I m B&B INF'oRmikiriom & imAmE M^m^ai@Emy 300 @iftoc D=Itnz-s Mau AMC Upoloca M,&IRLJBO$tmt P4^w 040 Z077Z 0 us^ 0 taol) 24@l 10 AR3:ZONA REGI)NAL MEDICAL PROGRAI, RM O'V'055 JULY/AUGUST 1974 REVIEW Application: Requests $403,482 for five new pr,3jects and one continuation project. CI-IP comten--s are favorable and included in the application. Status of RAG-Graptee R@tl2nz,ii-ps POIA=; On July 15, DRMP received a net set of bylaws which were adopted by the RAG on LTune 20. These bylaws appear to reflect compliance by the ARMP with the DRY-P policy. Ho-v-ever, in a tele- phone conversation with the AIUIP Director and his deputy on July 12, DRMP wa,,, informed that there still remains some local concern that the Board of Regents of the Univer@itlr of Arizona may not wish to accept a modified -ole for the grantee in ARMP. The Board will consider the new bylaws on July 20. Should-the Board decide not to approve these bylaws,-the Executive Corrmittee of ARMP, along with the Dean of the College of Medicine, is prepared to recommend that ARMP be permitted to operate under the new bylawE until June 30, 1975 At that time, the ARMP would incorporate and divorce itself from the Univerf,ity, should future conditions permit. The ARMP D(puty Coordinator reported that, even if the Boa:d of Regents accepts the new bylaws, there Ls a gen-ral feeling in ARMP that it should separates from tke University. Legal counsel has been retainer to investigate the ,establishment of a separate organization. Rbqe.;e@.. r Reao-naideration of Council Action on May 1 Application: ARMP requests that the action on the previous application be reconsidered in view of "the apparent misunderstanding about ARMP's continuing commitment for-improving the availability and accessibility of health services in medically underserved areas in response to high priority nee,:Is identified by CHP agencies. To that end, Arizona Page 2 the Executive Committee unanimously agreed that Should the funding level requested in our May 1, 1974, application be restored, such additional funds will be used to support that itment as an indication of a change in priority rating." The May 1 application requested $1,351,128. Counc recommended @860,000. The ARYP was funded at $817,146 with the condition that the ARMP be prohibited for initiating any new activities until it was in full compliance with the RMP Policy on Grantee-Regional Advisory Group Responsibilities. Further, Council noted tliat'the RAG placed the lowest priority on the rather successful activi- ties aimed at improving the availability and accessibility of health services in medically underserved areas. There was some concern that the RAG's decision had been urduly influenced by a representative of the grantee. Change in Chairman of RAG: On June 20, George Bock, M.D. :)f the Indian Health Service, was elected Chairman. Dr. Bock replaces Richard Flynn, M.D., who served as Chairman of the RAG since the beginning of the ARMP in 1967. DRMP anticipates that Dr. Bock will b g a different type of leadership to JMY COMMITTEE'RECOMMENDATTF)N Critique: WO/DRMP 7/16/74 ARIZONA APACHE COCONINO- #Kingman NAVAJO MOHAVE YAVAPAI GILA ESA Pho YUMA MARICOPA PINAL GRAHAM '-'Yuma Tueson o COCHtiE' PIMA CRUZ V.01vemp cn wo 14 o 4i C3 -4 rN r4 C%l 0 od ta 14 tj W W 0 C> 0 0 Ln in C> 0 0 -4 0 L) 0 u F4 cn w 0 0 -t 0 C) 4@ 0 ed r4 C-N 0 0 C-3 0 z o C,4 0, 0 0 0 t4 tn En eq co C" C-3 o D 0 C-i CT 04 cm 0 Lelt C,4 z 0 0 W tn 0 0 0 0 0 0 1.4 0 CT C-N In 0 -4 C:> )Ot.)Ozo4zo .4 0 CIN 0. cn >4 :3 0 CD C> 0 -C :> Ul C> C> cn IN 0 10 %O ID %O %O %D tw tw t" I" I" 4" I" U4 U4 tw, I" 0 $4 0 0 0 0 0 .0 0 0 0 cn C-4 -a cq %O In In. &i 0 f.1 w I- - ...- w 4i t4 .4 tn > es CD cn 13 Ei (4 tA 0 $4 to .4 w 0 (L) tn co 0 > ol > 9: 0 0 0 tA 0 C C.) a$ es 14 en 13L4 -4 40 0 0. 0 co > $4 0 :3 54 w 4J 44 :> C) 0 'a 0 r. A 60 $4 0 cn 0 0) > It .4 00 tn 1.4 4i Ai C4 0 4i r. x 0) r. co $4 0 -4 00 9) Si tn 0) m 4i r. 9: 14 03 $4 X L) P. 0 0 4i 0 c .4 93 0 >. I. 00 $4 - CS co 93 $4 t-) 44 Ca o u 4i Ai C) $4 -4 0) w to cn co :1 P. A. 0 co go 3.4 $4 0 44 0 0 C) 00 0 t-4 a. a 00 I.. 0 @ OL r_ > r. :3 0) t)O r. 0 0 0 z 9 0 $4 a 40 > 0 r: 0 0 cd r. -4 cis w z $4 cn co en C,4 r- 00 %D 'co C-i C4 (4 cn C4 cn M. :4 8 9 8 C-N g I CL, u u u ft ft I - -* *A ft l@ .@@ - I - I ARIZU,4A Mr OVEtVtB4 '@iny I and Julv I ADDlications (3) (4) (5) Budget Pequest Requ.est t. Comp 4 (,/75 9/74 - 6175 7/7/t-6/7@ ro. nent 1/74 6/7t,7/7 Cooo prograii lvlmiiiistratio,, 331,'259 665,400 --O - 665,400 - 0 - 339,690 -0 - 339,690 cool Expansion of Heal@h S rvice St-tes -0 - 20,100 - 0 - 20,100 C002 @tanpower "ecruit-,rcnt 30,000 C003 Self Prov der Educat'i ?n -0 - .30,000 - 0 - 20 D-,velol)meit of Bealth'Information System 103,526 - 0 - - 0 - - 0 22 Reduction of Strep In'ection In I'zo Countie.s -0 - 98,077 - 0 - 88,077 26 Continuat on Educa tioi Service Araas -0 -ii - 0 - 121,203 121,203 27 llypertens on 26,945 140,261 - 0 - 140,261 1 28 EM S 37,855 67,600 - 0 - 67,600 ,'O Fa.@ ly liu se Praction r Education Program - 0 - - 0 - 45,344 45,344 31 Inter-A.-c ey Planning for Rome Health Servicc - 0 - - 0 - 51,500 51,500 3 @-'@dical Ei-ineering I,,' nagement Services - 0 - - 0 - 63,720 63,720 i 33 Improving. Health Care Tnru Self-Plovider Ed., - 0 - - 0 - 74,171 74,171 34 Expansion of Dental S.rvices - 0 - - 'O - -47,544 47,544 .1 TOTAL 499,5@ 403,482 1,754,610 Recor@,m!nded by Jun? NAC-Column (4)Only 860,000 ..40@@A,482 1,263,482 Funde 1. by D',I;P 7 C Column Only 817,146 40'!",482 220,623 For Con;ideration b, July/August Review 403,482 .498,492 4ol JYAVI I/(Specific figures not available) (Note: Fi ures above 'o not I e "earmark !dll Pilot Ay hritis ct which requested $241 638 and approved and funded it $215, Total JuLy I Award wis $1,03 ($817,14@ plus $215,)00) @r: 7/ /74 Arizona @IP P14 00055 MAY/JUI%'F 1974 llrVIr-W Reqticst: @l, 351, 128 Committec Recoininc-,ndation: @860, 000 Overall as sesEiiic!nt by individual reviewers: Below average Critique: Arizona is considered below average for,several reasons, none of which is of recent origin. Non@compliance with DRMP guidelines'- concerning grantee--PIG relationships has made it necessary to withhold certification of the review process of the Region. It appears, also, that individual representatives of the grantee may unduly influence the programmatic direction of-ARMP, includ- ing program staff.activities. Finally, the leadership ability of.the Coordinator is questionable. The RAG membership, which is appointed by the Dean of the Medical School, has recently been increased by six. The staff appears stable. To the Review Committee, this appeared to be a pedestrian appli- cation. Future support of the continuing education program is still under study. The region needs encouragement to move out of the urban areas and to focus on rural health problems. The Regional Advisory Group is scheduled to meet on June 20, 1974 to,review new by-laws. ARMP staff will be in contact with the Region.to determine what progress is being made in this regard. 'f the application at a reduced The Committee recommends approval 0 .final-resolution of the RA@rantee level of $860,000, pendi@4- relationships and verification of a review process. JULY/AUGUST REVIEW Estimated request as of May 1974:$350,000.-425,000 ARIZOTIA - Page 2 NATIOIZAL ADVISORY COUNCIL June 13-14, 1974 Council concurred with the amount recommended by Committee, however, rather than having an award contingent upon resolution of the Rak,-grantee policy and verification of review process, Council recommended approval at $860,000 with the following condition: The ARMP be prohibited from initiating any new activities until the ARMP is in full compliance with the.@IP Polia Concerning Grantee and Reg,ional Advisory Group Responsibilities. DRMP FUNDING DECISION $817,146