ning ; 2 : an a AS Ae * a Draft 12/18/64 fo cow ive 1 Place responsibility upon a Sicic govrexaucntel agency In each State to conduct or arrange to have conducted the uccessary State and community planning which will be necessary to: | 1. Determine what institutions in the State (or in adjoining States) will cexve as heart, cancer ond stroke Centers to serve the needs of the State. . | 2. Determine where in the State and in what hospitals or otner facilitics Diognostic end Treatment Stations wil be established. 3. Devolop understandings and arrangements between the Dingnostle -— gnd Treatment Stations end the Centers which will assure that the networis concept in the Comnission's report is fully implemented and that the ) nightly cualitied professional talent in the Centers is: available to the Diagnostic end Treatment Stations. / “Under such an arrangement, Federal Duide would be avallable: 1. . To the designated State arvency to holp finance the State and ° community plaming and organizetdonal activities. - , 2, To the institutions designated wider the State plen as Centers “to heip finance research, training, end health service activities con~ — ducted in them and to help finance the services waich ‘the Center would. provide to and on behalf of the Stations which it serves. 3. To the institutions designated under the State plan as Diegnostic _ pnd Dreatment Stotions to hely finance training and health service eckivitdes conducted in them | | An ossentlal element of the elaginiaiey of ohither & Senter ov Stétien | @ for finanetal assistance would be that it conformed to the priorities _ -~ 2 « sd developed Sheouch State or lecal plernming «nd that the protesioe intex ; relationships between a Center and the Stations be such as to provide | en effective network for provision of high qualixy service ond training. tt would be envisioned that applications for Pederal Pinanctal assistance fox the coocu.uction and operational costs of Centers and Stations would come from the institutions concerncd (perhaps through the State agency) | end would be reviewed by peer group coumitic ces to help the PHS assess ! quality and priority. | Ema | “ats arrongement provides for orgauizaticnal and plenning aspects of the program to be carried out by or through the State and local organi~ | zations which are, on the whole, best equipped to consider the health @ neods and resources, in the orca and the necessary community relationships. This arrangement would provide for local communtiies to have a greater role ond initiative in determining what facilities and relationships would best serve their needs. . This arrangement would avoid plecing on medical schools the added ture | den of developing commmity plenning competence and let. them concentrate | thoir efforts in professional research, training, and health service | activities. Cons Some State agencies are poorly staficd and motivated to carry through with ¢he kind of organizational and plonning activity involved. The interstate character of the "Sorvice=area" of some of the @enters woulA require interstate cooperation in planning. Soag iavidémbieda Gi. Se asii¥GG tn mubmbine 8 tention Bente 4 wo oyiodto o¢ State-wide plouning. 8 ay | Esteblisch erlteria for ovproval of Fcdoral tinanclal assistaace for 4t9 acteblishient and operations of Centers and of Diesmostie and Treatment poeta of tions and then solicit ovplications from uny institutions waich may mM Seol it can moet these eriterlae Anon the erlteria established might te included, for cxamp 1. ‘hat on applicant for a Diemostic ond Treatxont Station grant must have a working relationship with a mdical schcol or major hospital ‘to provide complicated or expensive treatment cr diagnostic services to | its patients. | 2. That on opplicant for a Center grant mist agree to to establish - woxlsing xeletionships with local hospltale Gesiring such an affiliation which would make avollable to such local hospitals end their patients Ma @ ~he professional specialty services of the 3. Theat a Station grant would not provide support for costs of 2 Conter. expensive equipment or complicated services which duplicated unnecessarlly - the availability of this equipment or services im other facilities in the Exe. a Under such an arrangement, applications would come in directly from the applicant institutions and be reviewed and evaluated by a peer group for quality, edherence to established erlicria, and priority. Pros Tits alternative would permit promt action in the establishment of. Cortera oid Stations by avoiding delays waich would be encowttexcd through mows comprehensive regional. ox State planning. , @ Tt would open up wider opportunity for institutions to apply for: momoweh ad bovo Los words of thoda proposals considered by the PHS arly aN wih Ts would permit instivutions to cooly vi.ch ave located in on axca that may, for various veacons, not wish to becormc involved in coxmpre= “2 woGional or vate planning. Tt may, in soma instance, bo preferable to start first with the ectcbliis + of Centers and for Stations and ict the fuller development of tho network concept camo dater. Cons whe ats alternative provides less assurance