DEP OF @1H, EDUCATION, AND WELFARE Statement by Director Division of Regional Wdical Programs Public Health Service on Regional Medical Progrm Mr. Chairman and Nbmbers of the Comittee: It is my privilege to appear before you again on behalf of the Regional Medical Program for Heart Disease, Cancer, and Stroke which were authorized by Public Law 89-239. On November 9, 1967, the President sent to the C ongre ss the Sur&ecn Generalls Report on Regional Mbdical Programs transmitted to the President by the Secretary of Health, Education, and Welfare as required by the Law. In that Report the goal of Regional Medical Program is stated as follows: "lhe ultimate objective of Regional Medical Program is clear and Unequivocal. Ihe focus is m the patient. The object is to influence the present arrangewnts for health services in a er that will permit the best in mdem medical care for heart disease, cancer, stroke, and related diseases to be available to all." Progress_ to Date The Report describes in some detail the substantial and impressive beginning which had alreadybeen mde in achieving that goal up to June 1967, its date of publication. In bringing those facts up to date we are pleased to report that 54 Regional Medical Program have been organized, covering all areas and -representing all the people of the Nation, including Puerto Rico. Each of these Programs represents a cooperative effort among the health resources of the Region they themselves have organized. In each the purpose -has been to develop and implement a program of action that will contribute to and capitalize on new radical knowledge and techniques, undertake needed research, create new diagnositc and treatment capabilities, and evolve a 2 ces that will inProve their system effectiVI6.0rgmization of health resour for delivering to all the people of their Region the fLill benefits of aiTTeiltlY available knowledge and medical skills. Eight of the 54 Regional Wdical Pmgram are actually carrying out operational activities which involve the care and treatment of people in their Region. From ail indications, we expect that virtually all of the 54 Regions will be engaged in these types of operat4,,o.-@ activities by tbe end of fiscal year 1969. Operational Activitift ai 2ram which will improve read)r@mde-zway in the operational Pro_ diammis and care of those afflicted with these diseases afe@desdribed in the Surgem.@ralls Report. Mmy more innovative activities and projects were described at the recent January Coriference-Workshop m Regional Medical Pr.ograns which brought together mTe than'700 persons directly involved in the 54 Regional Medical Program. Ihey we-re able to exchange ideas and results not only on specific improvements in diagnosis, treatment, md professional education, but on ways to improve the cooperative organization of health resources in order to apply those resources to the needs of people. In s@g up the two-day C,onference-Workshop, Dr. Lowell T. Coggeshall, Vice President Ewritus of the Universit)r of Chicago, noted that he had found "substance,' in the Program. "In medical science and practice--health care--the ultimate substance is advancement of knowledge or method that makes some worthwhile difference in the lives of people," he said in describing "substance." Ihe Challenge substantial activities covered in the rt to the President and the Congress, ted further at the Cmfe-rence-Workshop, and being demonstrated :Ln the Regions, are only tqe beginning of this important Program. 3 As the foundation for action has been established the extent of the challenge has also emerged mre clearly. Since this program began only soft two year,.; ago, the threats of death and disability from heart disease., cancer, and stroke have remained strong and resistant to human skill and inventiveness. In these two years it has also become more apparent that the solution of these and other. major health problems will require significant improvements in the organization and delivery of health services. Therefore, the great promise of Regional Medical Pr,ogrars for the coming years lies in their demonstrating how M&cal capabilities can be more effectively organized to help solve Vwse problems through new patterns of collaboration of all available health resources. .Regional @rative Ar nts 1It is clear that aregional cooperative arrangement among the full array of the available health resources is a necessary step in bringing the benefits of scientific advances in medicine to people wherever they live in a region. Because it provides a system of working relationships among healti personnel in the institutions and organizations in which they work, such an arrangement enables patients to benefit from the inevitable specialization and division of labor which accompany the expansion of mdical knowledge. What is required to achieve this is a commitmnt df @ivi@ and institutional resources which nmt be worked out by each Regional Medical Program. When achieved, this approach provides a means for sharing limited health manpower and facilities to maxindze the quality and quantity of care and service available to the Region's population, and to do so as economically as possible. Regional Medical Program now have engaged the services of nearly 2,000 full-time or part-time staff; also involved are wre than 1,960 members of Regional Advisory Groups @osed of voluntary representatives of a cross-section 4 @)f medical leaders and inforwd laymen; and all of the medical Schepps, iliaa)@ Hospitals, voluntwy and public health organizations, and mst organization:, of health professionals. In addition, approximately 1,200 people are serving on special task forces and subcommittees. To capitalize m @ese conaitYneTits that individuals and institutions have already made to the development of their awn Regional Medical Program, and to realize the promise of the plaming activities they represent in all parts of the Nation, the President has recomended that the @orizing legislation be extended for a period of five years. Sufficient unit also.be provided to enable the translation of involvewnt into service, ideas into action, and cooperative planning into collaborative operation. Cmclusion The appropriation request for the Divisim of Regional *dical Prograr-is totals $68,922,000, which, when combined with $30,900,000 for grants carried forward from 1968,, provides a total of $99,,822,,OOO for 1969 obligations, or an increase of $46,036,000 over the 1968 operating level. The request includes $62,900,000 for regional medical program grants, $3,314,000 for professional and technical assistance, $905,000 for review and approval of grants, and $1,803,000 for program direction. I shall be happy to answer any questions.