ISSUE:  Criteria for activities in program areas not
                        specifically defined in Public Law  89-239


                     A.  Disease categorical versus comprehensive  projects


                     The Division staff recommends that Council reaffirm its position


                as follows:

                     The National Advisory  Council  reaffirms  the  policy  on
                categorical emphasis which is contained in the Guidelines, Chapter 3,

                item V - Eligible Activities:


                        'Ihe focus of Regional Medical Program under the
                        authorizing legislation  is  on  problem  of  heart
                        disease, cancer,  stroke,  and  related  diseases.
                        This broad categorical approach  must  be  a
                        consideration in the development of specific
                        Prograr,i elements under a Regional  Medical
                        Program.  Because of the broad scope o he
                        disease, cancer, and stroke,  it  would  be  difficult
                        and perhaps detrimental to some types of medical
                        services and educational activities if a rigidly
                        categorical approach were  adopted  for  all  relevant
                        Program- elements.  The emphasis of the Program does
                        require that the component  elements  be  shown  to
                        have significance for  combating  heart  disease.,
                        cancer., stroke, and related  diseases  through  a
                        regional effort intended to  improve  the  care  of
                        all those persons  within  the  Region  suffering
                        .from on-- of these diseases.  Hohever,  in  some
                        instances, activities which have a more  general
                        iTrpact extending  beyond  the  specific  problem
                        of heart, cancer,  stroke,  and  related  diseases
                        may need to be supported  because  they  are
                        essential to the achievement  of  the  purposes  of
                        Regional Medical Program .

                        The objectives of improved patient care for those
                        sufferin- fror,-. these categorical diseases  will
                        require the full development  of  the  process  of
                        regionaliz,ation, particularly  in  the  Program's
                        operational phases.  Therefore, individual,
                        categorical activities  should  be  designed  and
                        implemented in ways wnich will insure their
                        regiona'L rather than organizational or institutional
                        identity.

                     In so doing, however, it stipulates that support may be given








                 to activities which pertain to problems in heart, cancer, stroke,
                 and related disease but also have an impact on the diagnosis and
                 treatment of other diseases or also fulfill a specified objective
                 of the Region.























                                                                          February 1969