Nat PROFILE: rere OHIO VALLEY REGIONAL MEDICAL PROGRAM Grantee: University of Kentucky Research Foundation Current Chief Executive: William McBeath, M.D. Originally prepared by: Michael J. Posta Original date: September 1969 Up-dated: TABLE OF CONTENTS Face Sheet Map of Region I. Geography and Rationale II. Demography population land area health statistics facilities statistics Personnel statistics III. Politics » IV. Historical Review V. Core Staff VI. Organization : VII. Grand Design VIII. Funded Operational Projects Appendix Table 1 Policy Statement on Program Thrust aa ; PARTICIPATING INSTITUTIONS OPERATIONAL GRANT APPLICATI ONS : OHIO VALLEY REGIONAL MEDICAL PROGRAM A\ Participating Institution (First Grant Only) Participating Institution (Second Grant Only} *% Perticipating Institution (Both Grants} * s OHIO | ! | | ! { - L* a Cincinnati § o \ 8 seimapan Lexington Oterneon KENTUCKY annie’ enietatie oe sei Nae fae oa antagonism tn nein ls ma ig cet el in ees a ie ch ang ct ce aetna age te we a I. GEOGRAPHY. 1) The Ohio Valley Regional Medical Program is composed of 140 counties comprising portions of Indiana, Kentucky, Ohio, and West Virginia. 2) Six major metropolitan areas include Cincinnati, Dayton, Evansville, Hamilton-Middletown, Huntington-Ashland, Lexington, and. Louisville. 3) Medical schools are located at the University of Cincinnati, University of Kentucky, and University of Louisville. 4) Most of Kentucky's 101 counties (excluding the southwest bordering on Tennessee), 21 counties of Indiana, 16 Ohio counties including “Cincinnati-Dayton areas and 2 counties of West Virginia altogether comprise the Cincinnati-Lexington-Louisville triad or the Ohio Valley Regional Medical Program. 5) There is some overlap with Ohio State University RMP and, in Kentucky, with the Tennessee Mid-South RMP. Rationale mo 1) The boundaries are intended to be reflections of existing medical service areas, not determinants of future health care patterns. 2) Health interests within the defined region are free to participate in other Regional Medical Programs, and those outside the boundaries are welcome to participate in OVRMP. Pe en Sine i te ie wee hake, Mine ete tb Rie ali Mae lct time EE ne HUltE ea Ii. DEMOGRAPHY - 1) 2) 3) 4) 1 Reta kann ee Population: Roughly 6 million persons; Per Cent of State in OVRMP a) Kentucky - 2.8 million 87% b) Ohio 2.4 million 23% c) Indiana ' ,65 million 12% d) West Virginia 215 million _ 8% Urban areas:° population includes 2.7 million persons in the following metropolitan areas; : a) Cincinnati 1.3 million b) Evansville «2 million c) Huntington- Ashland -25 million d) Louisville -8 million e) Total Region is 71%. urban. Land Area: 50,000 square miles: Kentucky - 35 ,000 ; Ohio - 7,600; Indiana - 7,300; West Virginia ~- 800 Health Statistics: 1964 Mortality Rate per 100,000 Rates by States t U.S. Ky. Ohio ind. Heart Diseases . 366 368 381. 375 Cancer 151 140 159 153 CNS Vascular Lesions 104 122 113 122 Facilities Statistics: A. Medical Schools - Enrollment Cincinnati '* 308 Kentucky (Lexington) 263 Louisville 344 B. Schools of Nursing: There are 20 diploma and 5 degree granting nursing schools in the -Region. ° C. Schools of Medical Technology: There are 28 accredited schools: 12 - Ohio, 2 - Indiana, 1 - West. Virginia and 13 ~ Kentucky. fete rentticenvenen that ree Fo 5) Personnel Statistics: Physical Therapy School ~ 1 (University of Kentucky) Cytotechnology School - 1 (Louisville) Hospitals; In 1969, there are 157 hospitals with 2755 beds. The great majority of hospitals are short-term, non-federal facilities. ¥ As of 1969, there are: a) b) c) da) 5913 physicians 265 osteopaths 17,188 registered nurses 2,245 dentists ae in otek —. Tite (POLITICS West Virginia ~ 2 counties (Cabill and Wayne) District 4 Indiana ~- 21 counties - District 8 & 9 Ohio (Cincinnati & Dayton) District 1, 2, 3, 4, 6, 7, 24 West Virginia Senators: , Jennings Randolph (D) - Special Committee on Aging, Select Committee on Small Business, Public Works (Chairman), Labor & Public Welfare, P.O. & Civil Service ‘Robert C. Byrd (D) ~ Appropriations, Judiciary, Rules, and Administration Congressman; District 4 | Ken Heckler (D) - Science and Astronautics Indiana Senators: ~- Vance Hartke (D) - Commerce, Finance, Post Office and Civil Service, Special Committee on Aging Birch Bayh (D) - Judiciary, Public Works, Special Committee on Aging, Select Committee on Small Business Congressmen: District 8 & 9 (8) Roger H. Zion (R) - Public Works (9) Lee H. Hamilton (D) ~ Foreign Affairs, Post Office and Civil Service Ohio Senators: Stephen M. Young (D) - Special Committee on Aging, Public Works, Armed Services, Aeronautical and Space Sciences William Saxbes (R) - Labor and Public Welfare, Special Committee on ~ Aeronautical and Space Science District 1, 2, 3, 4, 6, 7, 24 Robert Taft, Jr. (R) - Foreign Affairs Donald D. Clancy (R) - Armed Services ae ~ e Charles W. Whalen, Jr. (R) - Armed Services William M. McCullock (R) - Judiciary, Joint Committee on Atomic Energy, Joint Committee on Immigration and Nationality Policy William H. Harsha (R) - Thomas L. Ashley (D) - Banking and Currency, Merchant Marine and Fisheries Donald E. Lukens (R) - Post Office and Civil Service, Science and Astronautics Kentucky Senators: John Sherman Cooper (R) - Foreign Relations, Public Works, Rules and Administration, Joint Committee on Library, Select Committee on Standards and Conduct Marlow W. Cook (R) - Agriculture and Forestry, Judiciary, Select Committee on Nutrition & Human Needs, Select Committee on Small Business Congressmen: Frank A. Stubblefield (D) - Agriculture, Merchant Marine and Fisheries William H. Natcher (D) - Appropriations William 0. Cowger (R) - Banking & Currency, Government Operations M.-G. (Gene) Snyder (R) - Public Works Tim Lee Carter (R) - Interstate and Foreign Commerce John C. Watts (D) - Ways and Means, Joint Committee on Internal Revenue Taxation Carl D. Perkins (D) - Chairman, Education and Labor Governor: ~ Louie B. Nunn (R) - four year term IV. HISTORICAL REVIEW Spring 1966 June 1966 August 1966 January 1, 1967 January 30, 1967 February 21-22, 1967 Deans of eight medical schools (Cincinnati, Ohio State, Case Western Reserve, Pitts- burgh, Indiana, Kentucky, West Virginia, and Louisville) met and determined that geographical area to be served by these 8 schools was too extensive and too hetero-- genious to be organized into a single regional medical program. Three of the 8 medical schools join forces to plan for Ohio Valley Regional Medical Program. William McBeath, M. D., Program Director, submits application for planning grant. 1) Region includes 3 schools of medicine. (Kentucky, Cincinnati and Louisville) 2) University of Kentucky Research :Founda~ tion was accepted by 3 universities as the grantee organization. First Year Planning Award of $285,000 (DC) Grants Management visited Lexington to obtain justification for proposed $50,000 sub-contract to Greater Cincinnati Plan- ning Council for “Patient Origin Study"; also checked out previous and present federal support to three medical institu- tions. Initial Regional Advisory Council meeting was conducted: Mr. Stephen Ackerman, DRMP was main speaker. 1) Primary objective stressed manpower to improve the quality and availability of care; less concerned about the need for addi- tional facilities and public information problems. . May 9, 1967 May 20, 1967 June, 1967 August, 1967 ‘December, 1967 July 12, 1968 September, 1968 PN pee UNE ee ng Spm tenements 9 ree . Program Director visited Division head- quarters regarding Continuing Education interests of the Ohio Valley RMP. OVRMP headquarters were established @ 1718 Alexandria Drive, Lexington, Kentucky. — Conference on Continuing Education was conducted with National participation. Regional Advisory Council develops 13 point criteria for future project development (See Section VII). Second year planning grant awarded for $320,000. Initial operational grant application reviewed by National Review Committee; site visit recommended. Site visitors expressed hope that Operational status will crystalize plan-— | ning efforts; application contained 6 ' operational projects. Visitors find: 1) 2) 3) 4) Strong conceptual strategy with focus of program at community hospital level; emphasis being placed on staff develop- ment. at selected hospitals and strengthening of educational resources of medical centers. Good formulation of functional relation- ‘ships. Active involvement of key people including Regional Advisory Council. Strong commitments of support from 2 of the 3 medical schools. a “November, 1968 January 1, 1969 January 23, 1969 February 28, 1969 March, 1969 National Council recommended approval for operational status totaling $866,000 (DC) and carryover of $50,000 from unexpended funds from 2nd year planning grant to implement a "patient origin study." ‘ This program was not carried out by the Cincinnati planning Council during the planning grant. Initial operational award granted for . $338,781 (DC) to fund Core Staff (Project #1). Anniversary year established - Jan. 1, 1969 - December 31, 1969. : , National Council defers supplemental project — applications #7, 8, 9, 10 and 11 for a site visit. Grant Award (Jan. 1, 1969 above) amended to: 1) Fund projects #2, 3, 4 and 5. These were funded at 75% of Council's recommendation; total amounted to $410,414 (DC). 2) Increase core staff to fund "Patient Origin Study"; total amounted to $50,000 3) Total amount of amended operational ‘award = $799,195 (DC). Site Visit: Drs. Phillip White, Lawrence Meltzer and Frank A. Perry: The site visitors reported favorable progress of funded projects; found RAC active and reported OVRMP appears to be stimulating involvement throughout the Region; suggested internal review mechanism be strengthened; Recommended: 1) Reduced funding for Project #7, "Auto- mated Multiphasic Screening. 2) More planning needed for Projects #8 and #10 involving Stroke and Coronary Care. 3) Conditional approval for Project #9, "Dosimetry" pending Council's special study, . 4) Approval for Project #11, Home Care Demonstration Program, April, 1969 May, 1969 October 1969 ao, - Regional Advisory Council established new thrust for Program development. (See Grand Design, Section VII). National Council approved $305,000 (DC) for Projects #7, 10, and 11 pending release of FY 1970 funds; Project #8, “Coronary Care Demonstration" was returned for revision; Project #9, "Dosimetry" was deferred until special stipulations could be answered in accord with Council's policy regarding radiation projects. Representatives of Grants Management and Program Assistance Branchs were requested to visit Region. Discussed available options to be considered for the Continuation application for the 2nd year of the operational grant. Lt ; V. CORE STAFF 1) the central office of the Core Staf£ is located at 1718 Alexandria 2) 3) Drive, Lexington, Kentucky. Staff personnel include: a). Program Director - William McBeath, M.D. b) Associate Director Program Development - Mr, Laurel True c) Associate Director Research and Evaluation - Donald Freeborn, Ph. D. ad) Program Development Specialist - Mr. Quintin Allen e) Program Development Specialist - Vacant, R.N. f) Administrative Officer - Mr. T. R. Newnan g) Research Associate - Mrs. Greers University Coordinators are stationed at each of the University Medical Schools: a) Cincinnati - James Schieves, M.D. - b) Kentucky - Frank Lemon, M.D. = c). Condiut Moore, M.D.- Louisville Each are employed on a 1/2 time basis. Each has secretarial assistance. The Core budget for the 01 year includes; a) Personnel - $238,613 b) Consultants - 8,000 c) Equipment - 10,078" d) Supplies - 8,100 e) Travel - 31,640 f) Publication - 9,500 g) Other - ' 32,850 h) "Patient Origin so. Study" _c 50,000 * Total $388,781 Additionally, Project #3. (Regional Medical Television) and Project #6 (Drug Information Service) can be described as planning functions of Core staff. A sum of approximately $16, 000 ‘has been earmarked for planning in these two areas. Project #10 (Regional Stroke Management Demonstration) will become part of the Core's planning effort effective January 1, 1970. A sum of approximately $20, 000 will be appropriated for this purpose. ‘ All Core staff participate in surveillance of ongoing projects. 1) » 3) 4) : 2 b) c) d) e) Mr. a) b) c) d) e) BIOGRAPHICAL INFORMATION S° _ William McBeath, M.D. - Program Director ®) Born February, 1931 B.S., Georgetown College, Kentucky, 1953 M.D., University of Louisville, 1957 Community Health Resident, USPHS assigned to Kentucky State Health Department, 1961-62 MPH ~- Michigan University, Ann Arbor, Michigan 1964 Director, Division of Medical Care, Kentucky State Health Department 1962-65 Laurel True, MPH Born 1933 A.B., Georgetowm College, Kentucky 1955 MPH, Michigan University 1963 Medical Assistance Program, Kentucky State Health Department 1961-62 Assistant Director, Division of Medical Care, Kentucky State Health Department 1963-65 oO Donald Freeborn, Ph.D. a) b) c) da) e) £) g) Born April 26, 1934 B.A. Degree, Lynchburg College, Lynchburg, Virginia 1955 MH Administration - Medical College of Virginia 1957 Ph.D. - Medical Care Organization, University of Michigan 1964 Assistant Director, University of Virginia Hospital 1957-60 Research Associate, United Auto Workers - 1965-66 Research Associate, University of Michigan 1967-68 Frank R. Lemon, M.D. a) b) c) qd) e) f) g) h) i). Born October 16, 1917 Certificate from La Sierra College, Riverside, California 1945 M.D. Loma Linda University School of Medicine - 1950 MPH - Tulane 1955 Private practice 1951-52 Department of Preventive Medicine, Loma Linda University School of Medicine 1963-64 Residency, Internal Medicine, Long Beach VA Hospital Private practice 1966-68 September 1968 - present - Associate Dean of Continuing Education, University of Kentucky 6). b) c) da) e) f£) 8) Conduit Moore, M.D. a Born ~- April 29, 1916 A.B, - Princeton, 1938 M.D. - Columbia 1942 Residency, St. Luke, New York 1942-43 Navy 1943-46 Residency Methodist Hospital 1947-49 Teaching (Full Professor) University of Louisville 1952-present James Schieves, M.D. a) b) c) d) e) Born - March 12, 1918 DVN - Michigan State College, 1940 M.D. - Cincinnati, 1943 Professor of Medicine, Ohio State University, 1962-67 Assistant Dean, University of Cincinnati College of Medicine ceegene meee ona rere . - x VI. ORGANIZATION (see chart - next page) Regional Advisory Council: 1) 2) 3) 4) 5) 6) 1) 2) 3) 4) Currently has 36 members: approximately 1/3 are physicians, 1/3 are representatives of various health care interests and 1/3 are lay consumers. The Chairman is Mrs. Rex Blazer, a volunteer civic leader from Ashland, Kentucky. Meeting’s are conducted quarterly, last for two days, and are held at various locations within the Region. Functions: Provides policy guidance in planning the content and direction of program development; also, is the final authority on approving project applications. , Elects its own Chairman and Vice Chairman; OVRMP Director (Coordinator) serves as ex-officio member and Secretary. The formula of Council membership was devised by Deans of the three medical schools to provide geographical balance from the three principal areas of the Region and from the schools. Executive Board: Is composed of the elected Chairman and Vice Chairman of the Council along with a designated representative from each of the three medical schools. , Functions: Serves as a surveillance body for the staff's administration of grant funds; not involved with review process or planning of the conceptual strategy of the Region. . Meets at least twice per year; sets salary scales. Role is minor when compared to RAC Standing Liaison Committees: 1) 2) Serve as formal auxilliary advisory groups which have been actively involved in program development. To date, Committees have been established on Medical Practice (22 members) and Community Hospitals (12 members); Others are planned for the future. pomp eT ape ne ene me Official Grantee-Fiscal Agent 4 ~ oo, OVRMP ORGANIZATION © REGIONAL ADVISORY COUNCIL 7 Mea AY te ak a ee ee Re rae nse mete metmage Associate Director Program Development i , Laurel W. | ecatemmanle f oa “ Standing Committees: Univ. of Ky. Research Foundation Community Hospitals . EXECUTIVE BOARD ——— — Medical Practice University Coordinators to ; ‘Cincinnati: James Schieves, iM. D. ; Director ; Task Force and ‘| Kentucky: Frank Lemon, M.D,——— —— — Se - _ Panels Louisville: Conduit Moore, M.D. William H. McBeath, M.D., M.P.4. ! i ' 4 i — : : Administrative Officer } Associate Director True, B.A., M.P.H.- T. R. Newman, B.A. : i Research and Evaluation wf { Donald K. Freeborn, M.H.A., Ph.D/ Program Development Specialist it Qu beat at ré Lg oN | u | ‘| | "Operational Officer ‘ Program Development Specialist _ Vacant ars yo } + Editorial Assistant Vacant meee ae tte tent em, _ lL. Secretary Mrs. Nancy Milam een tee anette Secretary Wanda Estep Tecate ca emanate Teaco etn tm ame rrin anle ye fll tt meneame Secretary Mary Norfleet re aetna ee Hee ate Research Associate Mrs. Ann Cook Research Associate Janet Ockerman G ae tea eH iron on mane tga pete napa ogee 7a Task Forces: »D Ad hoc task forces, specifically in the areas of Continuing - Education, Library Services and Television provide a broad base of technical assistance to staff in the development of program elements. Panels 1) Composed of medical center representatives, Council members, standing Committee members and others with technical expertise. 2) Serve primarily to review proposed operational program elements on we —T wenn behalf of RAC; make recommendations concerning the technical content of project applications; also serve as special study groups. Review Process of Project Proposals, 1) 2) Operational grant applications are reviewed in the following manner; (see graphical illustration on the next page). , All proposals are subjected to a "13 point criteria" which were prepared by the RAC. cf RR REE RTE Feuer, oan , SS : . Lé _— EF CESS for REGIONAL REVIEW of PROGRAM PROPOSALS 900.00000000000000g0000000 00000606000 0000000000000000 0000009000090 090000 0B 02 29 2R EATEN 2 00 OE ¢ ; . . NGLNE, c PROPOSAL 8 — OVEMP ' 8 REFERENCE 8 REGIONAL 8 LEAZSOW- é SPONSORS 8 CORE: STAFF 8 - PANELS 8 ADVISORY COUNCIL 8 COMMITTEES é “8 8 8 8 é 90000000000000000g 0000 000000000000008 000000000000000000g 00009000000000000040000000 000009000005 . 8 8 8 - & € BP000000000000000000000090000008 8 8 é 8 1. A proposed idea for a 8 8 099000000000000000000000008 é 8 progran element ts brought 8 8 la. Coumetl is surveyed 8 é . 8 to the attentton of staff. & 8 for preliminary comment. 8 & 8 8 8. ; a :; é 09000020000000000000000002000000 0000g000000000000000000R0000 £ - 8 8 é & é 20000000000 00000000 0000009000 000000 000008 8 8 é 2. Staff works with the resources 8 8 —~8 é interested in cooperatively sponsoring 8 8 8 é the program element to jointly 8 8 ~o iB. é develop the tdea tnto a formal 8 8 “8B - s proposal with substance defined. 8 8 8 g 8 8 8 i 90000000000000000 2000900000000 000000R0000 8 8 é —_ 8 8 8 g é B00 900000000000000000000000000000000008 . 820 000000000000000000000 000 : 8 3. Staff presents the proposal to 8 . & 3a. Committees receive 8 an appropriate Panel for revien 8 8 proposals and forward 8 ~ "and raconnendattons . 8 8 any corments to Council. : 8 8 8 ¢ 8C0900000000000000020000020000000000008 00000000 0g9000CID000000C 0000; 8 8 8 8 t 8 8 8299900000 0000009000000G0000000008 { B00 000000000000000000000000008 8 4. Council receives proposals 8 i 8 da. Staff assists Council 8 8 and reconmendattons 8 é 8 «in revtev and priority 8 8 for review and establishes 8 i 8 determination. 8° 8 ‘proposal's prtortty 8 2 8 8 8 relative to all proposals. 8 i ©00080000000000000000002000000 8 ~~ 8 i 8 . 8 0000000 20000000 00000000000R0000000 Z 8 - 8 8 8 i 9000009000000000 0000 0000000009 0000008 8 8 a 5. Staff assists sponsors with 8 8 8 é detailed vreparation of requests 8 8 8 t for funding. 8 8 8 é 8 8 8 i 00090000000000000g0000000000000000008 8 8 é 8 8 8 8 a 8 8 BP9009099000000000090000 0000008 d — 8 8 8 6. Council fornally acts 8 é 8 8 8 on proposal a3 a part 8 é 8 8 8 of grant epplrcaticn. 8 é é & 8 8 é . 8 8 0000046000000000000000002 009000 ; ; i ‘8 & 8 8 i OB00OOVCOGOCCODGNODO000D0GCNODCOOGO00N0 0090900000090 000000000900000000000000000000000000CC00060605 6" Sem a ge _VII.Grand Design Through the leadership and ‘involvement of the Regional Advisory Council, several policy statements have been prepared to enable the OVRMP to establish direction and emphasis in the development of project applications which will focus on primary priorities. | The first of these concentrated on the 13 criteria to be considered for - project proposals. They were formally adopted by the Council, published and widely distributed in August, 1967. They included; . 1) The proposal is a cooperative effort. More than one type of health care interest (e.g., medical schools, hospitals, physicians, voluntary health agencies, etc.) will jointly provide support to, influence control of, and derive benefit from the activities proposed. 2) The proposal activates a regional approach to health care problems. Resources and needs of multiple geographic communities will be involved and considered. Proposed activities will be functionally related to other elements and levels of the health services system. Potential benefits will eventually accrue to the entire OVRMP area. 3) The proposal is directed toward improved medical care. quality personal health services for individuals will be the ultimate - .goal and the primary concern of proposed activities. Concern for quantitative and qualitative adequacy will be assured. 4) The proposal emphasizes a concern for the problems of health manpower. a The net effect of the proposal will be to advantage the supply, distribution, accessibility, productivity, effectiveness, and efficiency of health sciences personnel. oN, af 5) . The proposal contains interrelated education, research, and service aspects. Activities emphasizing any one aspect of health endeavor will maximize reasonable opportunities to develop other aspects as strengthening adjuncts. 6) The proposal bears significant relation to the control of heart disease, cancer, stroke, and related conditions. Sponsored activities will offer a reasonable expectation for beneficially affecting the mortality associated with these conditions: Principles emphasized in the proposal will preferrably have applicability in the management of other health problems also. Activities will not be so categorically oriented as to compromise more comprehensive approaches to general health care. 7) The proposal presents justification of a need for action. Activities will serve to neutralize needs which are ‘objectively defined as to nature, extent, severity, urgency, and potential for correction. 8) The proposal defines specific objectives which are subject to subsequent ‘evaluation. _ Proposal design and planning will be influenced by evaluation consider- ations. Both short--term and long-range objectives will be established. , Evaluation will include independent assessments of objective attainment. see meee 9) The proposal seems practical. Evidence indicates that the proposed activities will be pursued by capable sponsors, in a manner which is technically sound and ‘ economically feasible, and with reasonable potential for success. 10) The proposal represents new or expanded activity. OVRMP funds will not be utilized as substitutionary or replacement . financing for established programs. Recipients of funds in support of expanded activities will satisfactorily demonstrate a ny maintenance or increase of non-OVRMP support. 11) ‘The proposal projects activities relatively dependent upon some OVRMP support. | | OVRMP funds will not normally be utilized to finance activities either eligible for funding under new appropriate existing federal programs, or acceptable for financing under established programs of voluntary agencies. 12) The proposal gives due consideration to continuation support. Alternative potential means for continuing financial maintenance of successful activities will be identified and evaluated. Demonstration activities will offer high potential for future adoption under non-OVEMP auspices. 13) ‘The proposal is contributory to and supportive of the total program of OVRMP. | ° Sponsors will identify their activities as a cooperating participant in OVRMP and its broader purposes. Cooperating participants in — OVRMP will accept the responsibility to be mutually supportive. aa : 5) LIBREXS The second policy document related to the development of a combination. of interrelated education, patient care and research activities within and among a defined network of cooperating hospitals. It is known as the "Skeleton" program and consists of; 1) CONPRED - Continuing Professional Education 2) PRETECT - Prevention - defection Program 3) CORONET Coronary Control Network 4) STREHAB Stroke Rehabilitation Program Library Extension Service . se Current funded projects (#2 through #5) deal with the above five program activities. | The third (and eer policy statement) was endorsed by the Regional Advisory Council in April, 1969. It serves as the current focus (or thrust) of the OVRMP. The initial priority calls for "the development and more effective utilization of health manpower for the delivery of improved ambulatory care". The term "ambulatory care" is defined as "all patient care except institutional in-patient care." Within the focal area of priority, six aspects are highlighted for potential consideration. They include paramedical personnel, emergency services, prevention and follow-up, Coordination of Community Resources, Patient Medical Records and Institutional Ambulatory Care Programs such as hospital OPD's and health department clinics. | " _ For a complete statement of the present OVRMP focus, please refer to appendix A. (page __) wane ENTS EE RO ee a FUNDED OPERATIONAL PROJECTS Note: This narrative deals only with project objectives; progress is #1 -- CORE. Objectives: #2 -- COMMUNITY HOSPITAL STAFF DEVELOPMENT Objectives: ‘not described. Funding levels are denoted in Table l. Support is requested for a core staff in Lexington, - Kentucky with general administrative planning and coordinating functions. Coordinating staffs at the three medical schools at the University of Kentucky, Cincinnati, and Louisville would also be supported. The functions of these groups include general university coordination, as well as personnel contributing to the operational projects. Support is. requested for seven Directors of Continuing Professional Education to serve eight hospitals ‘committed to OVRMP objectives. The seven DME's serving either full-tir or part-time, represent an effort equal to 5.7 full-time directors. The primary function of the director is to develop and coordinate an organized, hospital-based program of continuing education. The outcome of these. educational efforts will be evaluated in terms of their effect upon needs. Serve 16 hospitals. Hospitals involved include Brown County General Hospital, Good Samaritan, Harlan Appalachian Regional Hospital, Hopkins County, Muhlenberg Community, Owensboro-Davies County, St. Claire Medical Center, and St. Elizabeth . Hospital. . #3 -- REGIONAL MEDICAL TELEVISION Objectives: _ Support is requested for the first steps toward long~ range goals established in preliminary planning to develop inter-connections between the three University medical tele- vision functions. Partial support is also projected for the cost of tapes, production materials and distribution. #4 -- LIBRARY EXTENSION SERVICES Objectives: This project proposes to provide a strong library support function in the eight demonstration hospitals for which educational activities are to be developed in this operational application. Project funds are to be utilized at each of the hospitals listed under Project #2 and at each of the participating medical centers at Kentucky, Louisville and Cincinnati Universities. #5 -- UNIVERSITY CONTINUING EDUCATION. RESOURCES #6 #8 #9 #10 #11 conditionally (awaiting FY 1970 funds) Objectives: This project proposes to augment the continuing education resources of the three medical centers, described as not staffed, equipped or supported so. as to respond effectively to needs in the life-time learning of health professionals. Also, that the medical center - resources must be made more accessible to the cooperating community hospitals by means of staff specifically devoted to mobilizing these resources in response to specific local needs. (DRUG INFORMATION SERVICES) - Funded as a feasibility study. NAUTOMATED MULTIPHASIC SCREENING" - Cincinnati, Ohio approved "GOQOPERATIVE CORONARY CARE DEMONSTRATION" - returned for revision | "RADIOTHERAPY" - needs documentation per July 3, 1969 (News Information Data), can be sent to December 1969 Council if affirmative answers can be obtained . "REGIONAL STROKE MANAGEMENT DEMONSTRATION" ~ funds to be granted for planning only (from FY 1970 funds) - not yet funded. "RURAL MULTI~COUNTY HOME CARE DEMONSTRATION" ~ approved pending release of FY 1970 funds ~ not yet funded.