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                                                            RMP    Bi-State
                                                            RM 000   56



                  JULY/AUGUST 1974 REVIEW CYCLE-
                  During the May/June 1974 Review Cycle, the Bi-State RMP was awarded
                  $760,136 for the budget period 1/l/74-6/30/75.

                  The July 1 supplemental continuation grant application request
                  $472,458 for initiation of 16 new project activities.  These activities
                  include health manpower (6), quality assurance (3), health care
                  accessibility-underserved (2), local planning, long-tem care, kidney (2)
                  and hypertension.  Project #'s 58 - Interdisciplinary Patient Care
                  Audit Model and 1'60- Quality of Care Evaluation Systpm, are being
                  reviewed by.HSA - B r"e@u of Quality Assurance for conformance to PSRO
                                     u
                  legislation.
                  On pages 19-21 of the -application, the Bi-State RMP has attempted to
                  describe project sites and service areas by county in both Missouri
                  and Illinois.

                  DRMP received additional information regarding CHP review and comment.
                  The Alliance for Regional Camunity Health, Inc. (ARCH) has submitted
                  favorable comments.



























                                                                            MCO  7/15/74




                   MAY/JUNE 1974 REVIEW                             RMP   Bi-State

                      Request:    $1,129,608                        RM 000 56

                      Committee Recommendation:    See Below

                      Overall Assessment by Individual Reviewers:   Average to below averag.e

                      Critique:

                      The reviewers were disturbed that the Program has not  substantially
                      addressed the problems of accessibility and availability of care
                      except for EMS, nor have they addressed themselves to the needs  of
                      minority groups with the exception of Project  #55,  HealthServices
                      Recruitment of Minority Groups, nor to health delivery systems.
                      It was recognized that the Program was in a very difficult  situation
                      because they are attempting to provide a program for the rural  area
                      of Southern Illinois as well as the Metropolitan area in St.  Louis.

                      The proposed two new project activities do not appear to conform with
                      the document entitled, "The Health Needs of Bi-State RMP Region  as
                      identified by Joint RMP and CHP Planning Conference" which met  in
                      February, 1974. Reviewers expressed hope that the  new  activities
                      proposed in the July I application will more adequately reflect  upon
                      those identified needs.

                      Reviewers were surprised that the Bi-State RMP Regional Advisory Group
                      had disbanded and had relinquished its responsibility to a  15-member
                      Executive Committee.  [lope was expressed that a larger Pc-;gional
                      Advisory Committee should provide stronger  leadership.  Reviewers
                      rated Program leadership as minimally satisfactory.

                      Although reviewers did not recommend disapproval of Project #54  -
                      Graduate Follow-up Study, they were not in sympathy with this
                      particular activity.

                      Program staff performance was considered  satisfactory.  Reviewers
                      felt the Bi-State RMP Program Staff request for additional secretarial/
                      clerical assistance is out of proportion to the professional  staff
                      complement.

                      Recommendation:

                      1. Review Committee recommended $800,000 which is 63% of  the  target
                         and $329,608 under the requested amount.
                      2. Review Committee reaffirmed the November 1973  National  Advisory
                         Council recommendation that membership of the Bi-State RMP Regional
                         Advisory Committee should be increased in size and  become  more
                         involved in the decision making-process.

                      JULY/AUGUST REVIEW:

                      Estimated request as of May 1974:  $410,000                MCO 6/4/74
                      NATIONAL ADVISnDy COLINCIL - June 13-14, 1974
                      Council concurred with Conmittee recommendation.
                      DRMP funding decision -  $760,136                  MCO 7/2/74