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                   S     Y OF REGIONAL 14ED= PPOGRAM REVIEW CMWTTEE DELIBERATIONS ON

                        ISSUES TO BE RESMVED IN MAKFNG SPECIFIC RECO       ATIONS   ON

                                         OPERATICINAL GRANTS PROPOSALS


                   On January 14-15 the Review Committee  considered  in great detail the
                   four operational grants applications  from  Missouri, Kansas, Albany,
                   and Utah. on the basis of  approximately  nine  hours of deliberation.'
                   Many @ortant issues were  explored  which  relate  to the  basis  on
                   which decisions can be reached on  operational  grant applications
                   including both the amount of the award and the terms and conditions
                   associated with the award,  This document summarizes the discussionb,,
                   concentrating on the emphasis given in the discussions to the relation-
                   ship of the particular parts of an application to the whole Regional
                   Medical Program and to the need to encourage  decision  making  and
                   priority setting on 'the regional level,  In the course of these
                   deliberations other issues were also identified but  no  summary  of
                   these will be attempted in this document since they are considered
                   by the Staff to be somewhat peripheral to the main issues faced by
                   the Council in reaching decisions on the operational grants before
                   it at this time,

                   The Committee noted that approximtely $22 million of the $43 million
                   committed to grantees for the Regional Medical Programs  for  FY  67
                   would probably be spent by July 1. 1967,, lea@    a  carryover  into
                   PY 68 of $21 million,  @ver, there was no confirmation as to what
                   additional funds would be forthcoming in PY 68  for  the  Division,
                   Since the four operational grants,...tf funded as requested,  would take
                   a sizable amount of the funds  available,  the  Comittee  discussed
                   equitable       of allotting the funds so that  funds  would  remain
                   available for regions which were to request operational funds later'
                   in FY 68, if their programs warranted support,
                   Of.part@ar concern to the Committee  was  the  criteria  to  use  in
                   dete@ing a level of funding for  a  regional  program,,  and  allied
                   to this concern was the question of how fast funds should be
                   provided (i.t,, how quickly should      'be provided a region to
                   achieve ultimate level of support deemed satisfactory by the C@ttee,)
                   The C@ttee agreed that since awards are not to be made on a formula
                   basis, there must be some way of determining how much is reasonable
                   for a region, based on the application submitted.  After much discus-
                   sion it was suggested that where parameters are not completely defined,
                   or where funds are limited so complete support cannot be given, those
                   aspects of the program which the re-gion believed to be most essential
                   should be supported first,, with the remainder to be  supported  *a
                   experience indicates that the gap areas have been identified and as
                   more funds become available.  There was unan @ ty that if there are
                   aspects of a proposed regional program which are clearly supportable
                   and after giving consideration to the total availability of funds, the
                   Committee should recommend support mahout delay,




                                                                                  2/16/67