I i*MN Ilti p C- Statiic, of-' the Reg-'Lon: The Pi,,erto l@"-'co Pj'IP is ill an @;tat @IF, r,)rior to application. J-t @,,as in tli@,, process ol: lrepariiig its first tric@ri-,@tia.1 ap-pl,@,-catI.or, whe@ii the ]@ebrut,-@,,.@7y ]-()72 phas,@@ out telegram was received. The Program was last revJ-ew@cl by the Jiin@- 1972 @vAC. review @,@as based on the Coll-IMitteets reco,,P-,reiicla- tiC,ll, a, S-t@,P reCOTrj,,iendal:@,-o-j-i and a Dc-,;cc-ffi'b(,r 1971, f@-if'S staff a@-sistaTir-e visits Cot-incil accepted the Revie,,?- Cop,-,iiii.tte(, ,P,on-,-,nendatioii for increased support. Alt:hotizl-i conditions rot the absence of health and nTarsi.ng oii the P-ro,,vr,7,x, Staff an(] the FJ@G, and both the coirt ositi(,ri and peoii-aphi.cal distribution of p 0 P,A(@ members were express6d concerns. l-,a,-Adeqijat(@ contribution from the private. physician -in(! private hospital sector rema-,-nc.,.@,..l a continuing problem. The Program was initially scheduled for complete phase out on June '@50, 1973, as requested. The Region received $41,666 -in Au-ust 1973 (FY 74 funds) and the use of Linobligat8d funds awarded Drior to the phase out to continue operations. The remaining $173,794 allocation provided from the Departmental $17.lYi release -@,7as awarded per the attached back-up sheet. Current Status of the Region's Funding * FY 73 annualized level prior to phase out $1,000@000 * FY 73 l@AC recommended funding level $1,100,000 * Percent of total FY 73 funds - 1.26% * Maximum allocation from FY 7 un s $ 51@9,573 * -FY 74 funds awarded October 1, 1973 $ 215,460 * Maximum FY 74 funds remaining for allocation Jan. 74 $ 304,113 Pag,r-@ 2 - Puerto I'lico PI"TP III. Significant Evep-ts Since the Last Council Review A PdiPS staff visit was uiade In 1972 to discuss the NAC review a,-i(I provide ori.c,,r@tatiori pbotit lll,,'PS organizational structure T)olici.es a:Li.O. review procedures to t:i-ie new Puerto Rico P'@,,p administrator. * ti. llanage@m(@-.-ftt Survey wE,.E,, initiated in October 1972. The survey did riot disclose any gross Toanc@g(@@i'flr@tit deficiencies although several constructive recor!mend,.@,ti.,c)T),s were )il.,gdc@. The te@iiii found major iinprove,-aents relative to Proc,raui Staff and the ri,\-C@. C, * A Review Process verification visit was conducted in late October. The review process was riot certified pending f4 nal structuring and formalization of process. Docuirentation was received in late January 1973 that responded to questions raised during the verifi- cation visit. IT,.PS follow-up action was not completed. * Dr. Jorge Fernandez, Program Coordinator, appo4llnted Rafael r,.ivera-Cast@no, M.D., M.P.H., as Acti-Lig Coordinator in September 1972 while he was working on a Co@@n--ii.ttee foy National. Hca'ltii lnszj,ra-,.ice for Puerto Pico. Effective Septei,,,,]:)-C,@r 1, 1973, Dr. Rivera was appointed Coordinator. Dr. Fernandez has remained on the Progrim Staff (50% effor+,-) and is Pro-ect Director of a grant to the Puerto Rico Departin(.!j@it of Heei.ltli that is designed for trairiirc, of auxiliary personnel in dental health. 0 * Dr. Merlin Lugo-Fari'a, Chairinan of the RAG resigned subsequent to joining the staff of the VA hospital in Houston, Texas. Mr. Joel R. Garcia is the new RAG Chairman. * Program Staff Professional Tech & Secy Total Dec. 72 18 13 31 July 73 3 5 8 Now 4 8 12 AI,T,G(;AT'I(-)N BY 01)'I'1014' D-Kiciiic@y Ij'i.sc-,ase I,'Y 7 4 I y 1) c r t c i,, so n 'G I O'-,l PI 1, Puerto PicO R,,.i 0 0 C.) r. 5 10/]-/73-1-2/31/73 $ 17 3, 79,@** l@6 6 11110,111-"CT & ID. A B c D L OTIIER COOO Program Staff 73,1 C001 Health l@@anpoi,;er Development 54,@79 C002 Projett Evaluation 23,656 C003 Health Plannin@ l@ssistanCE 22,453 TOTAL 100,688 7-3,lC **In addition,' $35,000 has been awarded for Pediatric Pulmonary Disease *A@.7ardod 8/27/-73 fo" S473 L,, y ooc! @'L C t 'The o l@)c@(.n a e r,. A, 't" c, the- or). idn(.,@y a r@ I r ri c df Staff Rr@..c y JI.Z,4ps ,.;taff h StE;Lff t (a) d (b 17i @-i l'i c- 6 (c) or y- (d) ti@,,ixi of I uer,t@o ll,:@Lc 1, 1973. o@3 0 f 8 2 5 461 C- 02 l@ t Evalt!@ 2 i.1;8 -u 0 1. I p t i f f@ 4 -1,024 I 9 Pr() r,,3.ni f ox,, Atj,(' IRI't lo Y, 33,684 10 7B C&).-e ii), 1.3,000 @i@ s i@r Cai-e C)f -3.,otal@ @AI:L ProjecL@ C iv]2@.tY I,, t 68, 9 6 35 J. per 55. 6% 44.4 ,ent c t r 1 4 rejects,; c L@: i,@t to c(-@ e, '(i r@4i- i, t y 0'r coT.@t C C@l t (I LI T-, C (urrc--nt of tl),,@ PY to r@iii,,se out I.ev,,-@l. as of Jan. 1, 197'@1) F.eg:!.on's percent cj:C t(.@i.-al FY 73 1,26i. A.I.I.Cicctior@c, J-or FY 7!@ fund,,,; Am-ount of FY 74 ftiiid@,; to Oc'cober I., .1-97--@ -@ $215,460 Airount of PY 74 fi.inei,,; rcr:iain-,Ir.,r), to lieLti.oT,) @or allocation. January 1, 1974 - $30491-i'd, III. 34 Events Siric(-- last Council Revie@;: Staff Vis-.;.t was ra(le on three Fj'.iS Troject's iii. July 1973 of by-lalys to confc)rnt to IL@,"PS I)<)-icy concerning grap.tee and IV@G and relatic)i-tE,,hips T @st Vi):- abi.e to retain al -t:af f he 1%7L ,@:Lriia i@14P has I)eet'i .1 progr, -, @ c ,, o t ,,it have fotxrl.(] in other health tr,z,,r,tjers ex tw related agencies. 2't o r t i@ C C@ f,) 2'r S R 1 7 5 C,,i 2 iq C003 C 1) i 1 25 , (')O@) I- 5.,4 8 1175,0/,,2 25, 00,@ To -LE; 2 0 @l 1,6 'I 2 4 he, t@o c)" t hc -.L.:c j? o s I J- f d Ti ri s c) 7 1-972, c,, u f 7 h),,.rlcl@) ye@ic. s t@ @i'@ r f Py,o csf7, c@ d i 1. F'Y )-")74 fc).r, of a]-141 'c@nca. ,,s i.n @@t@ tc) i:)Iicat-i,.orl 7i-id ai .1@Cc tic)ri. 11@he l@est I as itt@ t e,,ne, this ai) 25. TI-@(@@ )..rleet:i,,ng o f th,@,@@ 3?.ZLf@, 4 S l,iritt ri cl",,@, li,ty c@i3, @-t-,l c-@d Cc@ rti. ce, t:L@)3.1 ol- 7-.;@ @l $'@14 O'i 3 tl a-[ W Th(,- I)y t @a ,3 t i@@! c,, i. C @-(T c@ Thc@ 1.@l. ty r c) 'c. an,,:i e @i:@ c@ FL,, @Lt v -t@ ty@ U ri v c:,,- s,@. c', @c@ s n a - a i i). pr( s a t t the t i v @i vc: @s ,-C. - c@ cut a t@C) El VI. 11/21-/73 Pr ,I-5 28 0 COO' 5 8 s r t i C 0 C f i i .@)4,i 073 (:005 C@' i-L C006 4) C@ L 6 1 31-, y 49@@)59 7 31, OC)O .152, 80/i 5 0. 2 1. .3 0. 2 FLOI@,IDI.N @,IP Status of the The Florida M-@,IP iio@,i in its 05 operational year (2nd Year TrionniLmi) received triennial status beginning ilarcii I., 1972, during the February 1972 Natior,al. Aclv@@soi-y Council. CoLmci-l's actions were agreement with the findings and recongnen.dati.o.Tis of the January 1972 R(-@view Coll)jnittoe and Site Visit Teain (conducted T)ocember 1971) with rocolTmiend-ed funding levels including a Developni--ntal Component) of the following: Fourth Year: $1,927,706 Fifth Year: $1,987,250 Sixth Year: $1,964,775 These funding levels included fundsfora-ronal project of $375,000 for the fourth year; $313,500 for the fifth year and $251,625 for the sixth year. By special action during the June 1972 N-AC, the previous NAC approved level of $1,927,706 was increased by $321 000 to a total annualized. level of $2,248,706. The action of the February 1973 iNtNC was in agreement with SARP and Rc--view Co,-fuTiittee's i-econ,.meiidatioi-i that the region's second year triennial application (05 operational year) be funded at the Council approved level of $2,248,706 including a developmental coii4)oi-ieiit and kidney activities. No key issues were identified. Florida's temination. date under the phaseout concept was November 30, 1973. The region siib,-iii-tted a plan which requested funds for t c continuation, of 14 operational activities, initiation of nine now studies and the gradual reduction to a staff of 12 botivcen June 1973 ,ciiicl February 15, 1974. The approved phase-but plan was for the reduction of program staff to 12, the continuation of three of the 14 operational activities, and the initiation of one study through November 30, 1973. II. Current Status of the ReEion's Funding: FY 173 annualized level prior to phaseout ....................... $2.%248)706 Region's percent of total FY 173 funds .... ........ 2.83% Region's maximum allocation from FY 174 i@as .......................... $1,166,978 Amount FY 174 funds awarded the Reuion 10/l/73 .......... i ....... $483,930 @imum l,Y 174 funds remaining to Region for allocation 1/l/74...$683,040 111. Significant Events Since Last Council Review: None B-Qu@ility Assurance ALI,OCATION BY OPTION FY 74 D-Kidney Disease E-Ilypertension Florida 00024 REGION- 101/73-12/31/73 413,130 PERIOD- PROJECT & PROGIWI ID. A c D E OTHER COOO Program Staff 175 0001 Comm. Based Midwidery Study 9,500, C002 Quality Standards for Rehabilitation 8,750 C003 Quality Standards for Car( of Burn Patients 7,500 C004 PSRQ - Quality Aasuranc6 Program 10,000 COb5 Neonatal EMS Network 50,403 6 Development of Policy & Procedures for Ed. alS 3)500 46A Hospital Required Infect- ion Surveilance (Miimi) 30,000 46B Hospital Required Infec- tion Surveillance (Tampa) 19,261 102 Community Hospital Output Drug Incompatibility Study 4,500 118 Blood Bank Managpment Control System Stud 4,150, y lig Data Bank for Health 'Planning 14,500 122 State and Area l@+ Wide lilth. Planning Process 40,0 00 Study 123 KiAney Reporting And Assessment Information Sys. 5,000 Community Based.Ilyperten-. sion Control Program 26'866 125 Community Based 1,1@-inpoiTer Development & ljtili. Prog. 75,00.0 FI,OIUDA I)li%,Fl I. Status of the R(@t)i.on: The Florida now in its 05 operational year (2nd. Year Trienni.Lmi) received triennial status be(Tinninf,, @,farch 1, .1972, during the Febr-uar), 1.972 National Advisory Council.. Councills actions were :Ln agreement with the findings and reconD-nend,-iti-ons of January '1972 rxlevi-e,%T Cofii-nittee and Site Visit 'I'c-wii (conducted DeceTiil-)or 1971) with -recoimici-idod fundinc, levels (including a Developifiontal Component) of the following: Fourth Year: $1.,927,706 Fifth Year: $1,987,250 Sixth Year: $1,964,775 These funding levels included f.-undsforare-nal pro 'ject of $375,000 for the fourth ),ear; $313,5C)O for the fifth year and $251.,625 for the sixth year. By special action during the June 1972 NAC, the previous NAC approved level- of $1,927,706 was increased by $321,000 to a total annualized level of $2)248,706. The action of the February 1973 NAC was in agreement with SARP and Review Committee's recommendation that the region.'s second year triennial application (05 operational. year) be f-iuided at the CoLuitil approved level of $2,248,706 including a developmental component and kidney activities. No key issues were identified. Flori(tals termination date under the phaseout concept was November 30, 1973. The region submitted a plan which requested -f-Luids for the continuation of 14 operational activities, initiation of nine new studies and the gradual reduction to a staff of 12 between June 2.973 u-id February 15, 1974. The approved phase-out plan was for the reduction of pi,og-rmi staff to 12, the continuation of three of tJie 14 operational activities, and the initiation of one study through November 30, 1973. II. Current Status of the Region's Fmdi-ncr- . FY 173 annualized level prior to phase-out ....................... $2)248.s7O6 . Region's percent of total FY 173 funds ... 0 ........... ........... . 3 . Region's maximum allocation from FY 174 funds ........ : ........... $1,166,978 . Amount FY '74 funds awarded the Regi-oi-i 10/l/73 .................. $4833,930 . @-laximum.FY 174 funds remaining to Region for allocation 1/i/74 ... $683,040 III. Significant E@vents Since Last Comcil Review: None B-Quality Assurance AI,LOCATION BY OPTION C-F'ilis D-Kidney Disease FY 74 E-Iiypertensioii PIIGION Florida 00024 PEIZIOD 101/73-12/31/173 $ 483,930 PR,OJECT & PP,,OGIZAM ID. B c D E OTIIER COOO Program Staff 175,0( 0001 Comn. Based Midwidery Study 9,500 C002 Quality Standards for Rehabilitation 8,750 C003 Quality Standards for Car( of Burn Patients 7,500. C004 PSPP - Quality Aastirance Program 10,000 C065 Neonatal IIIS Network 50@403 6 Development of Policy & Procedures for Ed. D-IS 3,500 'lie 46A Hospital Required Infact- ion Surveilance (Miami) 30@000 46B Hos ital- Required Infec- p tion Surveillance (Tampa) 19,261 102 -Community Bos-pital. Output Drug Incompatibility Study 4,500 118 Blood Bank Management Control System Study 4,150, 119 Data Bank for Ilealth @Planning 14,500 122 State and Area Wh4: I-lide Hlth. Planning Process Study 40,0 00 TV) 1.23 Kidney Reporting and Assessment Information Sys. 5,000 Community Based.flyperten-. sion Control Program 26'866 Community Based Manpower Development & Utili. Prog. _E@@O q 0 IIROGR/-@l -f(.@,c.tivel-,7 utilize t -ty to l@@f its J.,-'Y '74 @-I few i,7c-rc, tr3r@-ai-i-t,.ited, the key pro@,,.i-ani staff i.i-itact the pliasE!-o@it period. /,@s Of @fLi-o..e 30, 1.973, I'@ro-r&,in staff consisted of profess@t@,)t7Lj.].-- and t@ei.-L support stz)f-f. ']'I-le .@)reseT-it staff consists of one I)rc;fes@-,ic)iial, 1-4 professionals and fi.@v(.@ @:3-Li])port staff. r(.@gion is r(.@,-juesting, a total of 1.2 new program staff fu'i-]---tiii,.e ProYrail'. Manager positioyi,,-,,; one and eight i:l(@w support staff Tlj@- present staff represents a broad range of expertise including competence :in fiscal Trt@ti-iage-@ nciit, program design and develol?@,@ienL, evaluation, journalism, communications and piil)],i.c-.ations an(7i nursing education. The Florida P,LEP as -i.p. the. past continues to demonstrate. flexibility, ingenuity and in adapting and responding to TRIPS in-i,tat--'t.ves solve the heal.'L@'!,i -problems of the State. For example, tho@ region, prior to the hire that funds for EMS programs wer-(-@ available through @.IPS, the FR@LT (.IevcloT)ed and I..Mpl-@ine-rited a 1.)lai--) for EMS. A system of district EMS L Advisory Couzncil completed col,7er-i..i-.,- o' 1. areas of the state prbvi.exii:i-, opportunity for refl.iieii nt of broider system recommendations developed 13Y the State 1',,.@I.S Council and its spe(-i I technical Co@l-l'i'Ti-@l.t'L-(@cS. '-Phi.,3 ,cicti,vi.tv rccc--,,.t.-Ly received i-ri al)prol)@j,-i--- ation from the State -,i.ii zii:i amount of ov,c@,r $600,000 and is noi,7 operating -v.7ithout 'Li@ll-tlicr FPJ.T-T@ Iziu.pport under the auspices of the Il.c)rida Dpl)a-@tmer).t of Hc@,-Llth a@-j,d S&rvices/Division of Ilealth. Establishment of a state--N,7id.e lad@aey procram also C, demonstrates another area in i,,Tliicl-i the preceded the establishment of- special. federal funds for this purpose. Florida n.ow has a system of transplant cen.ters, an orocin procui,c@iiient program ind dialysis support facilities. St--ate funds in the Liinount.of nearly $500,000 have been appropriated to ;upport this program during fiscal year 1974. 1,1@til,e the issue of quality care evaluation. has not been seen as anurgentproblem in the State of Florida, the FRNP, as a result of the PYI?S new y)rioritie ,; and options, has been asked and is assisting in promoting and establishing quality assurance programs for health care providers in selected i,re-z@ts of the state. Based on its close iiiivolveiyt@@,nt in the plannirt- development and implementation Page 2 -- vlorl.da of the South.c@astern Iriter-JI.c@gional SyT3@pos4 ,,.LLM On QLtality Care T@val.ual-ion --I-n 1.9'72, the T)rocec.'I.(-'-d to traTl,,31-ate- this to meet Florl.da's needs tliroug'@.i a of @,7c)rl,,sl-i()T,,s ii:i Quality of Care i@i)@ community hospitals in South Flori a. The Regional. Advisory Gy@oi@p, cc)rrposp@cl of 27 -voting members has re@-@@a@Lned intact and active and conl--!.tLt.,,es to be a -v:Lable licialth improvement force. Tlii-oti!@@liout the I)ita@(.@-c)ut period, the Group its co-,Prit@.tec@,s has crnt--!..riued to ifiec,,t to clc@fi.ii.e probleri areas, devel-op new priorities and z?,.ppr@.iise in reJ.@ition to priorities and suggest areas for future The 1',',A.C has meet three tinLes during the current year wi.th an average attendance of 60 percent. V. Analysis of the Current AI)pl.icati.on Floi..-ida.'s application requests the fij-]-l rc-@mainin @1.1. 1 o c,-, t i o ii of @683,048 for the perio@l January I., ]@974 -- Juitc@ 30, 1974. The application @,.ras reviei,-,,-,.d and ful-ly endorsed by the ReF,,io-@i,).l Advisory Group on O(--tol)(--r 14, 1973. The Pro@,,-rant plan Includes requests for support of new pro- cct activities which i%till be conducted under contract between the Inc. , and various inst-littiti.Ol'IS and agencies in the State of Fl-oridi,; I)roject-I.ike acti.-vitiec, to be conducted by the Ilroe,rai@i Stif:E and support of the Program Staff itself. Of the activities included i-ii. the application, seven address the P@r.[,S option -@rea of Strc@ngtliening Local I'll.annin.-, I"rocesscs; seven are to '3tr(@@notl-ien Local Quality Assurance Efforts; four are directed to EMS; and two are directed to Kidii.(--@y Disease. Florida's record in the area of att,,-,.icti.i-),,- non-IUIP funds to support successful activities has been The region states that for every P@ dollar invested in. the State of Florida, more than five dollars in local- support @,,ere generated. Duri.ng 1972 - 1973, of a total of thi-@-t-y-four program el.ements, thirty--tl,7o were continued without further FRIIP support. Each activity presented in this application outlines the reCi.onts plans for those activities requiring ongoing support beyond June 30) 1974. Of the twenty new activities requested, eight wi terminate June 30, 1974. VI. Staff 'Recoimnenda,tioii: The Florida IOJP has requested $627,536 for the support of a program staff Component and twenty operational activities, all of which conform to the PJ@IPS priorities and options. Pkl"e al of the South C(--ntrcil. T'@raiich @3tzi:Ef re(--Gmjnei-i(,'@s ,pprov -tp-l@l-Lcation as Ti-ie Florida appli@ r(@qLie,,;t,,-, for the support of t@@@,ro Kidiic-y Cc)inpo-aeiits. The region stioti:].cl be a'ic-.,-i@'ted to them provision Contained iT) the Interirii. Rill.@-r3 issitE.--.@l i-ir@@lc2r Ti.tl.e #20, Chapter 3 t 4 0 5 of the SSA.- #5, a@. cle-,-@,il. 1-7(-,alth '!'his regulation. perta:ins to payi,'IE@nt for se@rvi,ces in. kid-aey and renal dialysis to entitled SCOB/DOD 11/20/73 I)a@te 1of 2 I y @/i y I)c,,17 c C- @j c)n lf'(@lo'@ ]--.1-ori.da 00024 I/ 1/7 4 -6/30/74 $ 683@048 A COOO-Prbgr@iiii S't 322,203 C-123-Ki.dl@).E@y 1.)j.sea--,e Rlc@j)orti.ng a2,id. Inf-o. Sys te:[-a I.O. 000 21,64.5 C-142-E@iS-I)al.m 1',each 30,000 C'143-QLiality Standards for Care of Patients ls,ooo C-144@-PSRO-Ql-l@i-lity Assuranc PT,og@r@aiii 20 ooo 6 of Policy and Ili.-ocedures for iiiergejic>r f@,I)ar4@ments 7,000 C-147@-Comiiiti@riit), Based N@-diqlfery Sti-ic'ty 20 , SC)D C-i48 Ouali-ty St;3i-idard-s 17, Soo C-149-N@lodel for Quality Ca.r,@,, Assessinerit in a D@i-sease Catego@r., 5,000 C-151-Goiietical-ly Do',--Crmiiie([ Disease R(,-soi,irce, Study 3S@000 C-152@-Quality @lodica.1 Care Standards for Sliort, l'orin Peiial Tn,;titutions 35,000 C-1.53-Qi.i-ali.ty Stiiid.ards for Care of Rei-ial Disease Patients 7JI500 y ilagc,, of 2 0 '.i I 0 Ii', G I (I;, 0 0 0 2 4 ]@/l./74-6/30/7@l 683@048 A o -f., I ii@, Blood Bai-il,,- Ma,,iacreifio,j-i'L- Coiitrol S5,s tc-f)] 7, 700 Silb-totial Pro@i--ant Staff- 7@,EF@ i t i -e s (546,348) 01@19-J.'@-ata BaTik for I-lealt]-i 29,000 01.26- L@'@,,IS Froscf@roof area -Do,ooo i(le iloaltli Plamii.Jlg Si-ippc)rt Vil 1.5,000 -Area.i,,,j@de I-IC@l-I.Itli Pl.aiining S,,il,,,port Rr@,gi@oi-i V-.1 -is,ooo 0-139-Are,m,,@i.de I-T ,ea]-th Pl@alini,ng S-u-,-)I)ort Regi@oi, IX 15,000 Pl.aiini.ng P,(,,g]-on 'rII 1-5,000 0-1@416-Study of lffil-)ulatory Care S6Yvices Attached to flealtli Faci-li,ties and @lajor Free Standi.ii,g Affd)-ul.atory Cc-liters 'I-9,000 Siib-totals Project Activitie@; (136,700) TOTAIS 1-19,500 135,200 88@645 17,SOO 322@203 percents 17% 20% 13% 3% 47P6 GEORGIA REGIONAL Ml,.DICAI-. Pl@,OGP@x, Stat--,js of the The -region will enter its (06) operational year, 31,-d year of triennium, on Jai--iuary I., 1974. T'ne 05 year continuation. aj-,-plicati-on was reviewed in SeDtoniber 1972 by the Staff Ilil-ai@L-\7r@rsory Panel @n(I the N@l,t-iorL@ll Review Dui-ipc,,@ its Octcil.-)c---r 1-972 the t@,lati-onal Advisory Codncl,l considered riclati.ons ol-' these grotiT)s Lin their approval to the- Di.r-c..ctor, R@LlT!S. The termination date for this region 1-i:ri@le3- the pi-tas(.,-oiit concept was 1.974. Th@- proposed the retention of staff Paer;,,!)ers to Fe'brtia.ry 14. All activities in tl)c.-. or:"-g:Lrial i)IELn were 'co have by Ji-@,i-ic, 'DO, 1-973. However, the plan -,jas latci: aireri(Jed the '.L--(".@ionts request for a two extension for selectee activities. The request was a,--F)roved. At the of the ph@@l,,.,c@-@ou-L app'Ll ation, the region was supporting, o-,jt of fiscal year 72 'Luii@,,.s, 14 contracts with t(@r@Ainat:ion. dates ranging from Iii,@yust 1973 their DE.,,cerrLber 1.973. These approved for coiiti.Titiatioti. Current Status of Pe@ion's Fiii-,.di-ng 17Y 73 aiinual.l.,-?c-@d level pri-or to ..... $2,563,000 Regi.on's percent of total FY 73 funds .... 3.23 Region's maximum allocation from li'Y 74 funds ..... $1,331,922 Total amount of 1,@ 74 fupcls awarded to region October 1. 1973 ..... $552,3110 Maximum FY 74 funds remaining to region for allocation January 1, 1974 ..... $779,592 Significant Events Since Last Review On June 5--6, 1913 an RMPS staff team visited the region to assess progress to date and plans for future support of the E@MS system in DeKalb County. The Georgia ILMP was one of the many RtIPs -,qni.ch competed successfully for special E@MS projects to be supported out of 1-Y 72 supplemental funds. A--Stren@7tlic,-iiiii@, l,oc@ Pl B-QLI',,.Ij.ty Assuriiice C-Lilis i'@1,LOCATT.O:@' j'!Y OPTION 7 D-Ki-diic2v Disease E-Iiyl)(-,rLcnsion REGIO',' Ceorgi@ PEP,IOD 10/i/73-12/31/73 $ 552, 330 E ID. B OTIIER Pln,OJEC'f & PROGPd'@,@-' 133,5 C"000 Program Staff 3 Visiting Consultants Progr@aTr@ for Community Hospitals 6,000 13,.-Statewide Cancer Program 18,1-08 20 Area Facilities for Continu- ing Education 47,519 30 Facility Planning and Develol'),,ient l@,969 Cardiovascular Area Facili- 39,980 ies 9,689 32 Stral@e Area'Facil4-ties -36 Kidney Disease Progi-aya for 1-5,000 Georgia 38 Emergency Care for South 60,900 Georcia and No. Florida 42 Statewide System of Care High Risk llater-,ial,/'Enf ant 9'857 43 Patient a-@id Family Fd. 6,700 53 Nurse-Mid@-iife,Service in a Mlilti(-,ctinty Area 13,000 55 Regional Emergency Service System 58 Hypertension Detection 3,700 and Treatment Prograrfi. TOTAL 42,934 60,219 .247,283 15,000 53,369 8% 1. I- 7@ 44% 3% 10% PF@GIO'@@AT, of the The reg-i on will its ((,6) operational. year,, 3r(I year of tric-iiT.ii.i.i-iii, ori Ja-i@ii-ta-@,,y 1, 1,974. The 0.5 year cont-j-.-!IU@L -.ion apt)!-I-c:.it-l on reviewed -in September 1972 by@tlii@ Si@:aff Aiii-i--i-vctr@-,@@iry Ponel a,.Jcl the Nation,21 PC,'view C C)Iiiir@.-I. ,,, f,@ c@ its Oci-obc-r .19i2 Advisory Council. c,)nsiderc-6 I1,@@tioris of these groups Fiid their a-,-) -i,(.-\7al. to t@@c@ 'j')irectc)r, RljTS. The termination date for this un@ci-T.- the colicaDt was 14, 1974. The of E,@taff to F(--i@rLic-,ry 14. All activities :Ln the T)l;-"Il @@@7cre to lia@7c@ l@y J-Li.-te '@10, 1973. a L @i.owevc-,-r, plan -.,7a.,@ 1. te-r follows -"Pg the s request for a -L,@v-1@o o,,ontl-@ exte--@;i.oT-i for ol,)c@rat-;.onal, activities,. The reci.@(@s'l- was At thc,- o:E -the phase out the rec,j o-;@ out of 14 contracts 3 72 funds - with termination @-,ate@- ranging A-uf,,tlFL 1'.11'3 tl-,r-Li D(@ceii).bei, 1973. These @@7E.,re a-.@)f)ro@,-i?d for 1. Current Status of 17Y 73 3:tin.ual.ized level. prior to phaseout ..... $2,563,000 Regioii's pcrcent of total Fg 73 fiir).eis .....3.23 Pegiori's P-@axj-,,liuTq allocation from rY 74 funds $I,331,922 Total amount of FY 74 funds ai.,,,arded to region Octobey- 1, 1973 ..... $552,3@10 Maxii,)um FY 74 funds remaining to region for allocation January I-, 1974 ..... $779,592 Sio-nificanL Events Since Last Review On June 5--6, 1973 an P@'VS staff team visited the. region to assess progress to date and plans for future support of the nIS system in DeKalb County. The Georgia PIT was one of the many rt@Ts which competed successfully for special EMS,projects to be. supported out of FY 72 supplemental funds. 0 A-St, local Pl )J-QLI,,-tlj-ty Assurance C--E@is l@LLOCATIO" i@Y OPTION Ii-diic,v Disease D- E-ilypel:tcnsion rdt RE GI O@L4_ or a@ /4,6 '2. PEP,IOD 10/l/73-12/31/73 _1330 PROJECT & PRCGPV-1 ID. A B c D OTHER 133,52 rograin Staff 3 Visiting Consultants Prograr for Community Hospitals 6,000 1.3,.-State@qide Cancer Program 18,108 26 Area Facilities for Continu- ing Education 7,519 30 Facility Planniig and Development 1,969 Cardiovascular Area Facili- 39,930 ies 9,689 32 Stroke Area Facilities 36 Kid1le7 Disease Program for 15,000 Georgia 38 Emergency Care for Soutti Georgia and No. Florida 60,900 42 State,,iide System of Care H:"c,h Risk Maternal/Infant 0 857 43 Patient and Family Ed.. 6,700 53 Nut8e4-,!,Iidwife Sei:-,i@Lce in a Multicounty Area 13,000 55 Re 1-oiial Emergency @ledical 9 Service System 186,383 58 Hypertension Detection and Treatment Progrim 3,700 TOTAL 42,934 60,219 @2l@7,2 5,000 53,369 8% 44% 3% 10% IV. Anal),si-s of Re(_Yioi-i's Capability To Effectively t)"Lilize its Allocation o@@6ni-a-i-ni.ng FY '7z@ Throuohout the phase-down peri.od the GRMP has maintained its key professional staff, providing overall program leadersliij@, program desigi-i and development, evaluation, monitoring, fiscal management, communications and publications; and a. Iii.story of solid relationships with health care providers in Georgia. During February, 1973, the G@'4@ had a total of 46 full and part-time staff positions. In the current application, support is requested for 22 full-time and three part-time personnel. There is one secretarial vacancy. Most of the reductions have been accomplished by the centralization of the I)ivision of Operations and ti-ius the elimination of field personnel and their supportive staff, plus the elimination of part-time RMP representatives in the medical schools along with their supportive staff. The leadership of staff in providing program development assistance to provider institutions a,,-id local con-DnLu-iity groups continued actively during ti-ie threatened phase--ou-t period. As examples, staff directed and participated in the development and preparation of hypertension screening program for a soutl-ieast multistate area; made cormiunity contacts and supervised t e ve opinent mid preparation of a large scale emergency medical service plan for the metropolitan Atlanta seven-coijnty area; assisted a number of small Geor@ia communities to develop and submit applications for personnel- @der the National Health Service Corps Act; and continued to manage and monitor t-wo quali-ty assurance related contract activities funded earli.er by the region. The Regional Advisory Group continues to be active in P@\T affairs, and, as such, provides overall guidance @icluding the approval of an effective contingency plan responsive to the FY'74 national priorities. Georgi-a has had a tradition of an excellent task force/coinnittee structure, which provides the RAG with professional and technical revi.ew of applications.. They have now combined all Ad Hoc and standing groups into three standing task forces. Currently the region has tj'ie following sta-ndi.na task forces: 1) specialized services; 2) prh-narv 1-iealth services and; 3) manpower utilization mid development. Because of tjie increased activity caused by the events of the past year, some of the groups have met on a monthly basis. The RAC meets three to four times a year. The region has been successful in attracting other funding to insure continuation support for IW initiated activities. For example, the ETVIS program in DeKalb County, which received one-year GRP support, is now self-sustaining. Also, when the original phase-out of @@-TP (February 1973) was announced, the region had a total of 86 program activities which it was supporting. As of November 1973, 80% of these activities are being supported by other than RMP funds. Further, The Georgia MIP has been a leader in establishing primary health care centers in under served areas. As of August 1, 1973, support for two of the centers, 1,@ilcox Cotuity and Danielsville, are being provided by the Department of Iranian Resources. 0 Geo-rgi-a RMP Page 2 V. Analysis of the Current Application The application for continuing support for the remainder of fY '74 funds was reviewed and approved by the Regi-oiial Advisory Group on November 5, 1973. The total request ($779,592) is the exact amount that constitutes the regi.oyi.Is proportionate share of available funds. 'Lhe_reaion h,-Lts not -requested indirect costs for @ii-iy of its T)roject activities. They have requested a-n-oroxiiiiaTte" direct Cos-ts in the L)@o(,T@@,i staff-. c@onent @l-iich a-re to be the @aT@c,(I, the Nlodd.cal Association of (@oraia. This is consi ered a iiec -ssar expense for office space, Treat etc. Projects #36B and #36C are requests for the continued support of renal activities. SCOB staff analysis of the application along with telephone conversations with the region reveal that @,IP funds ire being utilized for the training of personnel the development of an organ procurement program; and the development of'a statewide follow-up and data system. The application requests continued support for three BE activities which were initiated and extended through 12/73, two by contract and one as a project. The Goorcia JZL%IP has had a aoocl track recor in developing an EI%,LS Prototype program in I)eKalb County (one of the counties in the metropolitan. Atlanta area). These three activities are a part of the rcaion's overall plan to now regionalize and extend comprehensive 1',-,"!S systems to other areas of the state. Two of the three remaining project activities are new priority t ts, which are to be coordinated by the State l@ledical Society. The quality assurance effort emphasis will be placed on activities to begin to assist community hospitals meet PSRO Quality Assurance standards. The C,@-@IP th-rouali the Department of Human Resources has supported a successful Atlaiata-based Hypertension Control. Program. The region now plans in cooperation with the Heart Association, the department of Human Resources, local coniqtunities @-id hospitals and the State @ledical Society to extend the effort on a statewide basi.s. Each operational activity summary in this application outlines the reaioi-i's plans for continuation of the activity. lVhile the region has requested continuation only for the prescribed period 1/74-6/74 ' support is requested for some of the activities through 12/74, subject to the availability of funds. Further, the region states that they have "many appropriate projects" for which support would have been requested had there been sufficient funds in the current allotment. In the event additional finds become available to @@IPS, they have plans approved that fit the national, priorities.CoiRprehensive Health Planning Agency Revieii of this application have now been received. Georgia ]@NE.1 VI. Staff ]Zecoiinendati.oi-1, The Georgia @IP his requested $779,592 to support a program staff component and five operational activities i-iivolvi.i-ig eight institutions or organizations. Program Staff Component ............. $2S5,971 Operational Project Activities ...... $S23,621 SCOB Staff recommends approval of this application as submitted. The Georgia IN' application includes requests for the support of two Kidney components. The reaion should I)e alerted to the provision contained in the interim -rules and. regulations issued under title @20, chapter 3 of the Regulation #S, Part 405 - Fed.e-ral. Health Insurance for the A@ed. This regulation pertains to I)a)),jiient es in Connection with kidii6y transplants and renal dialysis to entitled beneficiaries. R@II)S: SCOB: DOD J'FJ:mg:11-19-73 AI,I,OCATI-c)@4 fly 7/1 D-Kiciiie-y GE@ORGIA "j --O $ 779.592 A D OTIIE]@ 000 Program Staff Component@ 285,866 36--Kidn.c-,y Disease Progr@ Emory LJni.versity 7,500 Medical College 7,500 55-Regional Er,@rgenc:y @ledical Services Systems: South Georgia @dical Center 54,068 C@4-ha,m county l@29,651 of Coluc@@)US 8S,550 63-Statewide System of care High Risk Matemal/Ii-ifa. n-,nory University 12,500 Apartment of Human .Resources 30,ISO 64-Strengthoning Quality Assurance Efforts- @40dical Assn. of Georgie 86@soo 65-Statewide Flypertension Control Program-Wdical .Assn. of Ceorgia 80,307 TOTALS 42,650 86,500 269,269 is,ooo 80,307 28S,866 Percents 5% 11% 3S% 2% 10% 37% INDIANA REGIONAL MEDICAL PROGRAM Status of Region The region is currently in anniversary status prior to triennium. The region was reviewed by the National Review Committee and the National Advisory Council during the September/October 1972 review cycle. The reviewers agreed that Indiana had shown considerable progress in turning the program around but was not ready for triennial status. A two year funding was recommended for the region at $1,200,000 for each of the two years to give them sufficient time to hire a full-time director and to respond to the new directions the program had delineated. II. Current Status of Region's Funding * The FY 73 annualized funding level for I@E? prior to phase-out was $1,000,000. This is 1.26 percent of the total FY 73 level. * The FY 74 allocation for the region is $519,573. * The region has been awarded $215,460 of the FY 74 allocation. The funds remaining for the region to apply for is $304,113 for the period of January 1, 1974 - June 30, 1974. * The phase-6ut plan as approved allowed the region to continue thru February 14, 1974. They had requested funding for an orderly phase-out of program staff, 5 operational activities and 6 contracts. The region was approved for the phase-out of program staff and the funding of the 6 contracts and 2 operational activities. III. Significant Events Since Last Review . Mr. Louis Gordon was hired as a full-time Executive Director to administer the program. . The tegion'8 review process and by-laws were re-written to conform to RMPS guidlines and policies. A-Strengtliening Local B-Quali,ty Assurance ALLOCATIO,@4 BY OPTION C-E@is D-Kidney Disease FY 74 E-Ilypertension R]7,GIO'4 iuq 00043 Tnri i nn:l PERIOD $ 215 460 1,ROJECT & Pl,',OGlzkNl ID. A B c D E OTIIE, 638 39,092 58,638 39,092 -58@ C/ COOO Progran Staff C002 Regionalizati6n 20,000 TOTAL 20,000 39,092 58,638 39,092 58,638 10% 18% 27% 18% 27% the o @f ii@i ]IS t@ 1.3)ie -s ol s @i jL CLl t tol- Dole i.s 3 't)c o s d( o l@@i 1) C-) S e F-, @.'D r@@ TI -I s t(@,@,0 to cl C. r) 1-0-1- C) "I' t -'C'C C)T i c) ot-i. c- crli t@-@o, C I i -i r L Aii @i 1--@,s i s f i.-c@-,@nt i-(711-1@-@i.oi of" SC@@IeTi: Proiect P-I,ol:)O,-"@ll.@; of' j-0 r i7 z,@l- o I, o of t sL@,, :Foa7 cire rec c, act@-1--@7-iti f@ -i, e i of I)y s-tlaff. I)eeii dur@i.ri(y to fill-icl -,,ilct I)I-Ojc.@ct..s 7,tlcl (@ont,j-acts liai;(@ of i,,ioozl,3 c@f-' fill. O@r@, SO@Di-i oiitcoiiic.!s of ti'i.ciF)e -i-c,@]@c@-.I,ts, bi-it of tlj.,@iii s'@@c)u'i.d. as Al fi@ Nt i-se Page 2 Ilie r(.!,@i-on has coi)ti.iiii-ld have I-ILqct @ 01-1@c@d as a I)j-oke3- iii developing a ntbjibc-i- of rqucli. programs at both re@'Yjojail. and silbi,egioii@i.1 levels. Some of are as Jol-@lows: 1'. Pi-ocltjcti.ori of @l-n i%i'@i bill. for by the C';oirernor -i.ii'Lo the sess@@io-ii. of ti,le 'I'hrott,@)]) oj'--'f-orcs of ,.is cool-(J@i.3-i.@itin(y y, some t-@%Tc,,iity groLti),_; develop ti@c@ Llj-l(i File participating in the effort to gain its passage. 2 . Strei-i@)thc@,,ied I)ett@,oon the and health functions in the region@. A series of con.- ferc.,ricc-,,@, aiic, S'c.-Lidi.cs this ,eii- resulted, :i.ii most. instances, i.1-i inclusion of Area Action Groups :into the planning process. 3. FLLqcl-i,T).c- and of projects a.Ticl contracts have it' u e I I)lii.sed o -@- of support and other means of f@i.n@uicin.g or sooil. 4 . Strei).c@ti)-en.ed rel.ati.orislliT,)s tl-)@i-o-Lin-h the -@vith health care organizations tl-irotighout the state, the lzfvlu to reflect 5. Development and ar)provi.1 of nc,@,,., by-l.ai@ts foi. national g)i-iideljj-tcs. 6. CoiilDl.eti.o-,a of @i -.r,(zvi-eiq process 'that ivitl). RNN-)S guidelines. Ii@id:iaiia has a. Statr@, and has developed a plan f-o-i. a. statewide program. As a result of the efforts of the l@P staff the, Stat Lef,,Yj-slature has appropriated $SOO,000 annuall.)r for the support of their cliroi,@.i.c dialysis and transplant program. 'rh.e transplant efforts @it the present time is a cooperative effort between Indiana Uii.iversi.t), School., VA Ilos-1.)ita..I., and iv@ctliodist hospital. of lyidiana:l-)bl-is. 'I'hey presently @i-.re ti'aii-ii.iif, 5S pati.eri.t@s for home dialysis, 1.2 per iieek C,enter, and i-re aii average of three i).,.-@,t:@entis monthly. Ili.--ojoc-L 003,5 i.-(.-.@c[uests funds for the expansion of tlii-s procTr@im aimed at the devel.bpnien.t of testing procedures for the prevention of jiniiiuj-ioloi,;-i-cal loss of transplanted kidneys. The IRNff) 'has been exti-eiiic@l.y cooperative in rocei-it months to advice and recommendations of R%IPS staff. The current application. suggests that the region is being more.respon.sive to the health care needs of the people of the state. CTII-L review and contents are included in the current application. Pa,ge 3 v'l.,. St@3.ff IDdiaj-i,i :[-'oi, Sta.:Ef tlii,ee activities; for tll,(,@ period -ids _/I/ '74-C)/30/7d.. SCOB St@aff rccoiTifliei approval of tli-i-s 7-,I)pl-ij'-(:,@@ltiOl-I @.s The lr4vfl3 af)Plicatioji includes one k-i- @iey Tii,e reaioii. sl,.,ould be al.(.,rted to the provis.-'f.c)il contb.j-nocl in the -ilat@@oi-i i-ssii-d ujidcT T"t-i-c 20 L'@",),ipter 3 Interiin i@il,es and l@eg, s 1. of t,5 - P,-,@rt 111-altli, Iiistirance for the Tlij.s i.-c;g@i.l.a,t-ion s i@iith kidi-i,@,), tr,-ai-ispl.ai-its L i@s to :in and Teiia' clialys' entitled beneficiaries. rCi,,,R)S.SCOB:Ml) 1IL20-73 W'F:cmg 0 ai'!;L 00043 30 30@ li@3 c cl, -------- --- COOO-Pi,o@yr,:,Jft Sta-ff 195 984 0034-Categorj.zation of 23, 500 1-1)0036-Kich-iey P-i,ojcct 39,429 f 0037--SI)cci,ali7-(.-,-d T@",-dical Serv@ices 45,200 .@'fOI'AI,S 45@200 23@500 39,429@ 195,984 i,celit of l@,ilocati.ori 8% 1-3% 6 @l 96 II s I Status of the Region: August 7-1. Coincil. -,)-,opro@,ed triennial stitiis, but ii-itlilield devel.ol)iiic@,ntal c,oi-flpoiic,@.t authorit), because of coq,,plexit), of organization. NoveiDber 72 Council accepted '.r@ovj.ct%T Coii@miitte.els recoi,,Pi,@iidatibn on the regio.-i's a-,u,.i--vc-,,rsary application i,,V-i.tlliin the which approved coiiipoiic-,nt authori-c.),. 'fhe was continued at its triennial fLIniiiig le-tTc--l ; a $100,000 ceiling placed on the dE-,volopT,ic-Tital coii-,,I)o-,-tent; the -region was co,,ripliTTieiitoo'. on its never and li 7 more w,@,aj-iingil-ul orga-, ational structure ,@u-id its nc-,,,,j 1),r-,(,i-onal j@civ'isoi.-), el - Comcil; and in view of the size and depth of core tl).e region was advised no further increases in core staffing were warranted. U-ie date of this region Luide-r the plia.,;e-out concept was February 14, 1974. Ilic i-c,@yi-on's plan proposed the reducti-oi from approximately 4S employees to 10 cii,,p'Loyces (but L3 en-q)lovees were inc.L-Lided in an expanded operational activity and were still. included in the budtyet). Tfle -plan a]-,.;o proposed -die conti-iiiati.on of 8 O' erati(L,-Ial jcti-irities. -Fi:di,,Iin(T 11-v(-@1- approved for phaseout was cor.,iyjtitcd so as to require rapid reduction of staff; and S operational. activities were &,I)pi-o-ved. Ilic e-@,?zui.dod ,@i.ctivit@ to receive 13 staff was not -Lpproved. II Current Status of J.',tiyicliiic,) 1,Y 73 annualized le-vel prior to -pli.@e-out .............. $1.,627,000 Percent of total FY 73 funds ........................... 2.05% MaxiitTu-n allocation of F-Y 74 @f-tuids ...................... $84S,338 1-iY 74 funds a@%@a.rded October 1, 19'113 1 ................ $350,5'@-0 Remainina F@Y 74 funds for Jai-iuary I-, 1974 a]-location ... $494,788 III Significant Events Since Last Reviei%T The ENIS activities supported by earmarked funds were site visited. in June 1973. Dr. Joseph Johnson, Chancellor and Vice President of the IJ.T. @,ledical Unit (an interested and informed supporter of ITNIP) has been replar-ed by D-r. Ed-mtmd Pelle2rin6 (an interested a-ad in.formd supporter of R%IP). ALLOCATION BY OPTION C-Eillis D--Ki(Iney Disease FY 74 I-',-Iiyl)erLension RI:GTO@ll- Memphis P@'RIOI) 10/l/73-12/31/73 5@550 I'll@OJECT & IIRO('11,A',Il ID. A c D E OTIIER .Cooo Regional Staff Serv. 106,-3: .COOL Ident. of Inactive Nurses 4,646 in Region .COO2 identi of Ilyper. Preva- 4,746 lence & Resources Assist. in developing Subreg. CHP Plan. 3,896 Ident. of Incidence/Pre- valence of Yid. Dis.,& Res 4,796 @@C005 Invent. of Hlth., Ed.& i @-,Ielfare Resources 31,662 High Risk Infant Prog. 20,000 3improved Assurance in Death Certificates 34,301 3-4 Nurse Audit & improved Utilization of N4rsing @lanpower 18,878 40 Hypertension Control 10,000 47 Audit Centered Post Grad. Ed. 15,099 48 Home Hlth Care & Ed. in the Mi@ssouri Bootheol 30,000 49 Crittenden Clinic Home Health Care Proposal 5,300 50 ExDansion of Mid-South Ey6 Bank 10,948 52 Mu@Ltiphasic Screening Evaluation 17,941 B-Quality Assurance ALLOCATION BY OPTION D-Kidney Disease I.'Y 74 L-Ilypertension 1, I-C RiM l@ O,,i Menlpliis (Cont'd.) 00051 PL:"RIOD 10/l/73-12/-jl/73 I'L@OJLGT & PKIO(',]?@l ID. A B c D E %)TIIER 53 Gibson County HI.th Serv. and Manpower Utilization Project 8,000 54 Arlingtoii Hlth. Serv. and Manpower Utilization Projeci 9,000 59 Hlth. Care Facill ties Utilization and Review Pro- posal 15,000 TOTAL 92,504 132,167 4,796 14,746 106,3@ 24% 38% 2% 5% 21% Status of -Cie -Pcgi(-)n: wi-@t,lil)c-l.d developmental A-Lic, ic:i' approved t:r-iciin'al starts, but ,,ust 71- Cou-r L 1 component aucJiori-Ly because of cortplc@,xi-t), of organization. Novei-iijl-)cr 72 Council accepted Co,,iq,,ii.ttee's rEco,@p@T@-,n(I-ation on the region s first arij).@ivers@tyy app-,Ll'catioi-i the t-i,@Lenillum, i@7]i-Lch T 'fhe reoi.on. was coi)-tir).ucd approve.Cl coi -1 @,. t." at its triennial finding lekiol.; a @,'I-00,()OO ceil-.Ill@Y placed on tiie deve,loT)-;P@,n-tai the re,(Iioii was oil its Fired T more c)l:-(,;,,7,iizational structure its ri.mi lle,2ional Acl-@7-i,- o-rN, Council; and ii-i v@iei,,r of the size -mid dol)-tli of coro, staff, t.1-ie rog-i.on was ad-trised no further increases in core staffing i@ei,e warranted. 'fhe tei-iiriiia,t@iori of this -rc-,pi-bn i-uidc.-r tlie phaseout concept was F,ebruar), 14, l@974. 'fh6 regioii's plan p-.r@bl-)c)scd -the reduction from al)p,@oxiiiiatel-y 45 emplo)70es to 10 eni,l)lo@,ees (but 1.3 employees i were i-iic!LiOcd- in an c anded oi)c,,ritioi.-ial activity stl- XP included i,i-L the bud,)C)t) Ilic,- plan al.so Iii-c),,)osed tl-@o contiialiat@ion of 8 operational a:l@pro@r(-,,cl for pl@iase-oiit was con-p-Litcd so as to requir(,, r-,pi.O. r(@,cliiction of staff; @:,iricl t 5 operati.oi,@al ac .,.v.Lcles we-.co approved.. expqjidcj, activity to receive 1.3 staf:F Members was i-iot approved. II CLirrent Status of F-Lu-idi.iig: FY 73 aj-uiiiali.zed level prior to phaseout .............. $1,627,000 Percent of total. 1,Y 73 funds ........................... 2.0.5% @laxi.ran allocation of l@'Y 74 fui-ids ...................... $845,338 FY 74 fund,, awarded October 1, 1973 ............... $3jcO,550 Remaining -@ 74 fwids for January I., 1974 allocation $494,788 III Significant Events Since Last Review The EIYIS activities supported by earmarked f-imds were site visited in June 1973. Dr. Joseph Jolinson, Chancellor and Ilice President of the IJ.T. @ledical Unit (an interested and inform ,ed supporter of IZNIP) 1-ias been replaced by Dr. Edmund Pollecyri-no (an interested and informed supporter of RNIP). ALLOCATIO'4 BY OPTION C-E-@IS D-Kidney Disease FY 74 l@l-Ilyperteilsion Rl:clollll Memphis PEIZIOD 10/l/73-12/31/73 50 550 & ill@0('IUI"Ill ID. j A c D E OTIIER ill@OJLC'f COOO Regional Staff Serv. 106,3. Ident. of Inactive Nurses in Region 4,646 ;COO2 Identi of Hyper. Preva- lence & Resources 4,746 ;COO3 Assist. in developing Subreg. CHP PI 3,896 an. i'CO04 Ident. of Incidence/Pre- i valence of Yid. Dis.,& Res 4,796 !COO5 Invent. of Hlth. Ed. & Wblfare Resources 31,662 High Risk Infant Prog. 20,000 3IEiDroved Assurance in Death Certificates 343,301 iNlutse Audit & Improved Utilization of Nitrsing Manpower 18,878 40 Hypert6nsio-i Control 10 000 47 Audit Centered Post Grad. Ed. 15,099 48 TIOTrie Hlth Care & Ed. in the Missouri Bootheel 30,000 49 Crittenden Clinic Honie Health Care Proposal 5,300 50 Expansion of Mid-Soutti Eye Bank 10,948 2Multiphasic Screening Evaluation 17,941 B-Qual-ity Assurance C-1@114S ALI,OCATION BY OPTION I-Y 74 D-Kidney Disease L-ilyperte,nsion @lemphis (Cont'd.) 00051 PERIOD lo/l/13-12/il/73 ill@OJLCT & ID. A c D k)TIIER 53 Gibson County 'Hlth Serv. and Manpower Utilization Project 8,000 54 Arlington Hlth4 Serv. and Manpower Utilization Projeci.9,000 59 Hith. Care Facilities Utilization and Review Pro- posal 15,000 TOTAL 92,504 132,167 4,796 14,746 106,3@ 24% 38% 2% 5% 31% v c-@z co i-@@ -"c i.:[- &p c.@, c-,c i @l V, i C, a.@ d of t ziii e s L. z C"l a.-, c@ -L, c, a. h- cx" 1, @ @@ of t,@d ay@p (a@ i f II reviews. 13 -t@ 4@ (5 f '[7i t:'r)@ pi t C) Y,: r. I-) c@,@ d@ C)n zti a.' (if $494,@788. jlhcsc@ ',O pz@ i- -y onc@O:L, (6 r,,f C'; 1, Fi,,@ard) to act-3.VZ;tc s-ta.ff coni.-rcot A@ll (-)f ttie CIIT P ai-)d ti.-ic),-;e C., OLIE@ returi@ed @AT, O'.c d4d Yiot '-o u@ -tli@it t-o I b u t ci Find c @l, l@iri (I lf':i I- 4, 0 @l. C' t-ci c c: c;, Y% i,,, h I- i @i I E,,,. i -i ic,nal. t i them st(@.d 4, t56@@,@ 0 @j, @l Onto 2 '7 1 2 50 .1 3@2 36 52 -@3 1. 6 18 , OC)o - 3 5 , 000 :NG3 - PI-@y ici.ai@ A,,-;sist. 4. 0 , 5'@ 6 4 - zi #65 9, O.-,2 .I- r) 3 4 9 2 7-1.2 9 4 -1 2 MISSISSIPPI REGIONAL MEDICAL PROGRAM Status of Region * The region was awarded triennial status by the National Advisory Council in October 1972. This award was based on recommendations by the National Review Committee during the September/October 1972 review cycle and a site visit to the region on June 29-30, 1972. - * Funding recommendations: 04 yr. 05 yr. 06 yr. Committee $1,500,000 $2,110,000 $2,325,891 Council $1,500,000 $2,110,000 $2,325,891 * No conditions or key issues cited by the reviewing bodies. II. Current Status of Region's Funding * The FY 73 annualized level prior to phase-out was $1,073,702. This represents 1.35 percent of the total RNPs funding level. * The FY 74 allocation is $556,686 of which $230,850 was awarded October 1, 1973. The region has $325,836 of this allocation remaining to apply for during the period of January 1 - June 1974. *.The region's phase-out plan was approved to continue the region through February 14, 1974. The region requested funding for 18 projects and an orderly phase-out of program staff. Of the 18 projects, 10 were to terminate June 30, 1973 and 8 to terminate January 1974. The region was approved to continue program staff and 9 operational activities thru February 14, 1974. III. Significant Events Since-La§t Review . New Medical School Dean - Norman C. Nelson, M.D. Vice Chancellor for Health Affairs - Dean of School of Medicine . Site visit was made to Jackson, Mississippi on June 19-20, 1973 to review the Memphis and Mississippi EMS activities. A-Strengthening Local Pl.i,, B-Quality Assurance ALLOCATION BY OPTION C-E@is D-Kidiiev Disease FY 74 E-ilypertension ITECTON Mississippi pjq 00057 PERIOD 10/l/73-12/31/73 $ 230,850 PITOJECT & IIIZOGI;L,@t,'L II).A B c D E OTIIER COOO Program Staff 59,341 C001 Statewide EMS Prog. 6,667 C002 Planning for a local hosp. Shared Service System 2,000 C003 Computerized Interact- ional Concurrent Qual. Assur. Prog. 21,475 04 Regional Quality Assur Prog. Support - Ed. Sys. 18,594 C005 State High Blood Pres- sure Screening and Referral Program .30,000 COO.6 Curriculum Development Assurance Nurse Coordinators 9,000 C007 Development of EMCRO EMS Criteria 2,000 COOS Development of Regiona Health Planning doun- cil8 - B Agencies 40,000 C009 General Contractual Activities Within Priorities 8,000 9,773 8,000 8,000 8,000 TOTAL 66,594 42248 16,667 8,000 38,000 59,341 29% 18% 7% 3% 17% 26% MISSISSIPPI REGIONAL MEDICAL PROGRAM Status of Region * The region was awarded triennial status by the National Advisory Council in October 1972. This award was based on recommendations by the National Review Committee during the September/October 1972 review cycle and a site visit to the region on June 29-30, 1972. - * Funding recommendations: 04 yr. 05 yr. r. Committee $1,500,000 $2,110,000 $2,3259891 Council $1,500,000 $2,110,000 $2,325,891 * No conditions or key issues cited by thd reviewing bodies. II. Current Status of Region's Fundia& * The FY 73 annualized level prior to phase-out was $1,073,702. This represents 1.35 percent of the total RMPs funding leve . * The FY 74 allocation is $556,686 of which 230,850 was awarded October 1, 1973. The region has $325,836 of this allocation remaining to apply for during the period of January 1 - June 30, 1974. * The legions phase-out plan was approved to continue the region through February 14, 1974. The region requested funding for 18 projects and an orderly phase-out of program staff. Of the 18 projects, 10 were to terminate June 30, 1973 and 8 to terminate January 1974. The region was approved to continue program staff and 9 operational activities thru February 14, 1974. III. Significant Events Since Last Review . New Medical School Dean - Norman C. Nelson, M.D. Vice Chancellor for Health Affairs - Dean of School of Medicine . Site visit was made to Jackson, Mississippi on June 19-2 to review the Memphis and Mississippi EMS activities. A-Strengtlleniiif,,, Local Pli,, B-QLiall.ty Assurance ALLOCATION BY Ol'TION C-l-@is D-Kidiiev Disease l,'Y 71i I E-Ilyperteiision REGIO'L Mississippi RM 0005T PETZIOD l@0/l/73-12/31/73 $ 2-30 850 I'L@OJECT & IIIZOC',IWL IL). A B c D E OTHER COOO Program Staff 59,341. C001 Statewide EMS Prog. 6,667 C002 Planning for a loca hosp. Shared Service System 2,000 C003 Computerized Interact- ional Concurrent Qual. Assur. Prog. 21,475 Regional Quality Assur Prog. Suppor@ - Ed. Sys. 18,594 C005 State High Blood Pres- sure Screening and Referral Program .30,000 COQ6 Curriculum Development Assurance Nurse Coordinators 9, 000 C007 Development of EMCRO EMS Criteria 2,000 C008 Development of Regiona- Health Planning Coun- cils - B Agencies 0,000 C009 General Contractual Activities Within Priorities 8,000 9,773 8,000 8,000 8,000 TOTAL 66,594 42248 16,667 8,000 38,000 59,341 18% 26% .29% 7% 3% 17% ]IT S @l@ SSI! i Al@ t-he- 'L@ 0 i by 39 fo@- 't)y year. 'j,"r@o "03- 1. ces o,- oil .1-6, 1973 S Z7rl @,c'i r@@ r c)-v @2 h t t o i j'- @r Lti@ i i- l@ t-@hc,, P_,,, C', -1. L@ 4 C)y c i r c, c t 1, T t C' ccir, c@ a-,-c@ c@"! @i I @i. I C) 1 s t@ f'rc@l-i-@ t i-@, j@ t .'I "7c@rL )C@ e 0 1 1 1: 1, C3 -.c r b@71,@-i.-i siiccesc;5-'til. :!.ri 0-F for 10 of 0-IL 0 -f) 'I@@ C -,I -1 t 0 Tti f of ti-i@@ 'L@,C'L<. of TI)c--, to tlic@ (,o-@Li@.)i-(,!Ii.cn.@;j.v(@ Y,,. 'I e. t L@ i@ of The bec!-ii a, in cai,c-, on 4y -P @.t- o' ttic, o. t@; I)COPI-e, c)@E t@l-ii-s i-@@ of Di-. to sc@rv(@ @,iE; CliL:i-i-@,@an pro in O-L- @l S(@l(-.ct lical.t@t coi of of 1)cjtli ol-Iii(,@j-@ @,-i (n-,i-iif I-ieall@@.1i. pc).T.@i-cy 1-n the State to IIE@a'Lt@i can @.i.ffo-.cted t@y 2 to eac@'Li tiie I)Y 'P"l@ as x,7e]-,t. as qu fis(-.al. C)'C L r@ -r- (-)I-l @(-"3 Of t[iis d c> f 'flosT C)tl-iel@ O' @i. 0 1".I.I j. Iv t i El S SI-aff pt,-d @325,836 to 13 for thE@ So-tiL@i Bra-f-ich of tlii.@ 1-li-oj(.@ct 1.711, 171'@, (,.are of tli,@ 1)(@ iTi. tl-ie L: ).n.d 20, 3 of SSA For Th,,a TI)i@,-@ to f,,)-i- sc@a-vices to SCOf@/DOD 1-L/20/73 7/i f f oo( 1)"@ p 17 T,-ITL -1 2 l@43,09' 2, 0 O,'. Care s @,5; to]-II 6, O(),') Cli-r- S c,, r v c(@ s 7 , 0 0 (i 9,200 tl i\s (3ti .@23- 1,000 1 V -i (3 Lo@oa 000 rare y 3@000 Pro,,,T. 5, OC)O l@)@ t(-,Ctj@ol-i Cl..32-Si-al-,e Poird of 1-1(@aitli 2,000 2 of 2 I y 71, i 0 SS,l C,--@Iii 00@)57 I 71 ---- ------- - -- (I i- c, t]. c,-o (I 'I Y, 000 Servi(-.c@s 2,000 g 35,019 0 0 52 t t.'i s t a f f ]@7, 740 1 7, 0 r)9 'fO'I'Al.,S 7,500 1.10 174 9, 0(@)c 069 5,000 1)(rr@,ent of 2% 33% 6% 1 96 2 @L, 4 NOR'IH CAROLINA I. Status of Region * The region-was awarded triennial status by the June 1971 National Advisory Comci.1 for the triennium 7/l/71 6/30/74. The region is currently in the 05 operational year. * The region's anniversary application within the triennium was last reviewed by SAIT in April 1972. SARP's recommendation to t.-ie NA during the May/June review cycle was a funding level of.$2,080,008 for the 05 operational year which was subsequently approved. * There were no key issues or conditions cited by the reviewing bodies. II Current Status of Region's Funding * The FY 73 annualized funding level for NRW prior to phase-out was $1,930,000. This represents 2.43 percent of the total FY 73 level. * The FY 74 allocation to the region is $1,002,034 of which $415,530 has been awarded. 'Ihe funds remaining for the region to apply for are $586,504 for the period Jan. 1-June 30, 1974 * The region took the phase-out orders from RMPS quite literally and proposed a phase-out plan to terminate all program staff aiid operational- activities by June 30, 1973. However 'when the current legislation was extendp-d and phase-out orders cancelled, the region Te-applied and was awarded the necessary funds to continue program staff and operational activities. III Significant Events Since Last Review None. ];-Qti;llity A@,,;ur-litice AI,LOCA'1'10'1 l@JY 0,11'r]ON I-)' 7 li@i,cioll'i, North Carolina 00006 10/1@/73-12/31/73 269,732 1 )8@ 111',O.)I"CT& 11). A c 1) L OTIII,-,R COOO Program S taff 6,943 6,943 C001 Medical Air Operation 4,200 4il5O 4,150 26 Emphysema & Lung 2,750 28 Care of Patients with Chronic Uremia 54,940 29 Health Manpower & Develop. 27,318 31 Cardiac Pacemaker Ed. Info. - 37,506 Family Nu'rse, Prac. 10,116 Radidtion Therapy Treatmen", Planning Service 17,686 36B Community Hospital Tumor Boards -12,446 40 Ed. Testing Service 8,630 41A Area Health Ed* Sys. 15,000 41E Area Health Ed. Sys. 15,000 42,Migrant Hlth. Serv. 23,790 49 Emer. Room Trng. 12,236 52 Measurement of Quality in Physical Therapy 5,928. TOTAL 8ot264 111,199 23,329 54,940 30% 41%' 9% 20% S(- i IC ol i@, 'c @f'ol- ti -IL e 4C oi @L, r o f I V"i C) '7 LI a.c @,-j- 0 I" j t A -1,@ r@i t e(j -i-ii, c, IL C. tc, Cs ill@ ti VI , St@@t-f@' si-@@l;y)@@@.i-t 27 this 1),-@@@-i.od of- tla.-i i I-)f) @i c @i t -i@ c)i 'Lc-@d, 'ITI oc @l b @@n e f i. c @,,j r j@ Cl.@ 7 3 C71! I c)@C 2 C,,,,@t ic) i-i 1 --71 .......... o j I," I)i-s 1. j.-o@ 2, 7 'IO of CJiroiiic Ureiii-i-a @250 -je r 2 7 3 3,'.', 31-CoTjil-). Pi-c) 3, 852 I.->, Nui@,F @e Pra---L@loii(2i@, 'Z.'O 2 -,'2 SC 1 7 6 8'0' 12,446 @s 15,000 0 0 0 42-tii,,irai-it IL-LL]tl-i 23, 790 Prc)g. in Jjia'betes 25,870 46-7COlpl). SI,@eecli wid 19 29, 796 48@-lValston BLiyg CoiT,,irLijjiity cliTilc j@.5,000 P,l 49-Drif-,rg. IZooia Training Coi-@llun.ity flbsoi.tals 124,472 I @isurcl,,@ejlt of Qti.al-itv 111137si@c,,il@ rhc,.Y@,apy 12d 536, o:l-' 5 3 - i- C, 1), C,D,'E 5 6 20 (),')O 2 0 Ci' PI @For G@ 2@',),847 R I- "A's. -S, s t (-,,,I 1 '6,403 (ii-.Ps@,,O prop'. 62@ Edti.c. Pro@T. 20 6 -:)o 'I O'I'A I 264,487 15S3101@ 1.06,036 @,0,250 20,630 '7 96 Perceiat oi- Al.1-ocat,@ic)n 4 5 96 2 6 1 8 @16 4 % SOMI-I CAROLINA I Status of the Region . Triennial status was approved by May 71 Council to begin July-, 1971. . June 72 Council accepted SARP's review of the region's first anniversary application within the triennium. The region was continued at its existing triennial funding level. The key issues were: l@hen this region entered triennial status it was advised that the scope of its interests needed to be expanded; that RAG needed -re- organization; and that goals and objectives needed updating to align with assessed needs. The anniversary application did not satisfactorily respond to those issues. However, freestanding of the application document (which was prepared 3 months prior to SARP's review) the region had planned an agenda for the annual retreat of the RAG'specifically addressing the areas of goals; RAG composition; RAG @nbership; and a reorganization of core staff. SARP recomended acceptance of the region's promissory note; the annual .retreat was successful; the -region updated its goals; broadened its interests; completed phase I of restructuring RAG; and reorganized staff-. The te-imdnation date for this region under the phase-out concept was February 14, 1974. The region's plan proposed the retention of 8 staff to 2/14 and the continuation of 8 operational activities (1 of which was a 3 part kidney project). The region's plan was approved. II Current Status of Funding: * F)(73 annualized level prior.to phase-out ................ $1,7003,368 * Percent of total FY73 funds.. 2.14% * Maximum allocation of FY74 $882,4SO . FY74 funds awarded October 1, 1973 ...................... $365,940 . Rem aining FY74 funds for January 1, 1974 allocation ..... 516,510 III Significant Events Since Last Review . Governor West has created a State Health Policy and Planning Council which is viewed ultimately as being the clearinghouse for health dollars in the state. Dr. Moseley serves on the Steering Comdttee of the Task Forces (developed to address-such areas as emrgency radical care, quality assurance, etc.). . In July 1972, the region's review process was assessed and the procedures found to be in comp.liance. Phase II of the restructured RAG m@ership question temporarily suspended because of phase-out orders. I L I,'Y 7 00035 South Carolina 19/l/73-12/31/73 $ 365,490 & I)IIIO(;)@A@l ID. A c 110,44@ -@COOO Program Staff Y'CO01 Development of Elth. Management info. Sus. 20,285 C002 State Aresi-7ide Health Planning Support 3,000- OV'@C003 State A-reawide Health i Planning Support 3,000. V C004 State Areawide Health Planning Support 3,000 (j C005 Area lianT)ower Develop- ment and Utilization 5,000- Area Manpoiqer Develop- 5,000 ment and Utilization VI @C007 Coastal Heart and Hyper- 8,079 tension Survey@. D025 @-IS Provider Conference 4,000 D026 PSRO Planning Study 2,000 A/iDO27 Pilot Project: Stroke Club 1,250 D028 Family Practice Confer- ence 2SP500 42 Heart Implementation 17,320 C 45 Nuclear Medicine Trainin- 11 980 C 51 Continuing Education for Health Professionals 29,572 Heinodialysis Continuing Education 13,522 i@'Y' Of,'] I(),: .Lilit-V 7 South Carolina (CON'T) A 55B Development of Transplant Unit 4,100 55D Expansion of Home Train- ing in Dialysis 6,000 59 Greenwood CCU Linkage 4,291 r, 60A Children's Cardio- Respiratory 8,537 60B Expansion of Childten's Cardio-Respiratory dis- ease Project 7,968 Bioengineering Support Service 2,000 Education Program for Diabetics 6,264 67 Perinatal Center 18,308 68 llobile Health Unit for Williamsburg County 21,400 /V@69 Shared HealthItanpower Development Program 6,020 Al 70 Eastern Pee Dee HoSDital Training Program 3,425 71 Advanced Training for Emergency Medical Techs. 32,096 12 Areawide Social Services 5,575 TOTAL 76,921 85,940 36,096 23,622 32,913 110,441 21% 23% 10% 1 7% 9% 30% SOU174 C"LIINA I Status of the Region . Triennial status was approved by @l-dy 71 Coui.cil to begin July, 1971. . June 72 CoLmcil accepted SARP's review of the region's first anniversary application within the triemitmi. The region was continued at its existing triennial funding level. The key issues were: When this region entered triennial status it was advised that the scope of its interests needed to be expanded; that RAG needed re- organization; and that goals and objectives needed updating to align with assessed needs. The anniversary application did not satisfactorily respond to those issues. Hoi4ever, free-standing of the application document (which was prepared 3 months prior to SARP's review) the region had planned an agenda for the annual retreat of the RAG'specifically addressing the areas of goals; RAG corflposition; RAG mditbership; and a reorganization of core staff. SARP recomended acceptance of the region's pron-Lissoiy note; the annual .retreat was successful; the region updated its goals; broadened its interests; completed phase I of restructur ing RAG; and reorganized staff. 'Ihe terndnation date for this region under the phaseout concept was February 14, 1974. The region's plan. proposed the retention of 8 staff to 2/14 and the continuation of 8 operational activities (I of which was a 3 part kidney project). The region's plan was approve II Current Status of Funding: * FY73 annualized level prior to phase-out ................ $1,700,368 * PerIcent of total FY73 funds ............................. 2.1406 * Maxim= allocation of FY74 funds ........................ $882,450 . FY74 funds awarded October 1, 1973 ...................... $365,940 Rem.aining FY74 funds for January 1, 1974 allocation ..... $516 sio . III Significant Events Since Last Review . Governor Vlest has creaWd a State Health Policy and Planning Comcil which is viewed ultimately as being the clearinghouse for health dollars in the state. Dr. @,loseley serves on the Steering Cormdttee of the Task Forces (developed to address- such areas as emergency Twdical care, quality assurance, etc.) . In July 1972, the region's review process was assessed and the procedures found to be in compliance. Phase II of the restructured RAG m@ership question teirporarily suspended because of phase-out orders. C- ],,y 00035 it IG I O:.l South Carolina 10/l/73-12/31/73 365 90 IIFR & I D. A 110 448 COOO Program Staff /@COOI Development of Hlth. Management Info. Sus. 20,285 V C002 State Areawide Health Planning Support 3,000. UiCO03 State Areawide Health Planning Support 3,000 /iCO04 State Areawide Health Planning Support 3,000. C005 Area.1tanpower Develop- ment and Utilization 5,000- Area Manpoiqer Develop- i ment and Utilization 5,000 /'6007 Coastal Heart and Hyper- 8,079 tension Survey-. D025 t@IS Provider Conference 4,000 V D026 PSRO Planning Study 2,000 VID027 Pilot Project: Stroke Club 1$250 D028 Family Practice Confer- ence 2 500 42 Heart Implementation 17,320 45 Nuclear.4edicine Training 11,980 51 Continuing Education for Health Professionals 29$572 He'modialysis Continuing Education 13,522 illy -,outh Carolina (COli'T) A 55B Development of Transplant 4,100 Unit 55D Expansion of Home Train- ing in Dialysis 6,000 59 Greenwood CCU Linkage 4,291 60A Childrents Cardio- P,espiratory 8,537 60B Expansion of Children's Cardid-Respiratory dis- ease Project 7,968 65 Bioengineering Support ervice 2$000 ducation Program for iabotics 6,264 61 Perinatal Center 18,308 68 tI.obile Health Unit for Williamsburg County 21,400 69 Shared Health @lanpower Development Program 6,020 IV 70 Eastern Poe Dee HoSDital Training Program 3,425 11 Advanced Traihin,, for Fmer ency '4edical Techs. 32,096 9 72 Aroawide Social Services 5,575 TOTAL 76,921 85,940 36 096 32,913 110,44 21% 23% 10% 7% 9% 30% SOIfIll IV @\i it@, Alloc@iti-ori o-f c-,i c cl@itlv is i,7i -i.@ii a 13 iiic@iiil)E.,r st,-@f 1', 7 of i,@oiild be f)n-i,-ized @is Oiic@ c,-J' 7 i-s @t -rcr i).tly i@1.1 e-ii@,-)-Io),ees. Nc) ,)rofessi.c)n.al slo@,- care @col@@113'..@..@;t(.,,O.. fic;@@(-,,vcr, was cii..,,;(--ussed at the recent fu,]-].. ii?,AC -I-ie also a. B stiff:@.n.,T I') i.1-torli iili@i-cli for ]-:ii-iii-Lc,(l o@,,@ the j)ro:fc@si@i-onal. ra@i-A@. c6o-i-rJ.iri@tol- and t]-ic, oJ' '(..I-Lo the ]@,@G that t-i@ii,,e the d(-d-i-cat-"Loi-i find the -remi,ijliiio the n-LicleLic, S('R@,I'j s-t@@,ff could Reflectively the activities at -Cie ci-i-rrent ll)laii B ey..I)-,,i-(ision. iias 4 c@'@@16,)P@l'OVE@d I- the event-, should an of @l(!( staff. SCj'.-@%,IP staff -Lo its fictional A(,IviFo@, Group ve-i@@ c(.)ii@,ei-vati-vc, (-oi-istitiieii.i7-y. SC,F,'@,',P staff (To@,s We'll outsl-l@i@ll("Lilj.(-, jol) of-' @@l: i@el.1 it-ifoi,-i-iiod. T@G I in ti-ic@ S,)i.iti-i Cai-c)].iii, IZ cc))i,,@ to IN@i@tli @i of fic rs c , cotic,@-ri-iin@7 the far at)ov,@-, coLititc-i@I)al,-t c lis(,t-rvatisifi 0 trends -@-,o T)r device confi.neincnts. 1,or c)ri.-,Ly p did tiic-, full l@",,,G body 11, @,2 000 I)i,7,Fiilj-rlg study ill ti'-ie P,@:. i(Tro-u-P, throunh the c@xL-r"lor(lina.i:y efforts of SC,,Ii)@@il) to issues to debate, the ItkG is irioviii.g in new di.-r@ections. current CI)ai-i-iii,@Ln also fortifies pro(-'T@)M efforts ill c@xpand,,3d interests. cli-.-O(--tioi),s beinc,, ed, project directors continued st)r)l)ort from i@eTe required to attest to -Cileir for Other sources -Ls a -I)rer,@@c[iiisite -for -fit the reyioi-i's funding plan bc,-Yoi-id )'ill?,e ')O, 1973. @iai@-iy co,,iij.)on.ejits 1)1.,ii,).s for co]-l-'--i.i-iuatio,-i for support (other than beyoi-id Feb-r-Li@.,,.i,y 14, 1974 ind the R@%G ad-opted a motion not to fluid S-0@CII aCti-@Tit-y beyond. tJi&,t date. S(-R,,,Ip staff- i)sui.ily introduces new concepts to IZAG via proposed ,iien -tal coil @y deve lop, ipoiierit ,:icti@i-ti@es. 'rile re(,io-,q's innrolve)iietit in PSRO Col-i@,:I@de:rclitj-ojas begai-i ill. tliil.-, f@L-,Ilioll. A providei- conference on ElviS is another exziniple of staff Is efforts to engage -the program ill type activities. 'Ihi,-; region possesses excellent capabilities lhe grantee i.s the i@,bdic@,il LIP@iATErsit@y Of L13outli. C,@irol.iiia Quiet therefore L all stiff are st,,I)jc,,cl: either to i:,@@CLI' ty COllsiclea-a.tioiiE, or S37s 1. '01 state pcrso,@i-it@,L 'I li, -I -1@n the ri. 1-i:,e instances false o ti classier - -action Of syst(-@@ C, @,-i liuvo 1: ose(I a dedicated coiiii)etci,it I)y pl@o@ f@o@i-i, of these 2 @i@ 'local of tf-iese I v tire 2 of mid I o:@@ these,, .@c@Ll-i-,@,-i.ti.c,!s is v(.@r)r goo(-.! si,)re a s@ one ers is j@e, II-, (-I s c@i',,- s c,. :'ii. -L.i).e s -L@ I- c-,, O.E the -'8 -icti-ITi-ti p-re 'c)i-iiii-ieiitl.)r p aii(J. 0 T'i' C o-.f cl()s(l, ti.ef,,,- tc) ir(,-a. @l,)erc-.t,es I t. Ilsb spc)iisors al'i C (I,:L)7 a I. -L I I c@, i rL c,,, j.)@c,c.-,.t-use C@i S" ill a.@te-- C' @p ()I,' ..I LI y 1) e, Sales @liti ri j'.@ -1, a c I s if; s; -Lic-@ (-I 20 Clial.)tcr :'@ (-)f i -e fc)-i@ Tl,ie A@@ 'F@iis to -,(@s i.n @3crvi., i@vli -Lla k@i(:',.-n.@,,ty Y@,iial. dia,],y@,i@s to I)oiiefic--'L.ari-es. VI Stl@if@t-' Sot.)-Lli Caro-.@-jr,.@t ]@,'@,!P 1-i s of $SI6, 51.0. lhc,@ Sc)ii,i,l). Cei-i't-ral ai)eriti.o@iis Iiraii.c!ii its ipp-r@ral@ as SCOB/.T-Y,@D 11/20/73 A--S tret)i,, t I ic!iij n,,@, As-,Lirince O@@@\7 liy f 7 4 !/.!-,/74 6f 27@416 12 650 67 coo 6 17. th 4 @l-, 14 2 69 5, 350 7 78/,, 71 TrFy. 35,0 5 72 i-rid 6,G,58 Ai.@i'i@u,'I-aLory 73 tir @)-cls 010 for Otiality A 74 .j,@)per Sa@,,nniiali 6, 325 Quality Assurance 75 -- Co,@puterj.zc@,,.! Cire 22 625 irt Yi.cln y Pjiseas(@ 76 liyper. Contr@cl 14,320 77 Erl. for 4,500 78 ijropith:!.es ii-id 24,1@iO li@ypt,-K'teils:i-on Screeni-n in Chilclrei.,i 9 O"il)ital 2 0, 000 "ildt)ey 6/30/7,@ PF f & A OTfl 8C) @L@, 2-@4 8L 20,158 82 10,850 7 , '3 7 39, @@.1.5 46 7 75 52 5.6 l,,)8,953 1'ei-ceritages 19% z 8% 9 % 36% . I @l , -. I . . . , . 1. I I . I . I I I ... I .. - I WISCONSIN I Status of the Reoion Ihe August 1971 N@k@ approved Triennial Status including a Developmental Component, beginning Septenber 1, 1971. The October 1972 Council accepted SARP md Peview Comdttee's recomendation on the Region's second year triennial application (06 operational year) to fund the reuion at a level of $2,153,624.' I'his amomt represented an increase of $374,552 over the NAC approved level of $1,779,072. No key issues were identified. . The Tendnation date for the IVIM under the phaseout concept was Deceniber 31, 1972. The region submitted a phase-out plan requesting funds for the reduction- of prouram staff to two, the continuation of one 0 operational activity (EIS) and three contracts through Februa-ry 15, 1974. . The approved pha-se-out plan was for the reduction of program staff to ,two and the continuation of the ENE activity through Decenber 31, 1973. II Current Status of the Pbgion's Fmding: PY 73 annualized level prior to phase-out ............. $1,779,072 Region's percent of total FY 73 funds .............. .... 2'.24% Region's .DYM allocation from FY 74 funds .......... $923,686 Ainount of FY 74 funds awarded to Region October 1, 1973..$383@040 Maximum FY 74 funds remaining to Region for allocation January 1, 1974 ............ $540,646 III Significant Events Since Last Council Review May 1973 - Staff visit to the Wisconsin @IP to assess ENE Program Progress, current status and plans for future supports Dr. John S. Hirschboeck, Program Coordinator resigned, effective October 31,, 1973. Dr. Paul C. Tracy, Assistant Coordinator for Program Development was appointed as Dr. Hirschb,,)eck's successor. B-Quzility Assurance ALLOCATIO' 4 l@Y OPTION C-E,"IS FY 74 D-Ki.diiey Disease E-Ilypertension REGION Wisconsin PEITIOD- 10/l/73-12/31/73 $ 383,040 PltOJI:CT & PROCRJ%M ID. A B c D E OTIIER 121,16 COOO Program Staff 30 North Central Wis. Out- reach 6,340 32 Research & Planning of Hith. Care Delive-ed 28,276 38 Wis. Hlth Care Review 23,042 40 aiS Program 194,846 43 Health Matpower Program for La Crosse Area 95375 TOTAL 43,991 23,042 194,846 121,16 11% 6% 51% 32% WISCO'@,'SI'li R.EGIO.",I@,.T, @@EDICAL I-T',OGR.L,4 IV. Pnalys@i.s of the to t-s- -I-, tion of. '71,, Funds Th)-ou@,,Ii(,i-it the pc-,ri(,d, Wi@@cori--iii RMP has been able to maintain o,,- its 1--e-y profesr@ioii,@.1 staff. The one exception was the r(2sicriation on October 31-, 1973 of the former Program Coord.iiiitor, ).)i-. John S. 'Jli-rschl@oeci.@, who assumed a poIsit-.1@()n@ in the health care delivery Da.-. Ilirscliboeck will. continue to serve as Secretary -and Treasurer of the Corporate Board of Directors. Dr. Paul. ]'racy, former Associate Corrdinator and a member of the program staff since September, 197'L, was appointed to Z7, 0 0 should exl)a-fisioi@i of t]-ie option areas materialize. I'lie Cl II'.A is represented on the IZAG wid its representative atteii ed the -it ijliicli this 11)1)1.icati.oll ivis considered. 'llic full. il)pljcati-bii lit-is been st.il)iiii.ttoci to the, A @ind 13's I-'or collillici-it. IVI)CII colibilel)ts are toy i-iill. be forwarded. Ilage 3 - 'Fei-r@iessee Mi.d--South VI Sta@lf Recoii-;-,@-@j,,datioiis: 'I']-ie 'Fey-messee 'flic.1-Soutli ]@%li.) has requested i--Ls fail]. rel-a@,@ii.ni-lig ,il.locati-oi,i o'@. 912. 'I'l@ie Soiitli (,cii-L)-al (.@eritions Brincli. rc,co,m@,ionds aT.)-proval. @i.s requested. SC'f' )B I)OD: @TPS U%I,K: II- - 2 0 - 73 Illy 1) T' OJ z A lo Pro(@rai-,i Staff 199 668 57-1@1),,pertensiort Foll.ow Lip 41,035 64-1@lecli,atric Ed.. Service Sy s tei-a 32,820 65-f-li-gli Risk iNel,@born 19 200 68-P3.-i.jp,aiy Care Course 14,898 Clini,c 32,000 of Noims @trid Stm-idai-cls 76-R(@i@ial, Dialysj,s 88,291 13@200 77 Pai-,i-.r@iedical. Ti@ainiiig is 000 8, S30 79-Org"@l, I)oiior I,-.d. 19 I- 38 80-Publ'i-c Edu(--acj-on 24, 350 SI -(7a. -.Tenn. F:IIS 50,000 ,S2-Cliroiiic Ki.cl@n(.,)r Di.sea-se so @000 8.3-Ilhari,ia(,its in Ilyper 2 Soo 84-H),per Screening s,ooo 85-Cos-t Reduction 10 232 86-Sta,Ti.dard Ilroced for 1,Yp,iplieci@D,,na folloi%rin.g @ll-'IS t e c t ol@y 3.1050 30,000 TO'J'Aj,,c3 157103P 91 @ 341. So,ooO 82,338 4 8, 535 199,668@ n A 11 I Irl I 1. I I'@ Mid-Continent Operations Branch' nalysis - F. Zizlavsky Staff A Louisiana RIIP: Current Grant Period 3/l/72 - 1/31/74 I. Statu-s of the Region * The Louisiana RMP has been operational under anniversary status. * SARP reviewed the last application in December 1971. * Last Council review: February 1972. * The March 15, 1973 phaseout plan was approved for program extension through 1/31/74. Nine projects and a reduced Program Staff were approved. * In contrast,-16 activities were ongoing prior to the planned phase-out. * On-Oct'ober 1, 1973, 11 program activities were approved. Five activities were previously approved in the phase-out. See attached chart, Allocation By Option. I4 Current Status of the Region's Funding * FY 73 annualized level prior to phase-out ... $886,580 * FY 73 NAC recommended funding level .......... 1,000,000 Percent of total FY 73 funds .......... 1.12% * * Maximum allocation from FY 74 funds (DC & IC) ........... $4611,843. * FY 74 funds awarded Oct. 1, 1973 ...................... -191,520. * Maximum rY 74 funds remaining for allocation I/l/74 ... 270,323. !II. Significant Events Since Last Council Review * Four HS/EA activities ($715,969) and 3 EMS activities ($325,940) funded as supplemental applications in June, 1972. * An HS/EA visit was conducted on May 21, 1973. * An EMS visit was conducted'on May 30, 1973. * Pediatric Pulmonary Project (#17) was funded $230,000 for the 02 year from R14PS earmarked funds. * Director, Joseph A. Sabatier, Jr., M.D. on 25% time 7/l/73. Deputy Director, Paul Cook, D.D.S. 100% time. A-Str(@@iii,ltli(,ninil, I,(.)cal II.II B-Qu,--il.ity Assurance AI,LOCAI'TON 13Y OPTIOIN C-L",S D-Kidiaey Disease F@' 74 E-11 pertension y R l@'G 1 O,,4 Louisiana 00033 RM PERIOD 10/l/73-12/31/73 $ '191,520 PIZOJI,"CT. & PRO(;IZAM ID. B c D E OTHER 000 Program Staff 76,249 002 Medical Ed. and Physician Utilization 2,000 003 HlthiManpower Inventory 3,000 004 Quality Assurance Sems. 6,000 Lcuisiana.Illth. Data Info 12,832 Updating EMS 5,500 HS/EA 13,550 31 HS/EA 13,550 33 HS/EA 17,650 42 EMS for Infants - 17,024 43 Containment-Costs.in Medicaid Pediatric Case 12,100 44 Hypertension 12,065 TOTAL. 62,582 18,100 22,524 12,065 76,24. Mid-Contirien't Operations Bl@-arich' Staff Analysis - F. ZizlEivsky Louisiana PJ,'iP: Current Grant Period 3/l/72 - 1/31/74 1. Status o@tlq- ion The Louisiana Rt,iP has been operational under anniversary status. SARP reviewed the last application in December 1971. Last Council review: February 1972. The March 15, 1973 phaseout plan was approved for program extension through 1/31/74. Nine projects and a reduced Program Staff were approved. . In contriast,,16 activities were ongoing prior to the planned p ase-ou . On October 1, 1973, 11 program activities t,,,ere approved. Five activities were previously approved in the phase-out. See attached chart, Allocation By Option. II. Current Status of.L e@ ILd@i FY 73 annualized level rior to pl,iase-out ... $886,580 p * FY 73 NAC recommended funding level .......... 1$000,000 * Percent of total FY 73 funds .......... 1.12% * Maximum allocation from FY 74 funds (DC &'IC,) ........... $461,843. * FY 74 funds awarded Oct. 'I, 1973 ...................... -1915,520. * Maximum FY 74 funds remaining for allocation I/l/74... -,,f;F7-U,32-3. III. @nifi a@nt Events Since Last Council Review * Four HS/EA activities ($715,969) and 3 EMS activities ($325,940) funded as supplemental applications in June, 1972. * An HS/EA visit was conducted on May 21, 1973. * An EMS visit was conducted on May 30, 1973. * Pediatric Pulmonary Project (#17) was funded $230,000 for the 02 year from RMPS earmarked funds. * Director, Joseph A. Sabatier, Jr., M.D. on 25% time 7/l/73. Deputy Director, Paul Cook, D.D.S. 100% time. 11.3 li-Quality @%,,;,.;urince l@Y 0III'ION C-11@',@lis I,'Y 74 I)-Kidiiey Disease E-ilypertension IZI-Glo, Louisiana 00033 RII Ill-"I@IOD ]@0/l/73-12/31/73 s 191,520 PL@OJI,ICT & Pl@oG@m ID. A B c D E OTliER 76,24! (000 Program Staff (002 @ledical. Ed. and Physician Utilization 2,000 '003 Hlth@Manpower Inventory 3,000 '004 Quality Assurance Sems. 6,000 15 Lcuisiana.Hlth. Data info 12@,832 26 Updating EMS 5,500 @O HS/EA 13,550 HS/EA 13,550 HS/EA 17,650 42 EMS for Infants 17,024 43 Containment-Costs.in Medicaid Pediatric Case 12,100 12 065 44 Hypertension TOTAL 62,582 18,100 22,524 12,065 76,2, t@,rarich F. I-ou-'@siar@ia its A'Ilo( IV. !s t a f-' -F @s P@@, @i1 -i s 0 -f I (',',a e U t'i I i z @o ati on of 76 St f 14. Fi@'@i as of 12-31-72 2 E.) as of c 5.25 (F.'['.L.) as of [,!,ov. 73 (A '1/4 P,'OfessiOrlc.l, I cleri al) DLir,ing the '@i,',PS 4@-.hl- Pi-ogi-ai@,i staff was cal I a 1)@,@s,i@iess c.1 r a E,@, c,@- r seven o f l,cl,r@ e !I -to P'!,.@r@inirig and ori 20',,@ F@@ir@ amid' r-@ v a'@ I-,, @.t t i Rol a, to i,e(li,@estec SI'a-f-F The fl ro,,.-i r to '10"1/73 ti,iru 12 - @l-@73 .... 33% i-i c ............. 9% 'I 2% rA! ri i:,., v i@ s e... ........... 0 ............. 6% ...... ............ 40% 1'he LR14P Rn@gio!-izil tdvis@r'Y G-'I"Olip ITI(,.,t O,,i @,loverri[,E@r 8, 1973 and reviewed and al)r.),f,oved this application. I)o,.vid [@,l. of the RAG, indicate "the PAG is @int@ict, and soillrz@ of its a@4c@ cori-tribl,At-irig generously of t@@eir table in an ongoing (?ffol,t 't@o '(-@hc,. I'@lrograiii Staff in program dev lop;-,,-fc@.@nt and '11073 there li,-ivc., f)e,@ii t@vo gs of RAG, b,-i@-,@ rr!cctin<; o,@ of it.,; E>,,,-CLItive Coiiii-nittc.,e and of Loard oF Tr-ust@,es, Pnaly@is of tv@e V. for S The LR' il requests $51,899 -f o l@ 2 1 o P(-,., r a,. t I o @'i activities. T[,tc@ nc-i,,, iciti 2-- vi t-, Se Et @i c. i-@ p.. c g r e e ti A I It ib@t C.).@)tioii. In shou Id be -c-,ser@rs EMS not d "i@.,-5,02" ti l';S'l qualit,@,/ E@@.sut-aric(.@ -i@, an activity to develop a @C@d to I C.,, 4Caid w , I 'I i it@l to pi-OV41C (trader TITL.',"--' XIX of of '1972. 'Fli.- Progrp,,,@i cc-,,,itiriur,s to medical sc,.rvic(@, activities foi@, con't'linL;at-@ic);@l of 27 ']'Y,air@ing, @.,,id #.42 - El@1,S for iiici@i Ris'ie, and ll'i Infants I - r-, @l P @ i a s S 0 L IIIt Cl C C, 1 1IU C t i @l e I Y 3@ t@ (-i (-'f f C C t i1 Y L I @, -C r, er Iv i c @ s, i q i t h 0 L 1 t 'long term It has to zic-tivic@-'Ies wli-i@ch have soi,ill.,@ degree of viab4il-ity and fisc@a.'i s@jpi)or'l- teri!li riates Ev-idetice of contir),t@,--,@d r, ,pl-)ort -@'or of' tire operational activities is VI. Staff 'I-i-te reqLiLs-(, for $270,3,9',@, is reCOiri!Tiei@.,e@,r@,d fee,, i-irova'l .the Progy,o-,m si-,,@jijld be bL-,, (i,ivc@n to oil a 25% basis. .1 I e (: a. ti s i-, o i@' @! w-La r k, e,i i) ,,I g C-! s @) I, (, @l 9 1 l'@ ci'U- C,@ Li t 'lu, 1l' l@) Li O@ li r.)'l a ri,-i e c,i p h a s e - o L,, -'c , @i se I visit to tire [)i-ior, to "t-Ilic- next s(,-,I)c-duled N[,,C in 1974. @16 B-Qtiality Assurance C-EMS D-Kidtiey Disease ALLOCATION BY OPTION E-[Iypcr,teiision Louisiana RF,IP REGION 311 PERIOD Fpo-jLrCT Pl@OGI@Aill I. D. OTHE[Z PROGRAT-I STAFF i6,874 N C004 -EMS & Quality Assurance 4,775 Sei-ninars N C005 -Quality Assurance Seminars-L.S.U. 6,000 N C006 -Q.A. in La. Medical Prograni 34,250 Total Progi-aril Staff-($'DI,899) PPOIECTS c #27-EMS Tra@in@ing 14,551 #28-EMS-Two-v,,ay CoaL,-nunication 36,028 ft32- Cenla [iS/EA 6,775 ft38- Outreach N(itritional Counselin'g Prograt,@i for Diabetics 7,229 c i'42- LI,IS for Fligh Risk [@eonates and III Infants 43,756 C #43- Quality Assurance in Medicaid P(@diaty,ic Care 25,934, C #'@14- Patient Follot,@i-up in I-;ypertensiob Screening Prograin 21,775 f,@ #45- fimbulatory Ilea'I'Lh Car@ Inventory 4-8,435 tl #46- Service Availability and'Utilization 7,041 li , #47- Cost containn,,cnt cri- teria for H6sp.@lealth Facility 6,goo TOTAL PROJECTS - (218,424) 25.6% 24% 36% 8% 6.4% --------- ---------- ------------------- -------- TOTAL .69,151 66,184 99,110 21,775 '14 103