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E P A R T M E N T O F H E A L T H, EDUCATION

AND WELFARE

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andYentd HealthA-stration....3

tivision Regio@.

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mutes ofthe,%etinglg?pJtiy28-2g,

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e N~tio~ AdvisoryCo~cilonRe@onalMeticdWqm,.. ,,,... .~nutes ofthe~entiethMeeting~/ ~\

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, Jdy2&29,1970 ~

me NationalAdvisoryComcilonRe@onalMeMcalProw- convenedforitstwentiethmeettigat 8:3Ca.m.,~es~~~J~Y 28)1970in .ConferenceRoomG7dof theP=tiawnB@ldiW, Roc~ille,ml~d=Dr.Harold?&gdies, ActingDfiector,RegionalMedicd Pro-

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Servicepresidedoverthemeeting.

me Coluncilmemberspresentwe~:. ,..

~. BlaadW. Cannon. Dr.

Dr.Mti L. Crosby(7/28oflY) ~D1~.:tichaelE.@Wey (T/290fly) ~.Dr.BruceW. Everist Dr.

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~mdD. Pell@inomfred M. PopmRussellB.RothIbckI.Shtioltz

~. WilliamR, ~~~it Mrs.FlorenceR.WyckoffDr.~exalaer14.McPhedran

A listingof ~ staffmetiers,andothersattend@ isappended.

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me met% wascalledto orderat8:30a.m.on JWY 28by~. Harold~Wg~lies. .

ToeComcilmemberswerewelcomedtothenew~nferencefacilitiesintheParWa~.nwildingad thegeneralarr=.~~ntsfortheconductofthemeetinginthesefacilitieswasevlained Dr.~Wlies~omcedMS plansforan executive sessionwiththeCouncilat thecloseof thefirstdayof themeeting..

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Proceedingsofmeetings~ restrictedtiess clemd bytheOffice.oftheAdministrator,HSW. Therestriction~latesto allmateri~submittedfordiscussionatthe meetings,the.supplementalmaterial,ad allotherofficialdocuments,inclutingtheagenda.

Fortherecord,iv isnotedthatmembersabsentthemselvesfromthemeetingwhenthe@~cil isdiscussingapplications:(a)~m theirrespectiveinstitutions,or (b)h whicha conflictof interestmightoccur.Thisproceduredoesnot,of course,applytoenblocactions--otiywhentheapplicationis underMtividualdiscussion.

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&~DU~ION OF JW YE=:,.

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Dr.r&guliesintroducedtwonewmembersofthe.Councilwhowereti atte~anceforthismeeting.mey are: willi~ R.H~t, M.D.~a Co~ssionerof theComty ofAlle@eny~ Pennsylvtiamd medicdpractitionerinMcKeesport,Pennsylvtia;andAlexanderM. McPhedran,M.D.,AssociatefiofessorofInte@ Medicine(Nemolo~),~ry UniversitySchoolof Y&dictie,Atlanta.Tnerecentappointmentof JW.C.RobefiOgdenwastisoannomced. ~m.Oqenispresidentof theNofihCO*t Lifehurance CompanyinSpokae,Was-on ad Chdrmanof theWashi%tiotiWaska RegionaiAdvisoryGroup.Hewillbeg~hisR~l& att6n&Ceat thenetimeeting.

< .~IONALr~~IC:iLPROGR&wASAPARTOF~=~ SE~C=AND~HW HR+ AD1WNIS~4TIOli- h. Vernon~,~ilson

~ MS firstmeeting~riththeCouncilasAdtinistra~orof theHeathSenices@ l~entdHe~th A~tinistration,Dr.Wilsonrecalledhislonginterestmdfirst-~~d involvementinthedevelop~ntofRegionalYtical.?rcl~vs.He assuredtheCouncilof hisstrongsupportof ~Re@o=l MedicalProgrw .asa patiof thebroadereffortsof~~.He expressedhisendo~serentof theprinciplesofdecentralizationoftheatitistrationof HSl&Xactivitiesgenerally,md hisbeliefthattheconceptof 3e~ionalMedicd Programscanrelateweiltotheseprinciples.Wthoughthemechanismswillbeworkedoutslowly,he iscotiidentthatt~s cantakeplacewithoutdilutionof effort, eitherintheRegicnsor intheheadquartersoffice.

h recognitionof thevery formidableproblemsfacingRegionalMedic~w~~ Service,Dr.Wilsonexpressedre~t thathe wasnotableat thepresenttimetoresolvethe.m@or s;affingproblem. HeassuredtheCouncilthishasveryl~ighpriorityon hisworkingagendaad thefactthat he is asyetunableto repo~%doesnotindicatethathe isnotactivelywortingtow~ a solution.

~.Wilsona~k~ thec~~,ciltomeet~~h h~ a~in ti apptifi~telysixto ei~>tweeks,ti a specialone-ay session.At thatt~ heis assw~edhe.willbe abletotiscusshisplans,asthey- basedonthoseof Secretary~chatison,fortheorganizationandatitistra~ionoftheDe@rt,mentseffortsto strenQtihenandincreasethenationscapacitytodeliverhealthservices.lieindicatedalsothatby that .timehe wotidhavemoredefinitiveplansforthestaffing~dorg~~ati~nof theRe@o~l MedicalProgramsService..

~tho~h hispla~swiilticludea generaoutlineofthelmissionlof Re@opQl~~edic~~~~ as a Dartof the~~ effOrt,~.Wilsonsaidthathewouldrelyhea~ilyon theadviceandguidanceoftheCowcilfordevelo~ingthepoliciesanddetdledpro~am directionsthatwodd leadto eve~-mreefficientandeffectivecooperative~angementsbetweentheprivatesector,wtichtheyrepresent,md the~der~ effo~

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activitiesat DkW,.~?~4,andR3BSlevels;thepossibilityof.

~nistmtive e~ k~ngof someMS forR@p~icipationincomprehensiveregionalkidney,diseaseprogrm; al ~ additionto atotal-mt slightlyinexcessof $77~llion requi~dto~et~1 continuationreqtiementsof ongoingre@on~ activities..

C. Fund.w StFateg,.,.

.Dr.&@iesrade a briefintroductionof anew managementinfo~tionsystembeingimplementedby RWS.

He alsonoted~heeffectof the1969-70strategofPefitt@ Regio~~st titiitedrebudgeti~ofmexpendedbalancesforpro~m

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e~~msion. ~. ~~Wlies statedhisintentiontobegnto aPPIYmre stri.hgently.midelinesto.thiskindof rebudgetingandtorecaptureSOE ofthesebalancesforreallocationamongtheRegionalIfledicalPro~PmsW responsetoevidenceof successfulregiodizationani?rogrmdevelopment.

D. TheFASTRecommendations

h abriefreviewof therecommendationsoftheFederdAssistanceStretiiningTaskForceandhispi~ forrespondingtothem~Dr.]~g~~iesemphasizedthe~rliaison~l~le oftheD~ RegiOnalOfficeStithe developmentof:HSfrflprogramsgenerally,andinhelpingtorelateRegionalfiledicalProgramstoboth?ubliclyandprivately-fi.ndedpro- in the=ea sewed;butwiththeretentionoftheprincipalmgewLent respomibilityir.theRe~o~l l~edic~~Ogr~SerViCe>at thenatiotilevel.He alsomentionedespeciallytheServicesconcern,ante&ttngtheTaskForcestudy,forbetterdel~eationofthemultiplicityof activitiesnowcoveredby thecorebudgethRegional?JedicalProgramgrants.

~. ?~=g~liese~lainedtheintentof ~PS inplacinga ProgramRepresentativein eachorthetenD~J RegionalOfficesanddescribedwhathe sees.astheseticeroleoftheseindividuals.

Dr.Sloangavea briefreviewandstatusreporton thethreecontractsmadeby theR~S fiderthetem of Section907ofTitleIX of theWblic HealthServiceAct,whichde=s withtheS *listor listsoffacilitiesh,theUtitedStatesequippedad staffedto providethemst advancedmethds andtec~iquesinthediagnosisandtreatmentofheartdisease,cancer,andstfike.... .

. ThecontractwiththeAmeric~He=t Associationin supportof thefitersocietyCotissionforheartDiseaseResources,has

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serialpublication.ofitsreportandwillcontinuesothroughouttheperidof thecontract.

. TheJointComitteeforStrokeFacilities,suppo~~dby.?contracttiththeAmericanNeurologicalAssociation,has chosentowithholdpublicationof itsrePofi~til it$s enttielycompleted.

Thereportof theSpeci~AdvisoryCofitteeonCancer .~&e Facilitiesof theCancerCotissionoftheAmericanCollegeof Swgeofi,whichwassupported~der a contractnowco~leted,hasbeenreviewdby theRegio~lMedicalPro- Serviceandwasreceivedby theNatioMlAdvisorycouncilat theApril1970meeti~~ Negotiationsbetweenthehrican Collegeof Surgeonsw;dtheRWS, preparatorytocompletiontim approval,ofthisreport>we n~w~e~Y*(~s ~S aSCUSS~ ~ ~re detailwithCO~Cild~- theNecutiveSession).

Multi-Prog&ServicesProjectGrats - ~s. =ha p~lliPs

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Authoriz@underSection910ofTitle~ of.thePublicHealthServiceAct,thisprogrm ofprojectgrantswillbe ~lementd fortheftistt~ earlyinFY 1971. TheCouncilwasremind~of itsorigimlroletithedevelopmentofthebasic~idelinesmd operatingpoliciesforthesegrants.Theywereass-uredthatthesearereflect~intheftileditionoftheprogramdocumentswhichwe nowinclearance.

TheCouncilexpresseditspersistentconcernaboutthepotentialeffectof theftiirgof thesewants onthetotal~ds availableforSection904~mts (operationalsupporttoRegions).M. lw~lies sa+dt~t heemectedto be abletopresenttotheComcilat itsnextmeetlm,aPA forallocationof&ant fundsthatwouldtakeintoconsiderationanappropriatedistributionof theavailabledollarsbetweenthesetwom~orwant activities.

C. RegionalMedicalProgramsinM~el Cities-WO Clevel~dCmliss

~e.Councilwasremfidedof theadministrativee~ kingof $1.9fillionofRMP~ 71~nt MS foruseinprojectswhichhavedirectimpacton.certaindesi~ted Mdel Citiesneighborhmds.Mr.Chamblissoutlin~

= . dete~~~~g thedegreeof such~~ct ad obtaini~theprocwdure,~o.thecertificationofModelCitiesofficialsinthisre~~ Althou@t~s procedureincludeseficrsementofD~ Regio~lofficials,~.C_li~s assh-edtheCouncilthattheprocdurewouldentailno authoritYforfurtherreviev.andapprovaloftheseprojectsbeyondthelocalegio@AdvisoryGroupandtheNationalAdvisoryCouncil.

Alsoh respo~eRe@onalMedical

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to specificquestions,D. Wwlies explain~thatWOW- which=e plti~~d sub~tt@Projects

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servemban populationsneednotpkthern exclusivelyfor~40delCities ~areas,andneednotseekanyetiorsementor concurrencebeyondtheh OW-Ireviewti approvalmec~sm. . .

D. SeniorCliticalTrtineeships-Mrs.Wtha Phillips. .. .

Ms; PMllipsrecalledtotheCouncilthecircmtanceslead~gtotheDepartmentaldecisionto placqresponsibilityfortheSeniorCIWcal~atieeshipprograminRegionalMe