bow oo. ao PROFILE: NORTHWESTERN OHIO REGIONAL MEDICAL PROGRAM GRANTEE: Medical College of Ohio at Toledo COORDINATOR: C. Robert Tittle, Jr., M.D. Originally prepared by: James A. Smith Operations Officer Original date: September 25, 1969 Up-dated: Ii. IIT. IV. vi. Vil. NORTHWESTERN OHIO Regional Medical Program Table of Contents Geography Demography Politics Historical Review Core staff Organization Funded Operational Projects Appendix I. Geography This region comprises twenty counties with an area of 8,635 square miles in Northwestern Ohio with a total population of 1,360,977. This is an industrial area with 90% or more of the employed popula-— tion engaged in non-agricultural occupations. Transportation facilities within the region are adequate to assure prompt access to medical facilities principally by Interstate Highways and the Ohio Turnpike. Seven major railroads serve the Region, in addition to two major interstate buslines, and four major airlines. The Northwestern Ohio Regional Medical Program is coterminous with the Ohio State Regional Medical Program, Columbus, Ohio, and North- eastern Ohio Regional Medical Program, Cleveland, Ohio. es orn - APPENDIX A ASHTABULA CUYAHOGA TRUMBULL 4 LORAIN \ PORTAGE MEDINA =| SUMMIT MAHONING . i bot ed op ghcog] ASHLAND | iff wranvor CRAWFORD RICHLAND WAYNE STARK ; COLUMBIANA | . | CARROLL MORI ! ynnen mn HOLMES, j TUSCARAWAS ~ 1 7 JEFFERSON . DELAWARE a } BELMONT f . iS MONKOE 4 * ~ 5 J CLINTON WASHINGTON : “4 7 0 X. . ww MEIGS . J BROWN | ADAMS GALLIA N, SCIOTO 2 fr cr ‘ ‘. —~ =~ Lf. \ LAWRENCE \ ° CY NX, bo _ Northwestern Ohio Regional Medical Pregram eo renaes preme gee, —™~ Il. Demography A. Population: As of 1965, there were approximately 1.4 million E. l. 2. 3. 1. 2. 3. people residing in this region. Roughly 73% urban Roughly 92% white Median age: 29.5 (U.S. average - 29.5 years) . Land area: 8,635 square miles . Health statistics: Mortality rate Rate for heart disease: 371/100,000 (high) Rate for cancer: 155/100,000 (high) Rata for CNS vascular lesions: 109/100,000 (high) - Facilities statistics: 1. 2. Medical College of Ohio at Toledo (first year activity) There are 9 nursing diploma schools (RN's) and 5 schools of practical nursing; also there is one AD Program located in Lima Ohio. There are 5 approved schoolf os Medical Technology. There is one Laboratory of Cytotechnology within this region. . There are 10 approved schools of X-ray technology. . The total number of hospitals is 43 with 5,976 beds. Personnel statistics 1. There are 1340 M.D.'s (98/100,000) and 120 D.0O.'s within this region. . The number of active nurses is 6200 (453/100,000). There are 26 physical therapists, 39 medical social workers, 671 dentists and 1,675 occupational therapists. III. Politics A. Governor: James A. Rhodes (R), 1967-1971 B. Senators: 1. Stephen M. Young (D), 1958-1971 Member, Special Committee on Aging Member, Public Works Committee 2. William B. Saxbe (R), 1968-1975 Member, Labor and Public Welfare Committee Member, Special Committee on Aging C. Congressmen: . 1. Charles A. Mosher (R) 2. Thomas L. Ashley (D) 3. Jackson E. Betts (R) 4. Delbert L. Latta (R) 5. William M. McCulloch (R) February 1966 2 May 1966 Summer-Fall 1966 April 1967 June 1967 July 1967 October 1967 IV. Historical Review First meeting by interested physicians in Toledo area to consider the development of a Regional Medical Program under Public Law 89-239. "Ad Hoc" Committee formed to establish a Regional Medical Program for Northwestern Ohio. Preliminary inventory of Regional Health Manpower and Facilities. Approximately $19,000 in the form of cash, manpower, and facilities for preplanning have been contributed by various agencies as evi- dence of strong community support for the ‘ proposed Regional Medical Program. Meeting held with DRMP to discuss preliminary plans for submitting a planning application. Encouraged by DRMP to continue work toward making a planning application. Twenty meetings were held by Ad Hoc Committee during this period. Entire region was covered _and discussions were held with practicing physicians and hospitals relative to their desire to participate in the program. Because of favorable physician and hospital response it was decided to organize a tem- porary Regional Advisory Group and proceed with developing a planning grant application. RAG elects officers and an Executive Committee with the directive to prepare a Planning Grant application. Dr. C. Robert Tittle Jr. Was appointed Coordi- nator. . First year request ~ $309,180. November 1967 January 1968 December 1968 Council and Committee critique of Planning application: }. Reviewers impressed with the applications which shows considerable pre-planning. 2. Reviewers felt the budget and program period should be rephased over a two-year perperiod to provide time to get tooled up. 3. Some question as to the resources within this twenty county area for making this a viable region. 4. It was noted by the reviewers that financial assistance had been provided by, the Heart Association for the planning phase. 01 planning award ~ $274,450 DC Recruitment of Core staff: Mr. Donald Grubb - Assistant Program Coordinator Mr. James L. Pullella - Systems Analyst Mrs. Loalouise Geiger - R.N. Mr. Thomas Browning ~- Systems Communication Consultant 02 planning continuation application submitted to DRMP DRMP staff review and comments: 1. Consensus of staff that region is making satisfactory progress toward meeting the objectives stated in original application. 2. Core staff recruitment as planned 3. Possibility of establishing a non-profit corporation to serve as grantee 4. Concern noted that 50% core physicians | who head categorical programs also serve as chairmen of these reference panels. Physicians who are chairmen of Reference Panels are appointed to Medical College faculty and paid $10,000 per year for their activities. They do not really head cate- gorical programs but chair panels which review initially all programs in their disease December 1968 January 1969 January 1969 April 1969 May 1969 category field. They recommend modifica- tions of the proposals, or recommend the proposal be accepted or not by the RAG. All concepts of regionalization are con- sidered in making such decisions. Planning Supplemental Request - $141,655 02 Planning award - $271,137 DC First operational application submitted - $1,530,680 , Site visit - Mr. Joseph S. Murtaugh, Executive Director, Board on Medicine National Academy on Sciences; William S. Spicer, M.D., Coordinator, Maryland RMP; Richard F. Matting- ly, M.D., Marquette University School of Medicine; DRMP Staff - Mr. Robert Jones, Mr. Walter Hangen. Critique and Comments: 1. Noted good interaction with other health related programs. 2. Key strength of program lies in the active support of program by private medical sector. Committee and Councils critique and comments on supplemental and operational request. 1. Agreed with site visit report. 2. Noted high degree of cohesiveness within the region. 3. Cooperative relationships and organiza- tional liaisons have been developed with other RMP's. a, July 4. Suggested that staff be increased to provide additional expertise in bio- statistics and epidemiology to strengthen the substantive management of data. Recommended: approval. 1969 First operational award - $690,702 DC — oo Lm ee meme feos eo eos V. A. B, Core Staff The Core staff is located in the Regional office at 1600 Madison Avenue, Toledo, Ohio. The following is a list of the major core staff and their | percent of time spent working in the Regional Medical Program. C. Robert Tittle, Jr., M.D. - Coordinator (100%) Donald A. Grubb, M.B.A. - Assistant Program Coordinator (1002) Loalouise Greiger, R.N. - Nursing Research & Lecturer Associate (1002) James L. Pullella, M.P.H. - System Analyst (100%) Thomas H. Browning, B.S. - Systems Communications Consultant (1002) Louis Black, M.D. - Heart Disease (50%) Daniel Hanson, M.D. - Cancer (50%) Anthony Ionane, M.D. - Stroke (50%) Herman W. Reas, M.D. - Related Disease (50%) James B. Felkey, B.S. - Systems Communications Specialist ‘Cynthia Ann Haskill - Nurse Associate ‘BIOGRAPHICAL INFORMATION 1) 2) 3) 4) 5) 6) C. Robert Tittle, Jr., M.D. a) B.S., Pennsylvania State University, 1934 b) M.D., University of Pennsylvania, 1938 c) President, Pennsylvania Society of Internal Medicine, 1962-63 d) Clinical Professor of Medicine, Med. College of Ohio at Toledo (July 1967) e) Program Coordinator, Northwestern Ohio RMP (July 1967) Donald A Grubb a) B.S., Findlay College, 1956 b) M.B.A., University of Toledo, Ohio, 1963 c) Manager and Grant Coordinator, Institute of Medical Research, 1965-1968 d) Assistant Program Coordinator, NWO/RMP, 1968 — Loalouise Geiger a) Born May 1925 b) R.N., Robinwood Hospital, School of Nursing, 1946 c) B.A., Baldwin-Wallace College, 1950 d) Head nurse surgical unit, Elyria Memorial Hospital, 1955-1961 e) Head nurse of surgical unit, Toledo Hospital, 1963-1968 f) Nurse Research/Lecture Associate, Northwestern Ohio RMP, 1968 - James L. Pullella a) B.A., University of Toledo, 1951 b) M.P.H., University of Michigan, 1962 c) Health Educator with Toledo Health Department, 1962-65 d) Planning Consultant with the Community Planning Council of Northwestern Ohio, 1966-1968 e) Systems Analyst, Northwestern Ohio RMP Herman W. Reas, M.D. a) B.S., St. Joseph's College, 1949 b) M.D., St. Louis University School of Medicine, 1952. c) Rotating internship, Mercy Hospital, Toledo, 1952-53 d) Pediatric residency, St. Louis Children's Hospital, 1955-57. e) Northwestern Ohio RMP, Related Diseases James B. Felkey a) Senior IBM operator, Owens Corning Fiberglas Corporation, Toledo, 1959-62 b) Assistant Supervisor, American Lincoln Corporation, Toledo, 1962-65 c) Data Processing Supervisor, The Mather Company, 1965-68 d) Shift supervisor, Kaiser Jeep Corporation, Toledo, 1968- e) Systems Communications Specialist, Northwestern Ohio RMP ar rormey rorareeptgunern nee pe cent oe the et eee omer ae 7) 8) Cynthia Ann Haskell a) Born September 1946 b) R.N., Maumee Valley Hospital School of Nursing c) Dialysis R.N., at Maumee Valley Hospital, 1961-1969 d) Nurse Associate, Northwestern Ohio RMP Karl A. Otterland a) Born 1920 Falkoping, Sweden b) M.D., University of Stockholm, Sweden, 1950 c) Ph.D., University of Gothenberg, 1960 d) Public Health Medical Inspector for juvenile workers, Gothenberg, Sweden, 1955-1961 e) Quarrantine Medical Officer, Gothenberg, Sweden, 1955-1960 ORGANIZATION CHART MICHIGAN REGIONAL MEDICAL PROGRAM OHIO STATE. REGIONAL MEDICAL PROGRAM NORTHWESTERN OHIO REGIONAL MEDICAL PROGRAM REGIONAL ADVISORY GROUP NORTHEASTERN OHIO REGIONAL MEDICAL PROGRAM BOARD OF DIRECTORS +O-0-O-0-0-0-0-0-0-0-0-0-0-0-0-. NORTHWESTERN OHIO EXECUTIVE COMMITTEE REGIONAL ADVISORY GROUP REGIONAL MEDICAL PROGRAM MEDICAL COLLEGE OF OHIO AT TOLEDO A PROGRAM A V OF ADVISORY GROUP AUXILIARY COMMITTEES | PARAMEDICAL EDUC. & REHABILITATION CMTE. EDUCATION COMMITTEE DIAGNOSTIC AND THERAPEUTIC NEEDS COMMITTEE COMMUNICATIONS AND PUBLIC INFORMATION COMMITTEE RESEARCH COMMITTEE ao (GRANTEE AGENT) \ FISCAL COORDINATOR REFERENCE PANEL ASSISTANT COORDINATORS ADMINISTRATIVE STAFF | HEART DISEASE t T I | CANCER | | STROKE | | RELATED | CONTINUING -0-0-0- -0-0-0- -0-0-0; -0-0-0+ +0-0-0-0-0-04 -O-0-0-0-0-0- O-0-0-0-0-0- -O0-0-0-0-0-0- -0-0-0-0-0-0- 0-0-0-0-0-0"| -O0-0-0-0-0-0- -O-0-0-0-0-0- -O-0-0-0-0-0- -O-0-0-0-0-0+ -O-0-0-0-0-0- 0-0-0°0°0°0- EDUCATION +O-0-0-0-0-04-0-0-0-0-0-0-0-0-1-0-0-0-0- +O-O-0-0-0-01-0-0-0-0-0-0-0-0-|-0-0-0-0- '0-0-0-0-0-04-0-0-0-0-0-0-0-0;0-0-0-0- -O-0-0-0-0-07-0-0-0-0-0-0-0-04-0-0-0-0- rO-0-0-0-0-040-0-0-0-0-0-0-0-70-0-0-0- 0-0°0-0- rO-0-0-0°O07-0-0°0°0-0-0-0°0 oS AGENT —____j assistant PROGRAM COORDINATOR | i SPECIALIST SYSTEMS/COMM, PUBLIC HEALTH FINANCE/ ANALYST PROCUREMENT -0-0-0-0-0-0-0-0-0-0-0-0-0-0- LEGEND > ADVISORY COOPERATION INFORMATION EXCHANGE ADMIN. COOPERATION OPERATIONAL COOPERATION DIRECT LINE OF AUTHORITY Farm pre, se rape 9 Se SRT. we i, TS eT ook meter om mmr ecm ate co f FLOW DIAGRAM — PROJECT APPROVAL PROCESS Submittor . Secretariat Reference Panel Originates Project Writeup Receive Register. Edit L Acknowledge to Submittor. & Send Copies to Reference . Pane! f 2 Receive Give Decision Approve in Acknowledgement to Submittor Principle or Letter |: Turn Down Receive / : \ Decision —_S * Cooperate in