ltilim liiiiiii PROFILE: WEST VIRGINIA REGIONAL MEDICAL PROGRAM Grantee: West Virginia University Medical Center Current Chief-Executive: Mr. Charles D. Holland (Acting Program Coordinator) Profile originally prepared by: Frank S. Nash Operations Officer Original date: August 1969 Up-dated: December 1969 TABLE OF CONTENTS I. GEOGRAPHY II. DEMOGRAPHY III. POLITICS IV. HISTORICAL REVIEW V. CORE STAFF VI. ORGANIZATION VII. APPENDIX I. GEOGRAPHY The Region conforms to the political boundaries of West Virginia. This determination was made on the basis of patient flow and medical trade area studies. For planning purposes the region is being divided into nine sub- regional:areas. The boundaries of these sub-regional areas are the same as those of C.H.P. and the State Economic Development Department. See map next page. M.. C m rioi rant c kson P. 0 Randolph pt.y on U.ii ncon e Fayett 0 NNest Virgini,.i Regions for Comprehensive Planning W.t fleginns as Defined by West Virginia State Qovelopment Plan le 0 le le 30 4* .11.0 Oo 00 11. DEKOGRAPHY A)@ Population: Approximately 1,811,000 1)@ Approximately 38% urban 2.)@ Approximately 95% white 3.) Median age: 28.5 years B) LancT area: 24,079 sq. miles C) Health Statistics: 1) Mortality rate for heart disease 422/100,000 (high) 21 Mortality rate for cancer 168/100,000 31 Mortality rate for CNS vascular lesions 115/100,000 D)@ Fadilities Statistics: 1): West Virginia University School of Medicine - 4 year school, enrollment 249. Z) There are eleven schools of nursing, eight of them university based. 3) There are seven schools of'medical technology, one at West Virginia University School of Medicine. 4.1 There are ninety-one hospitals (five federal) with 1-5,963 beds (1,396 federal). Seventy-six are short- term facilities. E), Personnel Statistics: 1) As of 1968 there were 1,550 MDs, (85.6/100,000), ill Osteopaths (6.1/100,000). bills in private practice. (il-9,65),. 1,279 or 76/100,000. Registered nurses, 5,011 or 276.6/100.000 (1966) POLITICS -A) Gbvernor@:. Arch A. Moore (R) 1973 B) Senators-- 1), Jennings Randolph (D) 1958-1973; Labor & Public Welfare, Special-Committee on Aging. 2) Robert.C. Byrd (D) 1958-1971; Appropriations C) Representatives: 1).@ Harley.O. Staggers (D), Interstate & Foreign Comerce 2), Robert-R..Mollohan (D) 3). John.Sl&ck (D), Appropriations 4). Kenneth-Heckler (D) 5) James Kee (D), Public Works IV. HISTORICAL REVIEW December, 1965 Dr. Clark K. Sleeth, Dean of the West Virginia University School of Medicine, convened,a meeting to discuss the possibility of the State's partici- pation in RMP. State Departments of Health and Welfare, West Virginia Heart Association, West Virginia Cancer Society, West Virginia Hospital Association, the West Virginia Medical Center and the general public were represented at this first meeting and it was unanimously agreed the State should participate. The Medical Center was elected to initiate and coordinate planning for the estab- lishment of a Program. The West Virginia State Medical Association later endorsed these actions and pledged its participation. April, 1966 - Twenty-eight (28) member advisory group appointed. June, 1966 - First meeting of RAG. Dr. Sleeth was elected Chairman, Dr. Robert J. Marshall was named secre- tary. West Virginia University Medical Center was chosen as the applicant organization for West Virginia RMP. The RAG established an interim 12 member Staff Committee to prepare planning grant application. (This committee was dissolved June, 1968.) December, 1966 Original planning grant awarded $131,348 (D.C.) for 12 months period 1/l/67 to 12/31/67. 02 commitment $175,250. 03 commitment; (6 months) $91,250. Review and Council Concerns: a) The degree to which the regional activity would be expanded into peripheral areas. b) Lack of information on resources of the Medical Center. c) Relationships with other existing programs (Appalachian Health Studies and Development). June, 1967 - Dr. Charles L. Wilbar, Jr. appointed Director of West Virginia RMP. December, 1967 - 02 Planning Continuation grant awarded, new funding of $131,865 and carry-over of $77,045 01 funds for total of $175,250 (D.C.) for period 1/l/68 12/31/68. The focus of planning for 1968 was to be in the following demonstration projects: a) Self Audit of Treatment by Medical Practitioners b) Coronary Care Training at West Virginia University Hospital c) Blacksville Area Survey d) Mechanical Morbidity Reporting Note: The continuation request for $127,632 above the committed amount - to fund the four demonstration projects. The continuation was awarded in the amount committed. May, 1968 - Supplement to planning grant awarded to support the four demonstration projects for 9 months $123,707 (D.C.) for period 4/l/68 - 12/31/68. June, 1968 - Amendment to planning grant to correct prior award to reflect actual end of year grant balance vs. estimated end of year balance. December, 1968 - 03 year planning grant awarded, $237,908 new funds plus $140,137 carryover from 02 and supplement - total $314,628 (D.C.) for period 1/l/69 - 12/31/69. January, 1969 - Program experiences setback due to untimely death of Program Director, Dr. Charles L. Wilbar. June, 1969 - Operational Grant application submitted requesting 4th year core and planning support of $384,661 (D.C.) and support for 7 projects for total re- quest of $694,162 for.period 1/l/69 - 12/31/69. (Application submitted as a request for 3 year's support - 1/l/69 - 12/31/71. Total requested for 3 years " $2,263,285 (D.C.) July, 1969 Site visit,k(pr&operational): Anne Pascasio, PHD, RMP Review Committee, Bruce W. Everist, M.D., RMP National Advisory Council, Desmond O'Dohery, M.D., Consultant. DRMP Staff: Dr. Manegold, Associate Director for RMP, Mr. Robert Jones, Chief, Programs Assistance Branch, Miss Dona Houseal, Grants Review Branch. The site visitors recommended operational status and approval of six of the seven projects; most at a reduced level and for less than 3 years, support. July August, 1969 Committee and Council recommended approval of operational status and approved three of the seven projects (most were reduced in time and amount). Recommended amounts were: 1/l/69,- 12/31/70 - $490,740 (D.C.), 02; $482,767 and, 03 - $555,953 for Core and projects. Note: Funding of this action is held in obeyance pending resolution of Fiscal Year '70 RMP budget. January, 1970 Mr. Charles Holland confirmed as Project Director of West Virginia Regional Medical Program (Medical Direction is provided by University of West Virginia Medical Center Staff and Medical members of R.A.G.) V. CORE STAFF A) Core Staff is located in the West Virginia University Medical Center in Morgantown, West Virginia. B) Charles D. Holland is Program Coordinator. C) As of 12/l/69, seventeen out of thirty budgeted core staff positions are filled. D) See Organization Chart of Core next page. .E) See list of West Virginia RMP Core Staff positions filled, budgeted but currently vacant, and percent of time. VI. ORGANIZATION A) Regional Advisory Group 1) Composed of 35 members representing 14 organizations and includes five representatives of the public appointed by the Governor. 2) Members appointed for three-year terms on staggered basis so that 1/3 of membership may change each year. 3) Currently composed of: 18 MD's, 8 other, 4 hospital adminis- trators, 1 D.O., 1 pharmacist, 2 dentists, 1 nurse. 4) Requests for memberships first reviewed by Executive Committee with final determination made by 2/3's majority vote 6f RAG membership. 5) Officers of RAG elected by majority vote of RAG membership to serve one year term. Officers may be re-elected for one addi- tional term only. 6) Meets quarterly (or more often for called meetings). 7) Functions: a) Advises and participates in the implementation of categori- cal health programs. b) Has full authority to approve all policies, programs, and activities of West Virginia RMP. c) Reviews to approve all project grant proposals. 8) Chairman is Dr. Clark K. Sleeth, Dean, West Virginia University School of Medicine. B) Executive Committee 1) Elected by majority vote of RAG and has 7 members. Must include one each from West Virginia Heart Assn., W. Va. Division of American Cancer Society, the West Va. Medical Center. 2) No agency or institution may have more than one representative on the Executive Committee 3) Chairman of Executive Committee is elected by the RAG. 4) Composition of Execut ive Committee is.reviewed by RAG each year at annual meeting (December or January). A maximum of three changes in membership may be made each year. 5) Meets monthly or more often (on call of Chairman or at request of any three members). 6) Function: Has authority to act for RAG between meetings (subject to ratification of action by RAG at its next meeting). Executive Committee does not have authority to approve grant proposals or to amend or repeal By-Laws. C) Project Review Committee 1) Membership proposed jointly by Chairman of Executive Committee, Chairman of RAG and the Program Coordinator. Confirmation rests with RAG. 2) At least 1/3 of Committee must be members of RAG. 3) Function: a) Responsible for project-review procedures and priority application mechanisms. b) Conducts individual project review and presents written recommendations to the RAG. 4) Reports to Executive Committee at least three times per year. D) Planning Committee 1) Membership proposed jointly by Chairman of RAG, Chairman of Executive Committee and Program Coordinator with confirmation by RAG. 2) At least 1/3 of Committee must be members of RAG. 3) Currently has nine members and meets every other month. 4) Reports at least three times a year to Executive Committee. 5) Function: a) Determines areas of need and recommends priorities for the development of overall program objectives and priorities. NOTE: There are three sub-committees of the Planning Committee: Research, Demonstrations and Education. The Education Sub-committee has Task Forces on Physician E ucation, Nursing Education and Dentistry Education. E) Sub-committee on Research 1) Currently has 5 members. 2) Meets every other month. 3) Reports to Planning Committee. 4) Function: a) Is responsible for keeping abreast of the latest innovative .approaches in delivering health services for recommendation of possible utilization by WARMP. F) Sub-committee on Demonstrations 1) Has 5 members. 2) Meets every other month. 3) Reports to Planning Committee. 4) Function: a) Assists in developing guidelines for community continuing education programs that can be related to local needs and priorities. G) Area Advisory Groups Note: WARMP is in the process of developing an area approach toward regionalization. It is their plan to develop nine areas within the Region(State). These will be coterminous with the comprehensive Health Planning Areas. Each will have an area advisory group which will be responsible for determining area needs and priorities and communicating these to the WARMP staff and RAG. H) Project Development Pattern of Flow SEE charts attached WEST VIRGINIA REGIONAL MEDICAL PROGKAM CORE STAFF Time or Title of Institution Effort Name Position Affiliation % Hours Charles D. Holland Director WVU Medical Center 100 Vacancy Assoc. Dir.. 100 Vacancy Asst. Dir. 100 Warren H. Moss Inform. Officer 100 Vacancy Communic. Specialist 100 Joseph Costello Biostatistician 100 David S. Hall Behavioral Scientist 85 Peter P. Gallina Program Planner 100 'Garvey Gilmore Area Liaison Officer 100 Phyllis Popovich Admin. Assistant 100 Margo Polen Research Asst. 100 Mrs. Snider Secretary III 100 Starlyn Tamaska Secretary II 100 Susan Rush Secretary I 100 Miss Dirkle Secretary I ioo Vacancy Secretary II 100 Vacancy Secretary (Field) 100 New Vacancy Field Representative 100 Wayne Dawson Area Liaison Officer 100 Vacancy Area Liaison Officer 100 Vacancy Area Liaison Officer 100 Vacancy Nurse Coordinator 100 Vacancy Secretary (Field) 100 Vacancy Secretary (Field) 100 Vacancy Secretary (Field) 100 Vacancy Secretary II 100 Medical Self-Audit Assistance Project (six months) Frederick M. Cooley, M.D. Project Director Part time 33 Vacancy Med. Educ. Specialist 100 Pamela Mowry Med. Records Techn. 100 Helen Scipio Secretary III 100 -G-A ----A -T,I- 0 N-A-L li A R T WEIO@T VIRGINIA LIN,14a -PIS T TY RECIONAL DIRECTOR ADVISORY CROUP EXECUTIVE CO'LOIITTEE OFFICE OF OFFICE OF STANDIN .. I., I COI%ZL@L ICATION G AD,MINISTRATION COIOIITTEE@ & iINFO@IATION ASSIttANt 'A ClAtt blp,.r,CTOR SSO D!RtCtOR -=,I DEVEL@ilr@ PROC 0 p I 0 N 9 A14D AT)@TINISTRATIO AREA PL&-qiNT-NC- DATA COLLEC@ RES Eik.% CH ADVISORY AREA A-N D TION AND AoD CROIJPG CONgtTLTATION DIA,,4Aio@ItNT EMUATION PROJECT DFVELOPMENT RFVIEW PROCESS Establish-.ient of objectives and priorities for the Region by the Plan,-.iina Committee with approval of RAG. Primary source of input for the Planning Committee is the Area Advisory Groups' communication statina needs in terms of the categorical diseases - heart disease, cancer, stroke, and related diseases and priorities in terms of.prevention,. diagnosis and treatment, and rehabilitation. .Proaram Staff and RAG Comiiittee Assistance to Projects for i.mplementinc, approved objectives and priorities. Project Review Committee (composed of representatives of RAG committees) view\lry RAG Division of Reaio,,ial Medical Programs -0 "G@ STRATEGY FOR VOLL'NTARY r OPERATIVE ARRAN i NITS ----------------------------------------------------------------------------- A D V I S 0 R Y G R 0 U P DIRECTOR --------------------- p EXECUTIVE COMITTEE c RESOURCE 0 COMM-ITTRES FOR E,-,IGIBLE R ACTIVITIES ?RO@, AM E REGIONAT- I'@UMRT RAG OBJECTIVES z OFFICE 0 0 AED COYuvlj-TEES PRIORITIES cn z C6 s T A F t\Y,q A AREA F o@.CES AREA NEEDS PRIORITIES v 0 HEART DISEASE PREVENT ION AREA ADVISORY @ITPPQRT TO -ARF-A r.TZOUPS C AI\TCER @LAC-XQS IS- STROK-L TREA @N-L x 9 ADV- I.SORY GROUPS RET,AT@.D DISEASES REHABI'ITKTION L ---------------- ----- --------------------------------------------------------