will be applied in awarding grants to individual Regional Medical Programs, Asa result, a sharp re~ _trenchment in grant awards will be made for those RMP's which have. been the least . productive in order to support selected increases for those RMP's which have shown : the greatest innovative-potential for moving the local -health care system toward im=. proved accessibility and quality of care. The new. policy will also require a:shift in emphasis.in the use of current funds by the remaining programs.© 9 "The major shift in emphasis will be directed toward improved and expanded service. by existing physicians, nurses, and other allied health personnel ; increased utiliza- tion of new types of allied health personnel; new and specific mechanisms that provide. £~yality control and improved standards .and decreased costs of care in hospitals; early. “detection of disease; implementation of the most efficient use ofall phases of health _ gare technology; and supporting the ‘necessary catalytic role to help initiate necessary | consolidation or reorganization of health care activities to achieve maximum efficiency.’ “Feb, 3 and 4, fornia. Région AMERICAN INDIAN FREE CLINIC... - will now be able to expand the current medical, dental and counselling services ++ has been offering to the Urban American Indian community through an award of un- determined amount from EYOA. An initial payment of $15,000 is available March I. The grant application requesting $100,000 was prepared and submitted to EYOA last fall by AREA V staff, The new funding permits full-time employment of a program coordinator, clinic manager, secretary, janitor, and two community aides, as well as the leasing of a VW bus for transporta~ tion of patients and supplies, and other items such as office equipment, legal counsel, rental and miscellaneous sup~ plies. A promise of $5,700 seed money and staff assistance from Area V was soon aug~ mented by gifts of sufficient equipment, drugs, supplies, and volunteer profes~ sional services to enable the clinic to open in Oct. of 1970. Since then, it has been serving approximately 300 patients a month, on the two evenings a week it is open. The family-style Clinic, oper- ated by and for Urban Indians, is the first of its kind in the U. 5. k * & * Correction In our Jan. 27 issue, the Task Force on Health Care Delivery and Organization was reported as recommending that RMP play a key role in the establishment of health maintenance organization (HMO's). The wording should have read: “expedite she implementation of effective health care delivery networks.” Kk &k k CARDIAC” According to the closing repov of the Faculty Training Course in Cardi opul- monary Resuscitation, 507 trainees now carry completion cards as CPR ir’ structors. The eight classes sponsored by L. A. County Heart Assn. and RMP Areas IV and V drew a total attend- ance of 566. AREA V contributed manikin practice under the supervision of Drs. Robert Barndt, Jr., Maria De Guzman, Julian Haywood, A, Hafeez Kahn, and Mohammad Mohsenin. The trainees are expected to teach CPR in their respective agencies for at least two years, as part of the Heart Asso~ clation's new program to promote wide- spread professional proficiency in CPR, George C. Griffith, MD, represented AREA V on the CPR Subcommittee. ccU Experienced coronary care nurses will be interested to learn that a special section about the medical and nursing aspects of coronary heart disease has been included in the [4th Annual Post- graduate Refresher Course presented b, the USC and U of Hawaii Schools of Medicine. Scheduled for Aug. 14- 25, 1971 at the Sheraton Waikiki Hotel in Honolulu, the sessions are described as "relaxed" with team presentations by cardiologists, coronary care nurses, attorneys and specialists in pulmonary _ diseases, cardiovascular surgery and psychiatry. For further information, call our receptionist at 576-1626 and ask her to mail you the brochure. Re Rk ek : AREA Vv. / REGIONAL MEDICAL PROGRAMS “CALENDAR February 197] RMP. Conference Room a Oa.m. ~ Conference Room _. Committee Chairmen AREA V_ = ace Washington's Birthday . oe RMP Office Closed “Wednesday, Feb. 17 . AfEA Y. a - a Le ~ Social: Workers BS ee ee oe Advisory Committee - . Staff Meeti 1 8a, ims = 9:30 a. m... RMP. Conference. Room “AREA V Ve 30 aut me: Conference Room Tuy r Feb, 13 AREA ve . ry fe 9 " Section 314 (a) of Public Law 89-749 which: created ‘Coinprehorsive Health | Pla ining { . (CHP) requires that each state designate.a single agency to ‘administer. ‘the planning — process and submit a "plan for comprehensive. health planning." _ THE STATE PLAN: FOR HEALTH ay Marlene Checel, Mee, Assistant Coordinator, Inter-Agency i AY " ~ In California, | this task has been undertaken by the State Office of CHP of the State Dept. of Public” “Health. The process of development for this plan, : guided Py sales A. Farag, P Ph. D., MPH, Chief of the Office of CHP, i is as follows: : During 1970, over 250 individuals, organizations, ‘etce were contacted to write: pos i- tion papers on specialized subjects in their area of professional competence ¢ and ex- perience. These papers were to raise issues, describe the present status of the topic | under consideration, make recommendations for future action, and set. forth guide~ lines for state and community action. Small technical committees were then organized to assist in the review of the position papers and fo discuss the issues raised, - There were 65 study committees organized around six main subject areas--health data; identification of health issues; health — facilities; health manpower; environment; and social, urban and rural health problems, These meetings were held in Sacramento during the month of November, 1970.° The 137 position papers and recommendations resulting from the 65 committee meetings ‘were distilled into 6 draft reports which were’ then considered by technical task forces during December, 1970, In January, organizations concerned with health were in- vited to react to the draft reports and the recommendations coming out ‘of the latter meetings and the task forces are now being distilled Py the staff of the stigla Offic ice of CHP. into a single document. Public hearings on the State Plan are scheduled | for : March; the Lo AS ‘hearir ng will be field at the State Building on March Il, 1971. Following these hearings, the approved wooo "version-of the State Plan will be submitted for approval of the State of Calif. Health Planning Council at a:meeting to be held April 28, in Ly A. . The Plan for: Health will then be directed through the State Governor to the State Legislature for approval, and wall be made available as a o quide f for health h planning gee are. joining with the Medical & Health. “Sérvices Council of the National. Asso~_ ae ciation of Soctal Workers inan open ~ nye ‘on Feb, 23. Featured speaker . be Area V. Coordinator Donald W. Petit, MD, discussing "The Total Health — Delivery: Process i in the Soviet Union," presented with slides from his recent trip to Russia. -The meeting will be held in — the Coronet Room of the Fog Cutter Res~ tavrant, 1635 N.-La Brea Ave. The tab of $5.50 each includes dinner at 6:30 p.m., tax and tip. Reservations should be sent to NASW, L, A, Area Chapter, 601 N. Vermont, ‘#20, Los Angeles 90004. koe & ® CANCER PLANNING COMMITTEE. . welcomes ‘two new members: Mrs. Catherine Cordoba, MSW, Service Dir- ector of L, A, Branch of American Can~- cer Society and Mrs, Lillian O'Brien, RN, Executive’Director of Visiting Nurse — Assn. of L. A. mittee will give ‘additional input on the © ivery of health care services. Con- — Dity of. Patient- Care Subcommittee has | also added new members with the same goal in mind: . Mrs. Olive Klump, RN,” been‘ ‘appoi inted. Director ‘of the N olaeed ~LAC/USC Cancer. ‘Hospital & Research Institute.” Dr. ‘Hammond. will coordi- °" nate: ‘planning : and developnient of the | Cancer Center. through Faculty’ ‘and ; Medical “€ Center committees: vt: _ The expansion of the Com-_ . they could be utilized i in the new ELA ~~ health centers.” Existing regulations make if impossible for a graduate of a Mexican medical school to inter in this 2. country until 3 years after graduation. former Director of Public Health Nurs . . State Senator Alfred Song | has introduced ing for. LA. Spa. and Mes Florence ES : tapped s source ) Picaly . Latek could ‘be utilized in Calif. oof. Frank Aguilera and Elias Chico had a .- busy day Feb.'4.as they a¢ fant ‘Dr. Roger O. Egeberg’ of HEW, Art — ~- Raya, his special assistant on the health _~ needs of Spanish Sumamed Americans "2 and other interested offi cials, ona tour ~~ which included visits to'the ELA Health “Task Force Offic ce on: ‘East Whittier Blvd., "| the E/NE Model Neighborhood Office “in Lincoln Heights, and the 8th floor of the LAC/USC Medical Center, (which ‘provides .a “community hospital within | a hospital " for residents of 22 census companied — tracts in the Eastside). Later, at a conference with LAC/ USC Medical Center and USC School of Medi- cine officials, Aguilera described on- ~- going efforts to increase the supply of bilingual doctors needed in the Mexican American communities: One plan pro= piar ; poses to encourage Americans currently ~ studying at the Medical School of Guada- lajara to do their internship in LA where isi which, ‘if passed, would shorten this period somewhat but other complex diffi culties ree: state li ae 000 bilingual ' el Te PT ry tt CAS. ecard trent ete ties tae oo : Published by, 0502 CALIFORNIA REGIONAL, MEDICAL PROGRAMS . wt ‘ eg RL ae ater et ae | Daly E. Anderson MPH : Brice Batnhill, B 7 Marlene: Creve, M. P, He : Elias Chico. ee Jane Z. “Gah, Bee kay D.’ Fuller, R.N.: | “Lem C. Hauck, MPLA, “John $, Lloyd, PhD, : - Elsie McGuff 2 Cyde'E, Hadden, AGSH. = Robert E, Randle, MD. cal Wit ee : tie les Dep. Coudinator mais mmimnity Programs ~~ Community Programs . Inter-Agency Activities . Community Programs - : Community Programs - Nursing Health Data ; : Evaluation Connunicatons _ Social Work : * Continuing Education a Ptaning Lewis Wc oa M. D. Gouge CG Grit M.D. Barbara Solomon, A.C.S. Members of the California Funeral Directors Associa- tion, hospital pathologists, and coroners are helping us to recover pacemakers from patients who have died. When- -ver possible, the information obtained from these units Jill be sent to the attending physician. Pacemakers removed for emergency or elective replace- ment are an integral part of the Recovery Program. Since the pacemakers will be forwarded to the respective manu- facturers, any potential exercise of warranties will not be impaired. PROCEDURE Please send removed units in the provided container to: Michael Bilitch, M.D. Los Angeles County ~ U.S.C. Medical Center Box 69 1200 North State Street Los Angeles, California 90033 Be sure to fill out the information sheet so that we can clearly identify the pacemaker. The pacemaker will be checked by the Pacemaker Registry engineers, after which, it will be forwarded to the original manufacturer with the information which we have obtained. A copy of the check-out report will be sent to vu, the attending physician. If credit is involved, the manufacturer will contact the original source of the returned unit. If you have any questions regarding the Pacemaker Recovery Program, please contact Dr. Bilitch or Miss Cassady at (213) 225-8462 or 796-0101 day or night. When pacemakers are removed at autopsy, it would be extremely helpful if one of the members of the Pacemaker Registry could “observe’’ the procedure, It is often possible to obtain valuable information at that time. Cova. b. WIM Sponsored by sae ANI nb mon California Regional Medical Programs - Area V University of Southern California. School of Medicine A project under Public Law 89-239 pacemake registr’ , a informatio! cente A Pacemaker Registry and Information Center has been stablished by the University of Southern California and ye California Regional Medical Programs. The Registry ‘ould like to be of service to you, the attending physic” “e 1 the care of any patients you are following with i. tanted pacemakers. The function of the Pacemaker egistry is threefold. (1) To provide a central registry and clearinghouse or patients with artificial pacemakers. (2}. To provide a 24 hour a day information center ‘om which physicians may obtain specific information 2garding patients, or general information about pace- iakers. (3) To provide a pacemaker recovery center so that | artificial pacemakers which are removed from patients yay be checked to determine their functional state. We would like to seek your cooperation in an attempt > accomplish these specific objectives. By doing so, we ope to be able to increase the reliability of artificial pace- yakers. Each of the three services which the Registry ‘ishes to provide function as follows: PATIENT REGISTRATION BJECTIVE The objective of the patient registration program is.to squire clinically oriented information on patients with tificial pacemakers. We wish to use this information to stablish a readily accessible central clinical and pacemaker le. This information will be used, in part, to assess the verall reliability and longevity of pacemakers and espe- ally to aid the attending physician in assessment of the acemaker’s function. ROCEDURE Whenever a patient is to have a pacemaker implanted r replaced we would appreciate knowing about it. Brief lentifying information concerning the patient, the attend- ig physician, and the hospital in which the pacemaker is » be implanted will be requested at that time so that we ay identify the physician and the patient. We will first ‘k you, the attending physician, if you wish to have the atient included in the Pacemaker Registry. If this meets ith your approval, the registrar will ask for basic clinical formation and specific information regarding the pace- aker which. has been implanted. We will ask that the itient be registered with the Medic Alert Foundation. DILLOW-UP At regular intervals we will ask you for clinical, electro- irdiographic, and, if necessary, x-ray information regard- g the pacemaker’s function. As a general rule, this will 2 at three-month intervals for the first 15 months of the the registry at a glance pacemaker Original Increased reliability pacemaker’s life, at two-month intervals for the 16th to the 20th month, and at monthly intervals thereafter. All the information which we collect will be placed in ¢ central file which can be used to obtain information, on short notice, as to the present status of the patient and pacemaker and a comparison of this with the patient’s prior history. lf, when new information is provided, there are indica- tions that the pacemaker may be malfunctioning, the attending physician will be contacted immediately by telephone. This will be followed up with a written report. lf the pacemaker is functioning correctly, a written report will be sent. INFORMATION CENTER OBJECTIVE The objective of the Information Center is to provide a central location to which physicians may call regarding pacemaker problems. We will be providing access to two different types of information: (1) General information regarding pacemakers. This might take the form of a question such as, “Who in my area is an expert on pacemakers to whom | might refer a patient or a problem? ” (2) Specific information regarding a patient. This information will only be provided to the patient’s attend: ing physician. The information will be given to other than the attending physician when an exceptional circumstance occurs in which a patient finds himself away from home and requires the services of a physician. The Registry Information Center will be available on . 24-hour call basis. As a general rule, information will be transmitted by telephone with a follow up confirming letter. If the infor- mation is of a non-emergent nature, information will frequently be provided by mail. When calls are made to the Information Center, the professional staff of the Pacemaker Registry and Informa- tion Center or designated area consultants will provide the expert advice. PACEMAKER RECOVERY PROGRAM OBJECTIVE The Recovery Program will assess the reliability of pacemakers by checking the electromechanical function of units removed from patients. In order to obtain the maximum benefit from this program.it is important that the Registry recover as many pacemakers as possible.