DEPARTMEN'R OF HEALTFI, EDUCAI-ION, AN[) Wr--LFAI@l-. PUBLIC HEALTI-I SC:1'4VICr OM ROCKVILLE PIKL@ orTHESOA, MO. 90014 fiEF'r.Tt TO:, July 24, 1968 Dear Mr. Ruppe,. This is in reply to your letter of July 3, 1968 to Mr. Karl Yc)rdy requesting additional information regarding the relationships between P.L. 89-749, Comprehensive Health Planning and P.L. 89-239t Regional Medical Programs. These two programs are authorized by separate pieces of legi,sliLion. While it is quite true that their long-range objectives ,ir(@ satily the same--belter health care for all Americans, their @-,IiorL- range objectives and their mechanisms are frequently For example, the Congress has required that the Regional Medical Programs specifically focus on the three principal "killer Heart Disease, Cancer., and Stroke. Comprehensive Health Pl,.innin@,, by definition, is noncategorical. Its legislative history is replete with the Congress' desire to decategotize and coiisolidIL(i L@ic several categorical grant programs which had previously been funded under Section 314 of the Public Health Service Act. Both therefore have attempted to increase the flexibility of regions, states, localities, and individuals in applying for Federal funds to implement programs which qualify for support. Frequently then there is prc)-rani -Planning which is carried out under both programs. So long as tiit-,Se efforts are dovetailed at each level, these mutual efforts cannot help but enhance each other. This kind of interrelationship at the state and local level will reduce the possibility of unnecessary duplication to an absolute minimum,@ @At: the Federal level., tt. comple- mentary relationship between the two programs has just recently bt-@ci-t reinforced. In its report to accompany 'fl.R. 15758, the o)cv(-@tis ion of "@@Regional Medical Programs, the House Interstate and Foreign Commerce Committee stated: The committee notes that there @,'are obvious @@@@,b@,tween the activities being developed by the regional LIS -i pliiinin,(,- medical programs and the compread ive heal.ti. @@@@,:@activit3'.es now beginning under the partnership Cor program 'The committee recognizes LliiL both progr@,ims are, just getting started but the co=tittee believes that Lli(@lie 2 programs should have a t expects that the administration of both ve coopcratioa -Ind will be carried out with effcczi .1 in or(Icr Lo IVOI.d interaction at the Federal leve duplication of activities @@n(I potential conflict ional medical programs and the cornprclieiisivc between re-b field." health planning agency in the several staLesA A region under P.L. 89-239 include or a portion of a state such as a metropolitan area. Tloiorc are numerous examples and all of these alternatives, altliou'@"n ,is Yor(,'7 indicated to you in his letter, the Michigan Region under II.L. 'C-"9-239 is COLLr-,ninous with t'ne state's boundaries. T[iL-rc, arc, 1-ic)Nrever, instances where there a-re indirect relaLl.onSlil.pG to anotiier i:cgio.,i, such as those of the Upper Peninsula with Wisconsin. Froin our perspective these kinds of relationships are benofi.ciil. to tli(2 development of both programs as well as being in the Sp-irit- of the flexibility with which this proeran. is being administered. State government is actively involved in the devel.o-@)mcnt of -i th's Involvement di"ers in P.L. 89-239 and P . L. 89-749, aithoug! I I @both kind and degree depending upon one particular For example, Federal funds under SeeLioa D OE P.L. 89-7li9 a)-c @,,.;:anLs to state agencies awarded on a formula Rc,,ioiiil Modica]- Program grant on the other hand are aiade -ivailal)lc Lo on 6he I bas@s of projects to be carried out by the SLlLe involvement in -at programs' is essential albeit these project gi:a different from its role in the formula grant programs. @'i am hopeful that this 'information in concert t4ith Lil@IL @ir. Yordy's letLer will@be helpfuli ',"'tr4 Yotdy, by wiy, become the DireCLor@of the ()EfiCe of Program Plaiiniiig Blvd Fv@llu,'tLic)rL of t he Health Service6'and 14ental Fca).tli Admi,.,iisLratic)-rL. This newly created Administ@"ation isi responsible for boon '.Regioikal l,4edical ,Programa@and Cotnprehensive@Realth VI@nning @t@thc Federal level, further 'means for coordinating If ,,there are. ot4er w h,6@lpfulo please let we know., ly yours, Donald R. C'@-, @,@i 6 w i. c kM.D. Ac tiiii, Director Division of Rkik;iollL',l Honorable Philip E. Ruppe,,@@, House of Representatives Washington,.,D&C., 2