ifil 110[lipillill *1 FROM ITS EARLY DAYS', AS SO@ING OF A COLLECTION OF SEPARATE AND OFTEN ING INTERESTS, TO THE MORE SELF CONFIDENT PRESENT, THE CALIFORQIA COIT117E ON REGIONAL MEDICAL PROGRWE HAS SHOWN A GREAT POTENTIAL FOR HELPING TO IMPROVE THE HEALTH OF CALIFOMIPNS. WE BELIEVE THIS POTENTIAL HAS BEEN TURNED INTO ACTION AS THE COiMMI7E GROWS VO[E ASSURED IN ITS DELIBERATICilS. THE COMIIIEE BEGAN ON Iti AD HOC BASIS IN 1965, BEFORE PUBLIC IA4 89-239 WAS ENACTED. IN KEEPING t-IITH A LONG STANDING CALIFORNIA TRADITION OF COOPERATION AMONG ALL t'AJOR SEGIIBTS OF MBICINE AND HEALTH, THE CCRMP INCLUDED REPRESEF\ITATIVES OF THE CALIFORNIA UICAL ASSOCIATION, CALIFORNIA HOSPITAL ASSOCIATION, THE MBICAL SCHOOLS, THE STATE HEALTH DEPARlTUff, THE MAJOR SCHOOLS OF PUBLIC HEALTH AND THE HEART PIND CANCER SOCIETIES. VERY SOON AFTER ITS FORML INCORPORATION UNDER STATE LA4, THE COITIITTEE ADDED SEVERAL DISTINGUISHED PUBLIC NYBERS TO BROADEN STILL FURTHER. ITS VIEWPOINT AS BOTH AN ADVISORY AID POLICY@AKING BODY FOR REGIONAL MOICAL PROGRAf'S IN CALIFORNIA. IN ITS FIVE YEARS OF ACTIVE LIFE, THE CUIMIIILL HAS ESTABLISHED SEVERAL SLBCUIMI@, EITHER ON A PEWANENT BASIS OR TO TU ACUTE NEEDS WITHIN A SHORT PERIOD OF TIME. FOLLOWING ADOPTION OF BY LAWS A PEMENT COMMITTEE OF STAFF ClYiSULTANTS WAS CREATED, WITH A REPRESENTATIVE APPOINTED BY EACH INSTITUTIONAL VEBER OF THE PARENT BODY, TO CARR( OUT THE POLICY DIRECTIVES OF THE CCU AND TO MAKE RECMUDATIONS FOR PROGRAM,ACTIVITY AND DIRECTION.- THIS GROUP ESTABLISHED SEVERAL SUBOOMMITAS OF ITS OWN - TO DISCUSS DATA NEEDS, OBJECTIVES, EVALUATION AND COMML141CATIRI. LATER, AS OPERATIONAL PROJECTS WERE FUNDED, ODORDINATING CUIMITTEES @,ERE SET UP FOR CORONARY CARE TRAINING, STROKE ACTIVITIES AID OTHER CATEGORICAL DISEASE INTERESTS SET FORTH IN THE LA4. THE STAFF CONSULTATITS COMMITTEE HAS THUS BEEN DELEGATED THE DAY -TO-DAY RESPONSIBILITY FOR THE SUCCESS OF THE REGION/S PROGRAM, ALTHOUGH FINAL DECISIONS CONCERNING WHAT THE PROGRAM SHALL BE REST WITH CCU. OTHER SUBCOMIITIEES OF THE CCWP WERE CREATED FOR BY-LAWS AND MEMBERSHIP, PROGRAM DIRECTION, TO SETTLE A QLESTION OF BOUNDARY LINES BETWEEI 1,10 OF THE AREAS IN' THE REGION, AND FOR THE ORGANIZATION PND PROCEDURES OF THE CCRMP ITSELF, AL-MOUGH IT DOES NOT MEET OFTM, THE MMERSHIP COMMITTEE IS A STANDING BODY, AND IS CHARGED @41TH MAKING RECUTE\DATIONS FOR CHANGE IN THE REPRESENTATIVE t'AKEUP OF THE FULL COMMITTEE - HOW THE NURSING PROFESSION OR Ifi@TISTS CAN BEST BE REPRESENTED, FOR EXAMPLE--AND THE [EKRSHIP COMMITTEE IS ASKED TO RECONOD NEW PUBLIC MEMBERS FROM TIME TO TIME. -3- THE AD HOC BOUNDARY COMITHE WAS ESTABLISHED FOR THE SOIF PURPOSE OF DEVELOPING RE ATIONS THAT WOULD SERVE THE INTERESTS OF A COML14ITY THAT HAS STRONG PERSONAL PND PROFESSIONAL TIES WITH TWO M)ICAL SCHOOLSO AS THE CC@IP EVOLVED OVER THESE FIVE YEARS IT BECPJVE APPAR91T THAT 1'r,) REVIEW PROCEDURES VIERE UNEVEti AND AT TIME INEQUITABLE. IN ORDER TO DEVELOP A REVIBI PROCESS THAT WOULD STRIVE FOR TEHNICAL PROFICIEIICY Al-ID FAIR HANDLING OF FUNDING REQUESTS, MD AT THE SAME Tlt'E A PROCESS THAT WOULD BE '@IEI I UNDERSTOOD THROUGHOUT THE REGION.- THE ORGANIZATIO[I AND PROCEDURES SMCO@-'MITTEE WAS ESTABLISHED, WITH DEAN GROBSTEIN AS ITS CHAIRM4. THE @IOST RECEI\FTLY ESTABLISHED SUBCOMMITTEE, ON PROGRAM DIRECTION, HAS ADDRESSED ITSELF TO THE DEVELOPING NATIO@,IAL PRIORITIES ON HEALTH AND TO CLOSER '@IORKING RELATIONSHIPS WITH ODIIPREHEISIVE HEALTH PLMNING EFFORTS IN CALIFORNIA. AS ONE OF ITS FIRST DUTIES THE CALIFORNIA COMMITTEE ON RMP DELEGUE THE RESPONSIBILITY FOR PLPNNING IN THE REGION TO THE EIGHT EXISTING MEDICAL SCHOOLS, EACH AREA WAS ASSIC41ED A GEOGRAPHIC TERRITORY AND BEGAN TO ORGANIZE ITSELF AS A SUBREGION, AT A RECENT TUING OF THE CCU A NINTH AREA WAS ESTABLISHED TO SERVE THE NEEDS OF HALF A MILLION PEOPLE IN THE WATTS-WILLa4BROOK SECTION OF LOS ANGELES. THIS NB4LY CREATED SUBREGION IS ADMINISTRATIVELY BASED AT THE CHARLES DP,DI POSTGRADUATE MEDICAL SCHOOL, WHICH IS GETTING @DERv4AY WITH THE HELP OF RW FUNDS. THE CCU AS MOST OF YOU ER, BEGAN WITH 27 MEMBERS, INCLUDING 8 PUBLIC MIBERS.- AND WAS EXPANDED LAST YEAR TO 30, ADDING REPRESENTATIVES FROM THE TUBERCULOSIS AND RESPIRATORY DISEASES ASSOCIATION, CALIFORNIA NURSING AND CALIFORNIA DENTISTRY. FIVE fvDRE REPRESENTATIVES WERE ADDED THIS YEAR, IN RECOGNITION OF THE NEEDS OF THE CALIFORNIA PROGRAM, ITS STRENGTHENING TIES WITH COTREHEISIVE HEALTH PLAINING, AID THE 1970 LEGISLATION WHICH ADDS KIDNEY DISEASES TO THE CATEGORICAL EMPHASIS OF WP AND DECREES THAT NEW COOPERATIVE ARMIUBTS SHOULD BE MADE WITH THE VETERANS ADIIINISTRATION. IF THERE IS ONE PARTICULAR POINT I WOULD LIKE TO LEAVE WITH YOU THIS MORIING IT WOULD BE t-IY FIR[I BELIEF THAT THE CCRIP IS GROWING t/DRE MATURE,.- CONFIDENT, EFFECTIVE AND ABLE TO CHANGE WITH THE TIMES, PERHAPS AN DMLE THAT WILL UNDERSCORE W FEELINGS CAN BE SEEN IN THE EVOLUTION OF THE REVIEW PROCESS. THOSE OF US ON THE CCRMP WHO SAT 04N FIRST TOGETHER AS A GROUP FIVE YEARS AGO WERE WILLING TO TRY 'W PROGRAM, BUT WE WERE NOT AL AH SURE IT WOULD WORK, THIS NE -6- .EACH OF US, I'M SURE, FELT THAT THERE WERE SOME VESTED INTERESTS THAT WOULD BE DIFFICULT TO MOVE TOWARD THE SPIRIT OF THIS N54 LEGISLATION, AT OUR FIRST MEETING WHERE OPERATIONAL PROJECT REQUESTS WERE TO BE CONSIDERED NO ONE OFFERED A SINGLE COMT THAT WOULD REFLECT ON THE [IIERIT OF THE PROPOSALS. THIS KIND OF REVIL-VI AND DISCUSSION WAS NEVER W-PEATED, BUT IT TOO!( US @1ANY HUNDREDS OF Ml HOURS BEFOREI,,IE REALLY BEGAN TO ACCEPT THE FACT THAT WE HAD TO FK HARD DECISIONS. ONE OF THE FIRST RECUMDATIONS OF THE 0,D@CANIZATION AND PROFEDURES COtilITIE WAS TO ESTABLISH A SYST[3,1 0 AS WE ENTERTAINED REQUESTS FOR PROJECT FUNDING. WE BEGAN TO CAST WRITTEN BALLOTS AT EACH @EUING, AND RATING EACH PROJECT REQUEST ON A PRIORITY s IL A PROJECT ',,4AS FUNDED, CAI, THESE PRIORITIES @@EPF- MAINTAI@JED UNT -7- AND FUNDS WERE AWARDED ON THE BASIS OF THE PRIORITIES, WHICH, ONCE THEY ARE ESTABLISHED, CANNOT BE CHANGED, THIS SYSTEM HAS BEEN IN EFFECT NDi FOR VANY MONTHS, AND CCRMP MEMBERS HAVE GROWN USED TO IT PND DEPEND TDRE HEAVILY WITH EACH WEING ON THE TECHNICAL UIEW PANELS THEY HAVE ESTABLISHED TO HELP THEM REACH THEIR DECISIONS. THUS VE BELIEVE THAT THE REVIEW PROCESS IS A DYNAMIC EMMPI F OF HOW THE CALIFOR[ilA 00@Til@ ON REGIONAL [4E)ICAL PROGP4@ IS GROWING INTO PN INCREASINGLY SOPHISTICATED INSTRUMENT FOR HELPING TO IMPROVE THE HEALTH CARE PROVIDED FOR CALIFO@@IA'S 20 MILLION CITIZENS. Remarks prepared for EWS Site Visit - UC San Diego Conference Room A., Building 111 Deder.ber 7, 1970