NOTIE@DO NOT USE, THIS ROUTE SLIP TO DATE SHOW FORMAL CLEARANCES OR APPROVALS I @ i@ fig TO: AGENCY BLDG. ROOM MIZ. (gp(vaa - \1-67 0 APPROVAL Cl REVIEW 0 PER CONVERSATION 0 SIGNATURE El NOTE AND SEE ME [:] AS REQUESTED MMENT 0 NOTE AND RETURN El NECESSARY ACTION FOR YOUR INFORMATION 0 PREPARE REPLY FOR SIONATI)RE OF REMARKS: (Fold for return) -------------- From PHONE BUILDING FORM HEW-30 Ray. II/% ROUTE SLIP,,-: @@,73 C) - @l-, 326 MEMORANDUM DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE HEALTH RESOURCES ADMINISTRATION BUREAU OF HEALTH RESOURCES DEVELOPMENT TO William F. Donaldson, M.D. DATE: December 12, 1974 Lawrence Shulman, M.D. FROM 'OJt h e4@' Public Health Advisor, DRNP SUBJECT: Selecting a Chairman for the January Arthritis Conference It would be helpful if the identification of the conference Chairman were resolved soon. The Chairman should be involved in the final development of the conference both for information, and to develop strategy to achieve conference objectives. Several alternatives came to mind: a. AAOS, and ARA representatives alternate in the chair; b. The two share the Chairmanship, as was done at the April 1 meeting in Chicago; C. An individual be selected who is acceptable to all. With regard to the latter, we recommend consideration of Dr. Roger D. Mason. We have found him to be an effective Chairman, and very helpful in resolving problems. He represents objectivity in coming from an RMP which did not Apply for an arthritis grant, and involvement as a practicing physician who is a victim of arthritis. On January 1, Dr. Mason will assume directorship of medical affairs for the "Blues", in Omaha, Nebraska. MEMORANDUM DEPARI'N,IEN'F OF III-"ALTIT, EDUCATION, AND @Vl-'LFARE PUBLIC IJEALI'll SERVICE IILALI'll IZESOURCES ADNIINISI'RATION BUREAU OF I[EALTII RI,-'SOURCI-'.S DEVEI.0]'MEN'I' TO See below (Participants in the DATE: December 12, 1974 Nov. 17 Chicago I'fly-in") FROM Public Health Advisor, DRMP SUBJECT; Plans for the Arthritis Conference, January 19-20, 1975 The enclosed pages present draft plans,conference "play script", etc., for your information, and to elicit suggestions for the final format of the Arthritis Conference. YOUR RESPONSE ON THIS MATERIAL IS NEEDED WITHIN TWO (2) WEEKS to assure that the conference will be acceptably structured and conducted. As you go through the material, two factors should be kept foremost. The preposed structure will permit pre-conference assignment of par- ticipants to the workshops. For tighter structuring, we could make a pre-conference distribution of workshop guides, and instructions. Secondly, conference attendance will be mixed; i.e., only half of tne parLICIpanES Wlli De PllySlCldli6 tipUL:l..L-LCa.L.Ly -LULIL:L.LUL@LLY, @b department heads, or practicing arthritis providers. The remainder will be AF Chapter heads, and RMP Coordinators. Your guidance is particularly needed with respect to the following questions 1. Who shall chair the workshops? 2. Who should prepare the conference report? 3. How should post-conference action followup be handled? It has been suggested that a short wrap-up meeting on conference plans be held in New York City before or after the ARA Executive Committee meeting on January 10. Who whould be available to attend such a meeting? Please let me have your comments and suggestions at an early date. I will be 'away from Washington during the week of December 14721. Page 2 I wish to maintain contact with you, however, and can be contacted at, or through the following numbers: Office: 301/443-1916 301/443-1500 Florida: Holiday Inn Oceanside Vero Beach 305/562-4164 Addressees: Mr. Kevin Anderson Dr. William Donaldson Dr. Ephraim Engleman Mr. Gerald Gar e Dr. Satoru Izutsu Dr. Roger D. Mason Dr. Lawrence Petrocelli Mr. David Shobe Dr. Clement Sledge I)r. Isaac Tayior Dr. Charles Tourtelotte For Information: Dr. Robert Brown, Director,- Kansas RMP Mr. Gordon Waller, Executive Director, Kansas City Division AF Arthritis Conference INDEX OF DRAFT @IATERIALS Subject Pages Conferemce Operational Assignments, and Estimated Costs 1 - 4 Outline of Conference Program Events 5 -13 General 5 First Day 6 -11 Second Day 12 -13 -,)/, First Day (A-1 through A-6) 14 -23 Second Day (B-1 through B-6) 24 Conference Announcement 25 -27 Mailing List Project Directors and Coordinators 28 -36 ARTHRITIS CONFE@ @NCE Schedule, Site, Assignments Estimated Costs, a]Ld Related Matters EST. PROPOSED (Typed Spear; other write in ITF-%'S AMOUNI SOURCES COMMENTS or telephone Spear) A. PLACE: Hotel Muehlebach Kansas City, Missouri B. DATES: January 19-20,.1975 C. CONFERENCE HOSTS: Kansas City Division, Arthritis Foundatio-n Kansas Regional Medical Program D. CONFERENCE SPONSORS: American Academy of Orthopaedic Surgeons Arthritis Foundation Participating Regional Medical Program E. AVAILABLE RESOURCES: 1. Travel/PerDiem of Participants: $21,0(10 provided by 29 RMP's for participation of Coordinators, and Project Directors. 2. Others (D@IP, Associations., etc.): Co,,t p.Eid by organization 3. Conference Sit6/Service Allowances: (Maximums) a. $2,500 American Acade77 of Orthopeedic Surgeon b. $2,500 Arthritis Foundation c. $1,000 Kansas KIQ, plu3 staff supllort d. Staff Support, KC Art@itis Cl-,apt4r e. Staff Support, Div. R+ional Ivadi+l Programs 2 (i) Abbreviations: AAOS Am. Acad. of Ortho. Surge(ns (ii) Footnotes: Indicates items which could be AF Arthritis Foundation partially or wholly charged to DRNP Div. of Reg'l Med. Prograns participants. lim Hotel Muehlebach KCAF Kansas City Arth. Chapter 1/ Items not required if costs KPuv2 Kansas Reg'l Med. Prog. covered by conference sponsors. K%T Participating RNP program(s) EST PROPOSED (Typed Spear; other write in IT@ Spear) IS @MOULN SOURCES COMENTS or telephone F. ESTIMATED COSTS: 1. Facilities: Plenary room, school room style 0 HM Blackboard & ea sel available in room Conf. Admin. Room 0 HM Outlets for typewriters, & tape player 6 Committee Rooms, Schoolroom style 0 HM Blackboard & easel available in each room Lunch Room 2 days 0 M-4 Dining Room 1 night 0 HM Sleeping Rooms for 120 - 150 $17.00 sgli RMP's,otheis 23,00 dbl( RMP's,otheTs VIP Rooms (2 or 3) 0 HM Post-Conference Work Room 0 HM (same as Admin. Room above) 2. Services: Paging 0 Presume hotel will also extend assistance PA system, Plenary Room 0 HM in flight rescheduling, if necessary Tape Recording, Plenary,, Lunch, 0 KRNP-KCAF and Dinner Rooms Typewriters, typing 0 KLUIP-KCAF Secretaries (2@5):(messengers) 0 KRMP-KCAF Reproduction equipment/services 0 KRMP-KCAF Re. Key Question sessions,(see Conference Pre-Conference- Post Conference 0 DKMP Playscript), need fast service for Reproduction reproduction of documents to go into workshops; also, re. workshop reports to be presented in Plenary. (i) Abbreviations; A-KOS An. Acad. of Ortho. Surge(ns (ii) Footnotes:.* Indicates items which could AF Arthritis Foundation be partially or wholly charged D@ Div. of Reg'l Med. Prograr@s to participants. F-24 Hotel Muehlebach KCAF Kansas City Arth. Chapter 1/-Items not required if costs Kr@ Kansas Reg'l Med. Prog. covered by conference sponsors. RMP Participating Rie program(s) EST. PROPOSED (Typed Spear; other write in ITE.NFLS -AMOUI\'T SOURCES COMENTS or telephone Spear) 3. Travel: * Representatives of 29 RM:P $21,OOD RMP's programs * Arthritis AD Hoc Review $ 3,40) Individual Committee (14 @ est. $240.00 ea.) VIP's (est. 2 @ $500 travel) $ 50) AAOS - AF Rep's AAOS, AF, DRNP, NIAMDD 0 Individual Special resource people, Est 3 $ 75) AAOS - AF 4. Meals: * Luncli (2 x $4.50 x 120) $ 1,08) AAOS - AF * Dinner (1 x $10.00 x 120) $ 1,20) AAOS - AF Estimated at $10.00/per as banquet; could be cheaper ($8.50/per) if handled'as a buffet "western'. * Cocktails (i x $1.25 x 240) $ 35) AAOS -. Ap Perhaps KCAF can get this tab picked up VIP'S. included above Breakfast (2) 0 Individual * Coffee Breaks (3 times) $ 24,) AAOS - AF Prefer this be set up on 1 or 2 carts, Coffee $0.35/serving in large urns; might be cheaper Tea 0.35/serving in this mode'. Cake 0.40/serving Abbreviations: AAOS Am. Acad. of Ortho. Surg(ons (ii) Footnotes: Indicates itmes which could be AF Arthritis Foundation partially or wholly charges to DP@ Div. of Reg'l i@ied. Progrzms participants. M4 Hotel Muehlebach KCAF Kansas City Arth. Chaptei 1/ Items not required if costs KRMP Kansas Reg'l iNled. Prog. covered b conference sponsor,, y R22 Participating RNP progran(s) EST. PROPOSED (Typed Spear; oth77 wri7e i-n ITEMS A'.% I 0 Ui\l SOURCES COMMENTS or telephone Spear) 5 lies: May need to call on KRMP/K@ if DRMP Name Tags (150) 0 DP31P supply ae@cie,,s balk at some of this. Registration Books (2) 0 DRNP 1/ Meal Tickets (450) 0 HM Re. 2 lunches, and 1 dinner. Would need 3" x 5" pads (500) 0 DRMP if (a) sponors don't desire to fully Plastic Bags (10) 0 DRMP cover meal costs, and/or (b) there is Writing Paper (150) 0 DRMP is a question of the attendance at the Pencils (200) Est. 0 DRNP dinner. Typing Paper 0 KRMP - KCAF Paper, Reproduc 10 0 KRNP - KCAF reams Envelopes 0 DRMP Postage 0 DRMP Reproducing Agenda 0 DPIQ If these can be drawn up in sufficient Reproducing Dinner Program 0 DRMP time before the conference; otherwise, will have to call on KRMP/KCAF. CONFERENCE ON PILOT ARTIIRITIS PROGRAM Nature and Sequence of Events Overall Conference Process: The conference is planned to proceed on the basis of development and discovery. That is, no preconference issue or position papers will be developed. The conference brings together professional individuals each oflwtiom is informed generally on the overall program, and specifically with respect to the project(s) with which each is associated. The process will capitalize upon their collective past experiences in the health field, and the current experiences of the pilot arthritis program to; a)-define and describe the program; b) identify salient features of note; c) explore its potential; and d) specify a number of feasible activities which can be undertaken individually and jointly to round out the pilot effort. The deliberations in the conference will be by the pilot arthritis program leaders, about the parts, and the sum of the program. Thus, the only input papers required are those prepared by assigned program speakers, and special resource people and guests invited to make a formal presentation. Conference outcome is dependent upon the will of the leading program participants with regard to: a) improved program comprehension; b) identification of program potentials; and c) specifica- tion of actions which the assembly agrees to undertake. Conference Program Playscript Comment Proposed First Day, 8:00 a.m. Registration Sign-in books will be available on at'least 3 tables, each table (book) representing a separate alphabetical group (e.g., a - i; j - r; s - z). The names of the signers will be checked against a listing to identify unexpected atten ers. Signers will be handed: 1. a name tag (prepared preconference, insofar as possible), and 2. a piece of paper (possibly color coded) identigy- Assignpi(2nts indicated by color coded, or ing the workshop5the individual is to. sylubol-riiarked, slips need not the individual's name. The lists in trip hands of the Registrars will indicate assignment to hand each participqi-it. The name tag can also carry a color P,-iarlc, or symbol so loss of slip doesntt matter. 3. Conference agenda 9:00 a.m. Call to Order Chairman (who)calls meeting to order in Plenary Room May be smoother if Dr. Brown or Mr. Waller (KDAF) convenes conference, and introduces Chairman 2 Proposed Comment Plenary room is arranged on a schoolroom basis (tables for all). At each place is: 1. writing pad 2. several 3" x 5" pads 3. a pencil 4. any background documents Chairman makes welcoming comments. Chairman makes introductions. Only 1 or 2 other people should be on the podium with the Chairman. Introduct ons may include special guests present, and individuals to contact for personal help. Chairman makes short talk about conference purpose Can be another person. Chairmen summarizesagenda.. pointing out pre-assignment Can be another person. of participants to workshops. 9:30 a.m. Key Question Period Leader introduced. Describes the purpose of this session; i.e., the experience of the total plenary group is being tapped to assist each subject workshop in completing its assignment. The plenary session will be asked to respond to 2 or 3 T'How" questions about each workshop subject (see section under each workshop). 3 Proposed Comment These are "knowledge" questions; the analytical factors of each.subject must be developed within the workshop. (Average of 1% - 8% of such responses will turn out to be useable; imagery stimulation to workshop can be quite high, however. Process: Leader will state one "How" question, and will indicate the time allowed to give answers (never over 2 minutes). Participants write their.individual responses on the 3" x 5" pads, tearing off completed sheets (normally, one answer per page). Whatever comes to resdondent's mind should.be written down. At "TIME", ushers go down the aisles with plasic bags (marked to show what sheets they contain), and collect the 3" x 5" pages. Ushers take the bags to the Administrative room, and Need minimum of 2 professional in return to Plenary with new marked bags. Admin. Room to go over slips; suc@ii responses typically fall into categories. sionals need to set ul) 2-3 categ(@r@@@,@-@ per question, and select not more th@,,ii ans- i.@ers per category to be typed on slieet for the workshop. After master is typed, a copy is run for each mei,!t)(r and delivered to workshop leader. T'tjcie should not be pre-selection by the profes@ionals-- the novel, and the "different", is i@,'iere this can pay off most. It will not be catastrophic if these sheets reach the workshops after they hav(:! convened, Leader poses a second question, and the above-proces@ is repeated. 4 -Proposed Coiiinien t is a demanding exercise on Process is repeated until all "How" questions for This the lst day are completed. pants. It is proposed that; a) l.'LC)t .iiore than 3 questions be posed at one tii@ie; b) question grg.14P(5i of ul) to 3 questions each be interposed b--!L,.,ic@en program presentations described im.-fic,di- ately below. 10:30 a.m. Coffee Break Coffee - tea - cokes, available in hall-way, or at back of Plenary ,on 2 - 3 carts. 10:45 a.m. Reassemble in Plen Room Presentation of 3 or 4 representative pilot arthritis See above. Fatigue factors asso(-,!;-ited programs by Coordinator, or Project Director Speakers. with, a) answering questions, and b") list- Short time allotted to each (15 - 20 min.) is offset ening to speakers can be reduced by inter- by the fact that participants already have in hand a spersing the two. program summary (these were called for by DRMP by E.g., 3 questions 15 mi.ii. memo November 11, 1974). 1 speaker 15 mi,,.i. 3 questions 15 mi,,i. 1 speaker 15 miii. Coffee Break 15 miTi. 3 questions 15 mii-i. 1 speaker 15 mi,-i. 3 questions 15 min. 1 speaker 15 mirz. 135 min. 12:00 Noon - LUNCH Two (2) short presentations on special subjects. Suggested: 1. Demographic applications Recommend Mr. Director Micl,li,_@,in RNP 2. Evaluating chronic disease programs Recommend speaker from Am. Soc. State Territorial Health Offices 5 Proposed Comment 1:30 p.m. Convene Workshops A-1 Physician Education AAOS and AF should recommend worl@liop A-2 Paramedical Education leaders. A-3 Patient Education A-4 Demographic Factors A-5 Arthritis Services A-6 Service deployment Each member of each workshop has available in the Secretarial service available in AdT,,iLn. workshop room: Room to type up Workshop reports in4@ofar 1. Statement of instructions and charge as time permits before presentatic)i-i. 2. "How" responses pertinent to this workshop. A typed workshop report is required in all cases either from tape recording of Plenary report or from Workshop Chairmen's notes. 3:30 p.m. Coffee Break 3:45 p.m. Reassemble in Plenar oom a. 15 min reports from each of six (6) workshops. b. Plenary discussion of reports. C. Plenary vote/resolution on any positions, or actions conference decides to take. If appropriate, Chairman either Schedule and reporting responsibilities 1. designates an individual to follow up must,be established. conference action notes, or 2. designates a group. --- Adjourn 6 Proposed Comment 6:00 p.m. Cocktails 7:00 p.m. Dinner If speaker desired, can schedule a) Cranston, or similar, or, b) David Rogers, or similar 7 Proposed Comments Second Day, January 20, 1975 8:00 a.m. Convene in Plenary Room 8:05 a.m. Key Question Period Same as lst day, but relating to 2nd Day's workshops. Recommend interspersing with talks (see below) as indicated above for lst d@iy. Schedule is shortened on the 2nd d@tv. This can be accommodated by alternatetively, or jointly: 1. asking fewer questions, 2. banking on more efficient operations, given lst day's experience; and/or, 3. sliding schedule downward a bit. 8:30 a.m. Presentation of Specia rams Select 3 or 4 from: 1. Michigan geriatric program If some of these which cannot be scil,.,,;,-Ii.uled @,2. Galveston minimal care unit in program are of sufficient interests.-, maybe 3. North Carolina industrial detection program desirable to request selected RMP',,@, tt) 4. One of the Wisconsin studies: submit "abstracts" on these subjected IS a. Patient/family education background papers for the conference. b. Quality of nursing care. 5. New Mexico, or Hawaii discussion of techniques to mobilize lay people. 6. Physician from Philadelphia to briefly highlight pediatric aspects of the pilot initiative. 7. Kansas, Alabama, or other RNP outline of program impact on physician at secondary level of service. 8. Virginia, Utah, or,other outline of impact on physician at primary level of service. 9. Summary by Dr. Evelyn Hess on automated reporting opportunities. in- ot-ht-y 8 Propose Comment 9:30 a.m. Coffee Break 9:45 a.m. Workshops Convene B-1 Evaluating physician training Who are the key people who are mtist B-2 Evaluating paramedical training participants in these workshops? B-3 Evaluating patient training B-4 Evaluating program services What alternative sequence of worl,@- B-5 Evaluating special studies shops might be better? B-6 Establishing continuing work groups to follow through on conference recommendations 11:30 a.m. Reassemble in Plenary Workshop reports ,1:00 p.m. Lunch 2 short talkson alternative funding opportunit es. 2:30 p.m. Reassemble in @lenary Conference consideration of workshop reports; resolutions or voting on positions, or follow up actions 3.:30 p.m. Plenarv Continued Resolution or voting on overall conference positions, or activity plans. 4:00 p.m. Adiourn Conference Post conference: @, KDAF, AAOS, AF, and D@ representatives must meet'in Admin. Room to resolve -- wrap up specific conference cost and action requirements. WORKSHOP A - 1 Guides and Instructions Subject: Physician Education Chairman: Recorder: Workshop Product: A document which describes: physician education generally undertaken across the country under the pilot arthritis program; indications of potential problems, as well as techniques and opportunities to enhance success; suggestions regarding maintenance of program quality to improve chances for continuity support; indications of subject areas, or training methodology which appears to be potentially most fruitful; the kind of documentation it may be feasible to obtain to 'record the overall pilot training activities; the recommended source of forms, or format; recommendation of who should centrally, or otherwise collect this information; recommendation as to who should receive this information, and how it should be disseminated. The workshop report should be dictated in the Administration Room if it is too long to write and have typed for the Plenary report. The Plenary report will necessarily have to be a summarization, but all specific recommendations will have to be acted on in a Plenary session. Discussion guides': Program description and development. What: a. physician education activities are being undertaken in the pilot arthritis program. b. existing curricula are being employed C. new curricula are being developed d. is the approximate ratio of physicians being reached respectively at the tertiary, secondary, and primary levels of practice. e. distinctions, if any, are indicated in methodology, and/or curricula in reaching different categories of physicians. f. degree of physician service upgrading is being accomplished through: increased knowledge; patient referrals; consulting teams; increased utilization of Allied Health, and lay personnel. g. are the major problems in obtaining physician cooperation and participation in pilot programs. h. measures are effective in overcoming resistance,, or problems. i. Other: 2 How: (discussion will be reinforced by responses obtained in Plenary session) a. can physician resistance to involvement in arthritis treatment be overcome. b. can teaching methodologies and currisula be made widely available. C. can individual projects obtain assistance, or counsel on program problems. WORKSIIOP A 2 Ciii.des and Instructions Subject: Allied Health Education Chairman: Recorder: Workshop Product: A document which describes: Allied Health education generally undertaken across the country under the pilot arthritis program; indications of potential problems, as well as techniques and opportunities to enhance success; suggestions regarding maintenance of program quality to improve chances for continuity support; indications of subject areas, or training methodology which appears to be potentially most fruitful; the kind of documentation it may be feasible to obtain to record the overall pilot training activities; the recommended source of forms, or format; recommendation of who should centrally, or otherwise collect and how it should be disseminated. The workshop report should be dictated in the Administration Room if it is too long to write and have typed for the Plenary report. The Plenary report will necessarily have to be a summarization, but all specific recommendations will have to be acted on in a Plenary session. Discussion guides: Program description and development. What: a. Allied health education activities are being undertaken in the pilot arthritis program. b. existing'curricula ate being employed C. new curricula are being developed d. is the approximate ratio of allied health being reached respectively at the tertiary, secondary, and primary levels of practice. e. distinctions, if any, are indicated in methodology, and/or curricula in reaching different categories of f. degree of allied health service upgrading is being accomplished through: increased knowledge; patient referrals; consulting teams; increased utilization of Allied Health, and lay personnel. g.' are the major problems in obtaining allied health cooperation and participation in pilot programs. b.' measures are effective in overcoming resistance, or problems. i. Other: 2 How: (discussion will be reinforced by responses obtained in Plenary session) a. can involvement of the conmunity's allied health population be increased. b. can allied health capabilities be optimized. c. can physician extension through utilization of allied health personnel be maximized. WOIZKSIIOP 3 Cul,des and Instructions Sul)ject: Patient Education Cliairniin: Recorder: Workshop Product: A document which describes: patient education generally undertaken across the country under the pilot arthritis program; indications of potential problems, as well as techniques and opportunities to enhance success; suggestions regarding maintenance of program quality to improve chances for continuity support; indications of subject areas, or tral.nin,, methodology which appears to be potentially m6st fruitful; the kind of documentation it may be feasible to obtain to record the overall pilot training activities; the recommended source of forms, or format; recommendation of who should centrally, or otherwise collect this information; recommendation as to who should receive this information, and how it Should be disseminated. The workshop report should be dictated in the Administration Room if it is too long to write and have typed for the Plenary report. The Plenary report will necessarily have to be a summarization, but all specific recommendations will have to be acted on in a Plenary session. Discussion guides: Program description and development. What: a. patient education activities are being undertaken in the pilot arthritis program. b. existing curricula are being employed C. new curricula are being developed d. is the approximate ratio of patients being reached respectively at the tertiary, secondary, and primary levels of practice. e. distinctions, if any, are indicated in methodology, and/or. curricula in reaching different categories of patients f. degree of patient service upgrading is being accomplished through: increased knowledge; patient referrals; consulting teams; increased utilization of Allied Health, and lay personnel. g... are the major problems in obtaining patient --cooperation and participation in pilot programs. b.' measures are effective in overcoming resistance, or problems. i. Other: How: (discussion will be reinforced by responses obtained in Plenary session) a. can patient education be made more broadly available. b. can patients be stimulated to make better use of their special education. C. can patient support services (psychological, and other) be improved. WORKSHOP A - 4 Guides and Instructions Subject: Demographic Factors Chairman: Recorder: Workshbp@r duct: A document which describes: general demography principles, and how they apply generally, or selectively to the pilot arthritis program; best or selected demographic techniques which can be applied to this chronic disease program; sources for assistance or information about developing demographic data; recommendation for any appropriate overall program demographic data accumulation; method; who should do it; where should they report it; how should it be disseminated. The workshop report should be dictated in the Administration Room if it +-II, Dl,, report will necessarily have to be a summarization, but all specific recommendations will have to be acted on in a.Plenary session. Discussion guides: What: 1. are the principal demographic characteristics of the existing pilot arthritis initiative. 2. evidence exists that the profile, or pattern, of care made available to arthritics now might be modified by the pilot arthritis initiative. 3. are the demographic factors which affect the efficacy of care delivery at tertiary, secondary, and/or primary levels of practice. 4. opportunities exist to obtain significant demographic data from the pilot arthritis initiative. 5. correlation exists if any, between demography and.a) level of care, b) access to care, c) involvement of Allied Health and others in care delivery. 6. is the evidence, if any, between demographic factors and the pattern of practice through which care is delivered. 7. demographic factors should project leaders be particular sensitive to with respect to program outcome. 2 Ho,vy: (discussion will be reinforced by responses obtained in Plenary session) 1. can a demographic profile of an arthritis patient group be simply developed. 2. can demographic profile of an arthritis treatment service area be obtained. 3.. can demographic information be utilized to improve the delivery-of care. WORKSIIOP A - 5 Guides and Instructions ect: Arthritis Services (types) Chairman: Recorder: Workshop Output: A document which describes: the various kinds of arthritis services being developed under the pilot arthritis program; the pattern of emphasis on the respective types of services; the degree to which any pattern is the result of particular characteristics of the grant program; the impact of such characteristics with respect to a) constraint on service continuation, or b) presenting improved opportunity for service continuity; discernible impact of the grant-supported "profile" on per- sonnel requirements, costs, broadened services, funding opportunities; recommendations with regard to documentation of the service profile, how, by whom; what information should be made available to the professions; how. What: a.' different arthritis services are being undertaken under the pilot arthritis grant program. b. are their respective frequency rankings. C. impact might the nature and frequency of service types have in terms of short-term, or long-term personnel requirements, costs, patient care needs, etc. d. services appear to possess higher liklihood of attracting continuation support. e. kinds of support may be attracted. g. cost-saving factors or practics are various service type amenable to. h. other How: (discussion will be reinforced by responses obtained in Plenary session) a. can new arthritis services be integrated with local and state health programs b.., can service types best be compared to identify the most viable under existing circumstances. C. can different service types be effectively merged to reduce personnel and other costs. WORKSHOP A - 6 Guides and Instructions Subject: Arthritis Services (deployment) Chairman: Recorder: Workshop Product: A document,which describes: the services being developed under the pilot arthritis program; any apparent differences in services with respect to geographic, demographic, or institutional distinctions; strengths or weaknesses inherent in locating specific types of services in particular sociologic, political or other environments; effective service deployment patterns in terms of grades, or levels of service; characteristics of services which can be effectively located outside institutioned or metropolitan centers; any service size, or intensity effects resulting from different deployment patterns; principal manage- ment concerns ofdeployment; recommendations concerning deployment of arthritis services. Discussion guides: Program description and development What: a. is the overall pattern of deployment of services in the pi ot arthritis program b. are the major differences if any, between this deployment, and the pre-grant picture C. are the major shortcomings and strengths of these deployments d. are the implications of service deployment via or vis service to different classifications of arthritis patients. e. are the implications of deployment with respect to providers. f. deployment is not being developed, but should be. g. key lessons abo@t service deployment should the pilot program be looking for. h. who should spearhead such introspection. How: (discussion will be reinforced by responses obtained in Plenary session) a. can the deployment of arthritis services be made more attractive to care providers. b. can the efficacy of service deployment be simply rated, or measured. C. can local communities attract, or stimulate wider service deployment. WORKSIIOPS, Second Day (B-1 through B-6) Development deferred pending discussion and resolution of draft material submitted. Suggestions and comments should include recommendations about the titles of these workshops, and the critical questions which should be addressed. (See p. 13). DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEAL,TH SERVICE HEALTH RESOURCES ADMINISI.RATION ROCKVILLE. MARYLAND 20852 BUREAU OF HEALTH RESOURCES DEVELOPMENT December 9, 1974 TO COORDINATORS OF 29 REGIONAL MEDICAL PROGRAMS WITH FUNDED ARTHRITIS PROGRAMS-, PILOT ARTHRITIS PROJECT DIRECTORS; AD HOC ARTHRITIS REVIEW COMMITTEE MEMBERS, AND REGIONAL HEALTH ADMINISTRATORS (for information, only). SUBJECT: Announcement of a Conference on RMP Pilot Arthritis Program, January 19, and 20, 1975. We are pleased to announce that a conference on'the pilot arthritis program presently funded through grants in 29 Regional Medical Programs will be con- vened. Dates: Sunday, and Monday, January 19-20, 1975 Place: Hotel Meuhlebach and Towers Baltimore and Wyandotte at 12th Street, Kansas City Missouri 64105 (Res. 816/471 - 1400) The conference will begin early Sunday morning, and will continue until about 4:00 p.m., Monday afternoon. A block of rooms has been reserved for conference participants for Satur- day and Sunday nights, January 18-19. Single rooms are $17.00 a night, and doubles Are $23.00. Reservations should be 'made personally. Conference Hosts are the Kansas Regional Medical Program, and the Kansas City Division, Arthritis Foundation. Conference Sponsors are the American Academy of Orthopaedic Surgeons, the Arthritis Foundation, and the participating Regional Medical Programs. The purpose of-the conference is to bring together decision-making indivi- duals associated with the pilot arthritis programs to expedite exchange of experiences and problems, facilitate development of mutual assistance activities, and to identify feasible activities which may be undertaken to enhance program quality, and document the pilot arthritis initiative. It is planned to conduct much of the conference in a workshop format. Thus, it is necessary to limit attendance to the number of key program represen- tatives which can be accommodated in a specified number of committee work groups. It is requested that designated alternates be permitted to attend the conference on behalf of Coordinators and Project Directors who cannot attend. 2 Travel and per them costs associated with this conference are appropriate obligations under arthritis project-coordination and evaluation activities, if funds are available. Followup activities which do not constitute program enlargement, including arthritis program surveillance, reporting, coordina- tion, and evaluation, were recommended by the National Advisory Council at its June 1974 meeting. The ongoing RMP responsibility for these functions is recognized, and the earmark ceiling on pilot arthritis activities is not considered by us'to be violated when arthritis is subjected to the same administrative overview as is addressed to other RMP programs. We would appreciate your completing and returning the enclosed statement of intent to assist development of the conference program. I you ave ques- tions about the conference, please contact Mr. Matthew Spear (301/443-1916). yours, Gardell Acting Director Division of Regional Medical Programs Enclosure Date: Matthew H. Spear" Division of Regional Medical Programs Parklaim Building, Room 15-42, D606 Fishers Lane, Rockville, Maryland 20852 Dear Mr. Spear: I plan to attend the pilot arthritis program conference in Kansas City, on January 19-20, 1975. My principal interests are: (please number in prio rity sequence) Educational activities Physicians Paramedical Other (Specify) Patients Program delivers aspects Types of Services Service distribution Program reporting Program evaluation Funding alternatives NAME: TITLE: ADDRESS: PILOT ARTHRITIS PROGRAM Project Director Coordinator Alabama Dr. Gene V. Ball Margaret S. Klapper, M.D. Professor of Medicine Executive Director Division of Clinical Immunology Alabama Regional Medical Program and Rheumatology 1108 South 20th St. (P.O. Box 3256) University of Alabama in Birmingham Birmingham, Alabama 35205 University Station Birmingham. Alabama 35294 AlbaU Dr. Lee Bartholomew Girard J. Craft, M.D. Albany Medical College Director, Albany Regional Med. Prog. 47 New Scotland Avenue Albany Medical College Albany, New York 12208 Department of Postgraduate Medicine Albany, New York 1220 Arizona Mr. Walter L. Benson Dermont W. Melick, M.D. - Southwest ChaDter. Arthritis Foundation Arizona Regional Medical Program 3833 East Second.Street 5725 East 5th Street Tucson, Arizona 85716 Tucson, Arizona 85711 Arkansas Colonel Henry Owens Mr. Roger Warner Arkansas Regional Medical Program Acting Coordinator Evergreen Place, Suite 215 Arkansas Regional Medical Program 1100 North Universiti' Evergreen Place, Suite 215 Little Rock, Arkansas 72207 Evergreen at University Avenue Little Rock, Arkansas 72207 Kelsy J. Caplinger, M.D. President Arkansas Chapter Arthritis Foundation P.O. Box 125 Little Rock, Arkansas 72203 2 PROJECT DIRECTOR COORDINATOR Calif rnia Same Mr. Paul D. Ward Executive Director Ms. Margaret Griffith California Committee on 731 Market Street Regional Medical Programs San Francisco, Calif. 94103 7700 Edgewater Drive Oakland, Calif. 94621 Dr. James J. Castles Associate Professor of Internal Medicine Univ. of Calif., School of Medicine Davis, Calif. 95616 Dr. Ephraim P. Engleman Clinical Professor of Medicine Room 671, HSE Univ. of Calif., San Francisco San Francisco, Calif. 94143 Dr. Richard B. Welch St Mary's Hospital and Medical Center 2200 Hayes Street San Francisco, Calif. 94117 Dr. George J. Friou Professor of Medicine C 1 4 rM- A 41 @'k 1 2025 Zonal Avenue Los Angeles, Calif. 90033 Dr. Michael D. Reynolds Asst. Professor, Rheumatology Division Orang.e County Medical Center 101 The City Drive, S. Orange, Calif. 92668 Dr. H. Walter Emori Assistant Professor of Medicine Loma Linda University, School of Medicine Loma Linda, Calif. 92354 Dr. John Hi n Chairma Depart)ne rch dation t al 037 Dr. F. Richard Convery Associate Professor and Director of Rehabilitation University Hospital 225 W. Dickinson Street San Diego, Calif. 92103 3 e t@Director Coordinator Central New York Edward T. Clark Mr. John J. Murray Central New York Chapter of Director the Arthritis Foundation Central New York Regional Med. Prog. 627 W. Genesee Street 716 East Washington Street Syracuse, New York 13204 Syracuse, New York 13210 Colorado-Wyoming Charley J. Smyth, M.D. Thomas A. Nicholas, M.D. Professor of Medicine and Head, Executive Director Division of Rheumatic Diseases Colorado-Wyoming Regional Med. Prog. University of Colorado School of 410 Franklin Medical Building Medicine 2045 Franklin Street 4200 East 9th Street Denver, Colorado 80205 Denver, Colorado 80220 Georgia Mr. Donald J. Trantow J. Gordon Barrow, M.D. Ceorgia Regional Medical Program Director 938 Peachtree Street, N.E. Georgia Regional Medical Program Atlanta, Georgia 30309 938 Peachtree Street, N.E. Greater Delaw Leonard N. Wolf, M.D. Executive Director Same Greater Delaware Valley Regiona Medical Program 551 West Lancaster Avenue Haverford, Penna. 19041 Warren J. Salmon, M.S. Medical Care Organization & Business Admin. Hahnemann Medical College & Hospital Philadelphia, Penna. 19102 Rodanthi Kitridou, M.D. Director, Div. of Rheumatology Hahnemann Medical College & Hospital Philadelphia, Penna. 19102 Charles D. Tourtelotte, M.D. Chief of Rheumatol.ogy Temple University School of Medicine 3401 No 'Broa Street Philadelphia, Penna. 19140 Greater Delaware Valley (Cont'd) 4 Project Directors Coordinators Allen Myers, M. D. I Chief, Rheumatology Section Dept. of Medicine Univ. of Penna., School of Medicine 210 Maloney Bldg. Philadelphia, Penna 19174 George E. Ertlich, M.b. Director of the Arthritis Center Albert Einstein Medical Center York and Tabor Roads Philadelphia, Pe--ina. 19141 Balu Athreya; M.D. Chief of Rhetunatology Children's Hospital 18th & Bainbridge Streets Philadelphia, Penna 19146 Hawaii Terence A. Rogers', Ph.D. Satoru Izutsu, Ph.D. University of Hawaii School of Medici-ik@-, Executive Director 1960 East-West Road; Regional Medical Program of Honolulu, Hawaii Hawaii, American Samoa, Guam, .Ehe Pacific Islands 770 Kapliolani Bouleval-d Honolulu, Hawaii 96813 Intermountain Ward Studt, M. D, Ward Stu t, M.D. Executive Director. Intermountain RMP.@-- 540 Arapeen Drive Salt Lake City, Utah 84112 Iowa Merlin Paul Strottmann, M.D. Charles W. Caldwell Asst. Prof., Dept. of Internal Medicine Iowa RNP University Hospitals The University Iowa City, Iowa 52242 Oakdale Hospital Oakdale, Iowa, 5231 Kansas Robert Godfrey, M.D. Robert W. Brown, M.D. University of Kansas Medical Center Director 39th and Rainoow Boulevard Kansas Regional Medical Program Kansas City, Kansas 66103 4125 Rainbow Boulevard Kansas City, Kansas 66103 Daniel Stechschulte, M.C. University of Kansas Medical Center 39th &Rainbow Boulevard Kansas City, Kansas 66103 Project Director Coordinator Kansas (Cont'd) John S. Lynch, M.D. Stormont-Vail Hospital 10th & Washburn Topeka, Kansas 66606 E. Dean Bray, M.D. St. John's Hospital P.O. Box 214 Salina, Kansas 67401 Frederick Wolfe, M.D. The Arthritis Foundation, Kansas Chapter 240 Greenwood Wichita, Kansas 67211 Metropolitan D.C. Kenneth I. Austin, M.D. Mr. Vaughan Choate Freedmen's Hospital-College of Medicine Acting Coordinator Howard University Metropolitan Washington Regional 6th and Bryant Street, N.W. Medical Program Washington, D. C. 20001 2007 Eye Street, N.W. Washington, D.C. 20006 Werner P. Barth, M.D. Chairman, Section of Rheumatology Washington Hospital Center 110 Irving Street, N.W. Washington, D. C. 20010 Michigan Ivan F. Duff, M.D. William Graham-Welko, Ph.D. Professor of Internal Medicine an Executive Director Physician-in Charge, Arthritis Div. Michigan Association for Regiona University Hospital Medical Program Ann Arbor, Michigan 48104 1111 Michigan Avenue, Suite 200 East Lansing, Michigan 48823 Mississippi Guy T. Vise, Jr., M.D. Theodore D. Lampton,M.D. Suite 425 Coordinator 971 Lakeland Drive Mississippi Regional Medical Prog. Jackson, Mississippi 39216 880 Lakeland Drive Jackson, Mississippi 39216 6 PROJECT DIRECTOR COORDINATOR New Mexico David A. Bennahum, M.D. Richard Walsh, M.D. Univ. of New Mexico School of Medicine Coordinator Albuquerque, New Mexico 87131. New Mexico RMP 2701 Frontier N.E. UNM Health Sciences Center Albuquerque, New Mexico 87106 North Carolina William J. Yount, M.D. Mr. Ben Weaver Dept. of Medicine, UNC School of Medicine Executive Director N.C. Memorial Hospital Association for the N.C. Chapel Hill, N.C. 27514 Regional Medical Programs P.0' Box 8248 Jesse Earle Roberts, Jr., M.D. Durham, North Carolina 27704 Duke University Medical Center Durham, N.C. 27704 Joh Kline N.C. Arthritis Foundation Durham, N.C. 27704 Paul Young, M.D. )31.dg. 3, Suite G Doctors Park 399 Biltmore Avenue Asheville, N.C. 28801 Robert A. Turner, M.D. Assistant Professor of Medicine Chief of Rheumatology Bowman Cray School of Medicine Winston-Salem, N.C. 27103 North Dakota John L. Magness, M.D. Charles A. Arneson, M.D. 901 Southwood Drive Executive Director Fargo, North Dakota North Dakota RMP 2200 Library Circle Grand Forks, N.D. 58201 Ohio David H. Neustadt, M.D. Mrs. E.L.-Hebbeler Chief, Section on Rheumatic Diseases Director Univ. of Louisville School of Medicine Ohio Valley RNP Louisville, Kentucky 40201 1733 Harrodsburg Road P.O. Box 4098 Lexington, Kentucky 40504 7 Project Director Coordinator Oklahoma.- R. T. Schultz, M.D. Albert M. Donnell Okla University Health Sciences Center Director P. 0. Box 26901 Oklahoma Regional Medic@l Prog. ohlahoma City, Ohkalioma 73190 University of Oklahoma Health Sciences Center P. 0. Box 26901 Oklahoma City, Okla. 73104 Puerto Rico Dr. Esther Ganzalez Pares Universi.ty of Puerto Rico, School of Medicine P.O.Box 5067 Rafael Rivera Castano, M.D. Sa-n Juan, Puerto Rico 00936 Coordinator Puerto Rico RMP Box CG, Caparra Heights San Juan, PUerto Rico 00922 Tennessee Mid-South Edward J. Eyring.-M-.D., Ph.D. Richard 0. Cannon, M.D. East Tenn Children Hospital Director Medical Program Eharles E. Richardson, M.D. 110 - 21st Avenue, South Director of Internal Medicine Nashville, Tenn 37203 Baroness Erlanger Hospital 261 Wiehl St. Chattanoogo, Tenn. 37403 William Sale, M.D. Department of Orthopedics & Rehabilitation Vanderbilt University Nashville, Tenn.. 37232 Texas Frank Emery, M.D. D. K, I-et-,gueo-n Univ. of Texas Medical Branch at Galveston Director Galveston, Texas 77550 Regional Medical Program 4200 North Lamar Boulevard, Bruce Bartholemew, M.D. Suite 200 Texas Tech. Univ. School of Medicine Austin, Texas 87856 Lubbock, Texas Glimer E. Walker, Jr. South Central Arth. Foundation 4814 West Ave. San Antonio, Texas 78213 Project Director - 8 - Coordinator Texas (Cont'd) John Sharp, M.D. Prof. of Internal Medicine Baylor College of Medicine Texas Medical Center Houston, Texas 77025 John D. Smiley Univ. of Texas Health Science Center ot Dallas Dallas, Texas Tri-State Edgar S. Cathcart, M.D. Mr. Robert W. Murphy Assoc Professor of Medicine Executive Director Boston Univ. School of Medicine Tri-State Regional Medical Program Boston, Mass Medical Care and EDucation Foundation, Inc. Vincent Agnello, M.D. I Boston Place, Suite 2248 Chief, Div Rheumatology & Clinican Immunology Boston, Mass 02108 Tufts, New England Medical Center Boston, Mass. Vir&inia Edward Smith, M.D. Eugene R. Perez, M.D. Newport News, Virginia 23604 Virginia Regional Medical Program 700 East Main St., Suite 1025 Richmond, Virginia 23219 Washington-Alaska Robert Vukich Donal R. Sparkman, M.D. Western Washington Chapter Director Arthritis Foundation Washington/Alaska Regional 506 Second Avenue Medical Program Seatt e, Washington 1 1107 N.E. 45th Street Seattle, Washington 98105 Western Pennsylvania Carl H. Eisenbeis, Jr., M.D. David E. Reed, M.D. Medical Director Director Dept. of Comprehensive Medicine & Rehab- fgeste-rn Penns. Regional Med. Prog. St. Margaret Memorial Hospital 200 Meyran Avenue 265 Forty-Sixtti Street Pittsb-ulrgh, Penna 15213 Pittsburgh, Pennsylvania 15201 9 Project Director Coordinator Wisconsin Mr. Donald McNeil Mr. Charles W. Lemke Executive Director Coordinator Arthritis Foundation gf Wisc. Wisconsin Regional Meidical Program 225 E. Michigan Street 5721 Odana Road Milwaukee, Wiconsin 53202 Madison, Wisconsin 53719