REGIO'@@AL IIEDICAL PPOrRAI-1c, ST,,-RXTICE .N(-@e-,ing wit'-h 'rtliri-t-4s CoiTiTnittee on RYP February 9,,. 1974 Proposed Discussion PI-an I'@od.@-rator: l@r. Cleveland (Bob) Chambliss Acting Director, IUIPS, HRA A. Introduction of Attendees Mr. Chambliss Arthritis Committee rl,:,p Coord-'Li-iatoi:s Ri,r2S Staff B. Objectives of the Ileeting Mr. Chambliss C. Ilow - Why Arthritis in @T Appropriation Mr. Ward D. Overview of the Status & Needs in Arthritis Dr. Engleman E. Review of MV Program Development Mr. Peterson F. Pd-T Organization & Practices- Mrs. Silsbee G. Financial Processes & Problems Mr. Gardell H. Legislative Matters Mr. Baum I. Program Problems Mr. Chambliss & Staff J. Defining/Developing Arthritis Program @T - ARA Discussion Note: If discussion is needed beyond 12:00 o'clock, the meeting will reconvene in this room when-, the ARA participants complete their other meeting. All who can stay over are invited to participate in these further discussions. DI'3'CUSc-ION GUIDE LM,2etin@ on Arthritis 8:30 an Fe'bruary 9, '--974 iesda Holiday Inn, L4brary 7 (7th Floor) Bet" S120 Wigcnniin Ave Discussion Area Discussion Leader Notes A. !NT'@RODUCTIOYQ- Mr. Chanbliss 1. Arthritis Committee 2. Rif? Coordinators 3. PI-,@, S S t a -,-@ r- B. OBJECTIVES OF TIIE IIEE@LING Mr. Chambliss 1. To exchange information and perspectives on Ar-hr-1.@4s in the @T settin-. L.L To ide-,iti'Ly Arthr-@-t,4.s i:)-fo&ram objectives and Activities To d4-scuss najor -,Dolicies To discuss the sc@ledule of grant appl-ica- t4-ons and review processes Th'a was originally schedulled fo".and at Noo-i, because our have another -,midday meeting. In view of the many matters T"P- !lave to discuss, Dr. E,-i-ler.,iaii and Mr. ST)ear have agreed to con- tinue discussions this afternoon, if more time is needed. Alilof of you are invited to continue your participation in the extended r.cetir,-g this afternoon. if your schedules permit. To assure that we hear th-- @ie@s of everyone, I propose that we procedd as fol- lows: I will ask l@ir. Ward to generally discuss how the Arthritis -=la-@i,-Uage got @-Itto the Senate appropriations language. C, - The-,@;,,I will a,@k Dr. E.-Laleman to give us an overview of the concept of an Arthritis Center, and the status of Arthri- t-Ts resources around the country. - Then, I will ask our Staff members to'discuss background procedures and requirements of the P,@iPS. - F@-inally, we shal-,. undertake more detailed discussions abiDut -2- Discussiton Area Discussion Leader Notes the Arthritis '-Pr@-graiT, which should be ,,ndertaken--- objectives, operational emphasis, and proarari criteria. This is the part that may require more time th-i-§@-afternoon. We want zo be sure to tap your expertise and experience while we have this o-,oportur,4ty for face-to-face conversation. I Hope that we can proceed in a very informal manner, and that everyone in the room will feel free to contribute to all conversations. Each person should feal free to ask questions, or interject clarifying, or illustrative comments at any time. Of course, if anyone has a prepared statement, we wil'i- be glad to hear that, and defer comments aid questions tlntil after the statement. C. HOW ARTTIPITIS LLN-GUAGE GOT IN THE @ APPROPRIATMON Mr. Ward 1. Sequence of events Basis of the $4.5 million figure ($4,275,000 net to program) @3. @@P concept of A-ctqritis @',rogram. D. OVEi-jV'LF@14 OF THE FIELD OF ARTEPITIS Dr. Engleman 1. Concept of an Arthtitis Center 2. Present status of Ar--hritis resources 3. Salient needs to advance, or improve program. E. '.@,,hV.IEW OF P,.@ PIZOGP-4-M Mr. Peterson (Hand-outs: Fact Book; '@kl@,'-ss-Lon Staterrert; P.L. 91-515) 1. Sirun,@ry history cf P@- , and milestones of the program 2. Orgar-ization of 1. Ei..,Da-iided atthori of 'L970 amendments (kidney, y primary care, quality of care, 910, contracts, etc) - 9- -3- Disc@iss4-on Area-."- Discussion Leader Notes 4. Program phaseout announcements, exten- fpeterson, con t) s'loris, possible proaram. deadlines. F. DESCRIPTION OF @NIP ORGANIZATION & PRACTICES Mrs. Silsbee (Handouts: @-RAC-Coordinator-Grantee Relationships; Training Policy) 1. Oraanization a. Grantees: fee.-stand4-@Ig VS university, or other. b. RAG structure & role C. Technical committees d. Coordinator & staff roles, and opera- tional prb4ects e. Number of operating @ 's, & staffing. 2. Review Process a. MT accreditation b. Technical & RAG reviews; local -review process CAI CIIP & RO rol@es, and differences 904-vs 910 d. Headquarters reviews; Council involvement. .@.)Direct ?HPS or other Federal- review of speci-aJ. -Drc)ject classes; e'-g., kid- ,ley, Probably Arthritis. PROCESSES AND PROB-UE@c' Mr. Gardell .-andout: Listi.ng of RMP'S, and Grantees) threuyh Juie 30. 2. Su@'Lt OnL@@ Court 3. @,,ei-ease of 1973 -.r.,-)oundm,2nt and balance of l@'74 f-ar@ds. atiori of Ju-.e 30 termination date. No P,,@T's in Ohio,,and DelaiTa-@e -- problems IllO interests af@c@.zted by releases of large r s,,L-,.s -Lnl--eres,-- -;-r, otherprogram. -7 "- - -,@, , ;__ , t-.; ^- @ -4- T Notes Area Discussion Leader H. LEGISLATIVE P-ROSPECTS Mr. Baum 1. Roy, Rogers, Hastiiigs bill 2. Possible HEW, or other bills 3. Kno@7n proposals would terminate @RNP, CHP, and Hill-Burton, and replace these with new program focused or, facility & service planning & cost containment 4. Fe aware of opportunity to mesh RIT arthri- tis program with Cranston Bill. 1. BASIC PROBL'f2-IS ASSOCIATED WITH iLRm@ILIRITIS PROGPLM Mr. Chambliss & Staff 1. Timing, working back-T,7ard .from 6/30/74 Location of Program fi@-@a.-icing Applicatio-,qs station, ar- any being written may",? How many sh,@uld we expect? Li-kl--i-hood of goo6 program results if funds are l,ipiited to one ycar 5. Ability of Centers to continue activities after Pederal funds are terminated. (i. Probfo'L@a application forms, and reports. 7. Review, negotiation & awards. j. DEI'INING & DEVELOPING THE ARTHRITIS PROGRAM RNP and ARA joint discussion Meaning of appropriation language --- to what extent must we let this limit our outlook? (Fina-,icial & strategic 2. Arthritis Program Object4-ves --- what is it that need for tight, well-run We SpeC4fcally i-ite-@id to do? programs.) 3. I,,rnat is the scope, and variety of resources now in place on Which we can build? 4. What are the need@3 in Arthritis? a. Prioritize them. b. Classify them as long term/short term. c. Classify them as achievable within 12 - 18 months. -4- -5- Discussion Area Discussion Leader Notes What is an Arthritis Center? .................. Normal ........... Optimal 3 basic R@IP needs: - location a. Objectives, and - purpose how t'@ley can be - governing body met. - contact with State/local agencies b. Program outline, - services to focus activitii staffin- and improve C> s@ln,,,Ie/multip'Le -L-eciii-ty counseling. geographic, -Drofessi-onal,or c. Criteria,.evalun- other boundaries tion of adminis- - relationship with other, related tration, services services or resources and nroduct. - non-physic4@an participation 6. Program roles of noii-center resources & services a. Shoald@.,ue consider other applicants? b. Should there be special contracted studies? c. Shall affiliations be required? d. What referral channels are needed? 1) How can this be achieved? e. What Arthritis training/education is' needed outside the Centerl 1) How can this be achieved? 2) To what e-z@tent can lay persons be trained/used in delivery of services? 3) Tvhat continuing education is needed? 7. Involvement of other Professions a. Who are they! b. Where are they, as a general pattern? c. How can they be -Trade to feel a part of the act? 1) Should we require their input in application development? If so, how? d. How can professional resources be brought to bear on the stated-r,.,E@-ds? 1) Orthopedic surgeons 2) The Therapists -5- -6- Discussion Area Discussion Leader Notes 3)Comr.unity hc--zD!tals clinics Private 14C P ub @@T,@ consumers S. Advisory Grou s p a. I%That, if any, are needed? b. Vlhere, and for vihat purpose? c. Who shall they be (membership)? d. Is there a ro'Le for a "mini peer assessment" group to review and report on program progress? e. Is there a role for travellin- consultant groups to consult, advise, demonstrate f. How can any of the above which are desirable,, and feasible, be called into being? Program requirements a. Given implications of above considerations, and other considerations, v7hat shall be the requirements to which grant applications must be responsive? 1) Location Z') Purpose 3) Existing resources/competencies 4) Participation a) Pro@Lessional b) Conuiun--t ty c) Othcr 5) Outreach measures 6)=Coordina-@ion of serkices 7) Training 8) Reportin- 9) Budget 10) Other -7- Discussion Area Discussion Leader Notes What are the criteria by which applications shall be evaluated? 11. What are the values, or measures by which prograra.; proktegs shall be evaluated?