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                                            UNIVERSITY OF VIRGINIA

                                               SCHOOL OF MEDICINE
                                              CHARLOTTESVILLK, VIRGINIA


              OF  THU  OMAN

                                                                         December 10, 1965









                      Dr. Stuart Sessoms
                      Deputy Director
                      National Institutes of Health
                      Bethesda, Maryland

                      Dear   Stu:

                                I would like to make some comments about the guidelines
                      for the draft of the Regional Cooperative Centers before they are
                      put into final form..

                                I would refer specifically to Section 66.9.  I realize
                      that this must,be part of any Government document but the severity
                      of the wording troubles me a bit.  Do you suppose it would be pos-
                      sible to soften this a bit by saying that the grantee would be
                      warned that his project has failed to meet the requirements and
                      unless these requirements are fulfilled that his grant will be
                      terminated.  I am sure that is what would happen but I wonder if
                      this ought to be put into legal language that might possibly be
                      acceptable.

                                The thing that also concerns me is Section 66.10 (Para-
                      graph D).  My comments would be directed to the fact that it seems
                      to me that there must be a limit to the number of patients in each
                      hospital that could be hospitalized per year.  I am not sure that
                      this should be in the guidelines or whether this should be something
                      that the Advisory Council should put out in their guidelines.  It
                      seems possible to  me that two things might happen if an actual
                      number of patients to be hospitalized was not stated.  First of all,
                      there could be tremendous pressure by-the public to be hospitalized
                      in one of these facilities and secondly, the rising cost of hospital
                      care presents a possibility of a great bulk of these funds being ex-'
                      pended for the care of patients.  I don't think that should be the
                      function of the program and as it is stated, I think it is a dangerous
                      one.  My suggestion would be that perhaps the council could be re-
                      quested to work out a formula based on the total number of hearts
                      stroke, and cancer patients ordinarily hospitalized in the institution
                      and then a percentage of these be funded for demonstration.  I don*t
                      have any magic figures as to what the percentage should be, but I
                      only present the concept.












                      Dr. Stuart Sessoms
                      Page 2
                      December 10, 1965


                               I enjoyed our meeting and I appreciate being invited.
                      Please let me know if there is anything further that I can do to
                      help.

                               Best regards.

                                                                  Sincerely yours,



                                                                  K. R. Crispell, M. D.
                                                                  Dean

                      KRC/Ihj