nu QQ FROM SUBJECT: OPTIONAL FORM wa. 10 BOLO+105 MAY 1662 EDITION GSA GEN. REG. NG. 27 UNITED STATES GOVERNMENT Memorandum. NIH-OD-OPP Dr. James M. mundley DATE: December 31, 1964 Assistant Surgeon General for Operations, PHS Chief, Office of Program Planning, OD, NIH NIH Comments on Draft Specifications for a National Heart Disease, Cancer, and Stroke Program In our telephone conversation this morning, éuring which I transmitted in rough%, fashion +he NIH comments on the draft prepared by Dr. Dempsey, I promised to send you our suggested revision of this draft. The attached revision indicates, througn the use of underlining and brackets, the changes made in the original draft. Since the time ror review hes been so short, tnese revisions still represent a limited effort to come +o grips with the many complexities of this proposed program. T would also like vo reiterate some of our general concerns woich I expressed this morning. We feel that there needs to be some additional clarification of the perimeters of the program in terms of the limits of authority bein: sought. The reletionship of the services provided in the diagnostic and sreatment stations to tne normal medical services in the community is uncervain in the draft and provides & source of future controversy if the definitions are not sharpened. The draft does mention in several places the intention that the financing of patient care would be done through present mechanisms except where clearly related to clinical research. The general language of the proposal ought to be made more consistent with this indication of the limits of the functions of the diagnostic and creatment stations to be financed by Federal funds. We ave also unclear about the relationship of this program to the present categorical progrems supported by NIH ana to the councils which review those programs. Should the categorical research centers to be established as part of the network be subject to review by the appropriate categorical gadavisory council? The report of the President's Commission seems to indicate that the categorical counciis would be involved in the review of applications involving the establishment of such centers. Since the proposal involves the financing of a network which ineludes & medical school, there needs to be some specific expression in this pro- posal of the intention of financing only those medical school expenses which are necessary Tor the establishment and maintenence of the network. This statement should make clear that general support of the medical school and development of additional medical centers of high quality would be provided through other mechanisms. an The specifications Por ao proposal, are quite det DE the actual establisnament & network. A number of the items listed for inclusion would seem to us to be the logical product of the in Le enning oes For vhis Teason | we believe that it would de specificatic:. for an initiel plesning gra. * application. A major purpose of the planning grant mip vrovide financing to the grantee for the inivievion and conduct ol the extensive planning activities which would be inherent in vse Gevelopment of the complex applications for support of the network. ed on pages 4 and 5 of the concerned primarily with We hope that we will heave the opportunity co comment on subsequent aérafts of specificetions for this program as well as the draft bill ‘sroduced by the Office of tne General Counsel. Since the deadlines ~ are so tight, we will Se glad to come down to the Office of tne Surgeon General to look over the proposals if time does not permit you to send us &@ copy. Attachment . REVISED NIH-OD-OPP DRAFT 12/31/64 SATIONAL HEART DISEASE, CANCER, AND STROKE PROGRAM Purpose tae ae The program shall have as ites purpose tne development of networks or research, service, and training programs in the fields of neart disease, to increase the wu Q o Q O a wi wu Ci eancer, and stroke, so & +0 high quality health s 4 services for the diagnosis and treatment f these diseases, to enaance the potential for meéical research and to eniar e the nation's capacity for education and trainin w This purpose shell be pursued througs 2 grant program to university medical centers or other public or private nonprofit agencies 44% them in planning, establishing, and maintaining [Sperating/ regional networks of [cooréinated andy cooperating institutions for the conduct of clinical researca, training, anc Tor improving and extending facilities and services aveilable for the diagnosis and trea tment of persons with heart 1.