I -- -- --- - --- - -- PROFILE: CALIFORNIZI REGIONT%L IIEDICAL P@D@C)GRt@l Originally prepared by: Anthony I,. Koiiiztroff, Operations Officer Original date: March, 1969 Up-I)ated: June 9@69 Sept ,i@be@, 1969 CZ Planning $223,400'; UCLA, USC, UCSF, @@oisi $1,099 UNIE.RF, 04A -1)96@- cranl--s for planII4 na at 'OlS2 tile VI-r-7ous L@rea o,'f-'-ces) Davis $14,635 -<--'iOlS3 San Diego C) o $49,080-<- 'OlS4 Stanfo-d $109,965 $1,026,936 02 Plannin@-$2,504, 97' 0 $2,232,864 01 Operational -1@4 0 , l@2 41 02 Operatioral (+Core),@ $8,435,030 GE(It:--,@,APIIV AND DP-I-fOCP.APII'Z Thc- :Region is coterminotis with the State, except for the Reno and Las Vog@t..s, Nevada, areas which are "shared" jurisdictionally with the @IOLI-.@,Lain States and Interriountain KIPS. Cl.tr@.-ently, the Region is divided into eight Ar eas, each centered around a lill,dical school. Data for the entire Region will be presented first, fol"ciwed by dat a for itidividual-Areas. I.,@,,nd Area: 156,573 sq. mi. --@tal p ula 3@on: 18,293,000 (1965) % lJrban: 81% Median Ace: 30.0 (average) Racial (1960) WI-iite: 92% Negro: 6% Other: 2% ll,.@jor metropolitan areas (1960): l@or th San Fraiicisco-Oakland 2,649,000 Sacramento 626,000 San Jose 642)000 Stockton 260,000 'South Los Angeles-Long Beach 6,039,000 San Diego 1,033,000 San Bernardino-Riverside 810,000 Anaheim-Santa Ana- Carden Grove 704,000 Bakersfield 292)000 Fresno 366,000 \Ote: Breakdown of population by RMP areas will be 3.ncluded later. @.-',.31th Statistics: Mortality rates Ileart: 322/1001000 (low) Cancer: 139 (average) Stroke: 89 I!-,alth Facilities: Medical- Scliools will be discussed under Areas NursiLig Prooranis: 62 total programs, including 42 collegiate Medical Technololy Programs: 20 Hospitals: Total: 615 (138,722 beds) The vast majority are non-federal, short-term hospitals Personnel: Physicians (includes all but about 100 osteopaths x-ilio have been given MD by State medical examiners) 35,224.(212/100,000 high) Nurses: Total: 91,961 Active: 57,700 (347/100,000 high) 4 POLITICS Governor: Ronald Reagan (R), 1966-1970 Senators: George Murphy, (R), 1964-1970; Meiiiber, Senate Conmiittee on Labor and Public Welfare. (HealLI-i Subcoiiimittee) Allan Cranston, (D), 1968-1974; Meniber, Senate Connittee on Labor and Public Welfare (licaltli Subcoirri-nittee) Congressmen: John McFall, (D), Appropriations (not on IIEW ubcominitte,, s Jeffery Cobelan, (D),'Appropriations (not subcommittee) Clenard Lipscoiiib, (R) Appropriations (not subcoimiittee) Burt Talcott, (R), Appropriations (not subcommittee) John Moss, (D), Interstate and Foreign CowLnerce not subco-Lmnittee) Lionel Van Deerlin, (D), I & FC (not subcommittee) iiloi@loi,,OCI.CAL Rl",Vf Et4 ce of Pi, 89-239. Witlil-i-i ti,,@o months, committees C'b c Oct 3.965 Passa bad been appointed at UCSF, UCLA, St@inford,-and USC to study the IC-islation. The California State Department of Ilealtli oi-c,@iiiize-d the "California Cc)c)rclinatioii Agency for Triiniii(,, Research, 1-:cli-tcation, and Dci,@toiistrat-i.oi-i in the Field of Ileai--t Disease, Cancer, Stroke and Pcl.ated Diseases" This agency included representatives from tLic California Medical Association, the California Ilospiti-1. Association, and the Dean-- of the eight scboo-l-s of medicine. The Aaency was organized with the purpose of developing an overall pl.a@,i" for cooperative medical- arr@in,ei-.ionts throughout the State. Planning. for developing regional medical programs was to proccde at each of the participatin- medical centers. The Coordination Agency would "develop sLi-cc@stions" to delineate geoc,ra' Iiic p areas of responsibility for each of the medical center,-;, and would coordinate and mediate other questions. The proposed of operation relied heavily on systclilIF; analysis techniques. liiy 19'06 The Aaeiicy submitted an application outli.ni.-oc, its structure and goals, as describer above. At this times, the A(@,eiicy Chairi@.an was Dean 1,obert Glaser of Stanford, and the Project Director was to be Dr. Neiiiat Borliani of the State Department of Public health. The 'pi .@r@u@tioii raised by the application the creation of a "',IO -.-a qu.bstion not discussed in PL 89-239. 1966 Site visit: Team included Dr. Marston, Mr. Yordy, Dr. Sloan, and others from Di@,,IP, as well as Dr. Dr. Everist, and Dr. DeBakey from the Council. Dr. Marston indicated that lecal counsel bid advi-S'E!Cll against P\.@lID creitinc., a central- agency unless 5C wci-O to coordinate a group of "subrp-,ion-,." The Pegion decided on this kind of structure UCLA withdrew the plannin- application it had independently The various ric,@cli.cal centers agreed to -reco,,iE;i-clo-r Fit a later date i,71i@,tlicr to break up into sevei-@il- rcr,ioii,,;, Perhaps before receive -nj operati-olicil. cyriiitF,. C-1 U6 A revised application incorporating the decisions; June, 1967' OlS2 Planning Award $151,358 from 6/l/67 to 10/31/68 (kavis) September 1967 OIS3 Planning Award $10,417 from 11/l/66 to 10/31-/67 -t@D@o September 1967 OlS3 Planning Award $37,256 from 11/l/66 to lo/31/67 tinf @cl) October 1967 01 Plannin@ Review: 1. Most activity had occurred in the prior three months 2. Planning and decision-making were going on primarily at the Area level 3. UCLA and UCSF had begun to place staff outside tlie'$-r-.@ medical centers 4. Contact between Areas and with adjacent Regions was documented 5. Plannina underway included:' C> a. Review of morbidity and mortality data b. Analysis of hospital discharges c. Inventory categorical disease special resources d. Inventory of allied health proarams e. Analysis of patient referral patterns December 1967 02 Planning Award $2,509,197 from 1/l/68 to 12/31/68 Total cost budder breakdown: Area I(UCSF) $559,035 Area II (Davis) 220,184 Area III (Stanford) 247,582 Area IV (UCLA) 689,747 Area V (USC) 533,892 Area VI (LL) 118,000 Area VII (UCSD) 148,935 Area VIII (UCI-CC@i) 187,500 cc@IP 219,331 CMERF 503,291 April 1968 Site visit on Operational- Application Millikan, Mr. Thompson, Dr. Raveiitoq, Team- Dr. Dyson, Dr. Schmidt, Mrs. Phillips, Dr. Conley, Mr. Alpert The team felt that each Area had begun to for-e meaningful cooperative relationships within the community it served. They were disappointed, however, by the apparent lack of interaction between Areas. Total regional plai-i-@iin-. and direction were hard to discern. June 3-968 01 Overati.oiial A@,7ard $1,957,11-,6 from 7/l/68 to 6/30/69 Inclides nii-i,@ -nrojecls two "carin,,irl-,.-@") of 21. requested. reached ac the Site Vi.sit, Was Submitted. T I i coordinating agency bc,,c;Fiinc- a nonprofit corporation qrtd i-ts to CiJ.iforiiia Committee oil Regi.onal @,.P-dir-al- ProcrEiuis (CCP@IP). The Cr,-@-cLtee bec@iiiic- the California Medical Ecluc@iLi-on and Research Foundation (CMEI',F), a second nonprofit corpora tLoii, the fiscal arii, of CCIU-IP v7ith its o@qn stiff. 1966 -fine, t@%,7ard $223,400; November 1 1966, to Novembei 01. Plani October 31., 1967; for CCIVRIP only. February 1967 Mr. Paul D. 1,@'ai-cl @ippoiiited Pro-ram Coordinator. February 1-967 Site Visit. Team: Mr. Yordy and Dr. l'iazen of Discu ssioii centered around Council's concern that the planiiii-ic application for stibi.-ecioi-is deiioiistrateid little cooperation betiqeen the subregions and little overall planning. Mr. I@ard @is--Lirecl the Visitors that a revised application %,70ul.d be submitted. March 1967 Site Visit. Team: Dr. Stianlioltz, Dr. @fillikan, Mr. Yordy, Dr. SI-oan, Mr. Alpert. The team found: 1. The ReL@.1-oii hid been divided into areas covering entire., 0 state, each with i.ts own active Local Advisory Cou-@,.;-,littee. 2. Funds x,7ere belief directly traiisiii.tte-cl ttiroLi-L-i the ceiiLra office to the Areas. It. TtiE! central office i-7as felt to have pr-.ti@tiry value m 1-n settina overal-.I. pro@@ra 'theircs", adjudicating disputes, more dispassionate evaluation, re]-ati.iic, to the California Medical and Ilospital Associations. it %,7as recommended that the central office re,,,,iain siiiil-1, ancl. that it be phased out in future years if tlii-s --ecv.,,cz:d indicated. 5. It x-7as decided to recop@inend fltndiiic, plaiiiiin, proposals sepircitely j.dei-iti.fi-ed as eiianati.ii- froii the California C> @ledicit]. Association and California Hospital Association, for "LicLi-c@il reasons". April 1967 01-S]. Ai.?ar(I $9li5,70'0, Ai)ril- 1, 19C,7 to OcL-cl)or 31-, 1.967 for pla-nni.il,(,- ic I!'C@F, UCI@A, USC, ilid CilA. I I I\Ioi- See discussion Of Projects later. Oct-olt.,cr 196'@. OISI Award for in the iqorLlic-@.-tEiL c),iii Va.)@l.ey .(LA poverty ai.-ca)--$]-I.9,99'0 to 6/30/69 Docci@ibcr 1968 Sit@ virl[t to review se.-,Tci:al supplemental ol)c!i-iitioiail projects. Team: Mr. Thompson, Dr. Raventos, Dr. Pic-.lds, Dr. Koma-coff, is. Salaza3-. Action on these projects will be discussed later. Administrative action pcnclinc, on project request. Deceiiiber 1968 Care stiff support e-,tcncled at current level and June 30 1969, pending April- site visit evaluation. March -1969 March 3-969 Technical Site Visit on Medical TV Project April 1969 '@p@ial- Site Vi-sj-,t to each of the Areas, I.asti.,iL. 5 clays, with purpose of evaluating pl:oc,,rc-.s,,i of the overall- procri-ani. Individual projects were considered only briefly. Site Visitors were impressed with most of the 'Areas, particularly with Areas 1, III, IV, V, VII, and VIII. Most impressive- was the evidence of true peripheral involvement. The Watt@S-1@ill.01-7L)rool-, District appeared to be prooressina very well. Duri.n- the Visit, Area TV (UCLA) raised the possibility of makiii- each Area a separate Region; there was little support for this position outside of Area IV. June, 1-969 Roger 0. Egebc,.rc,, II.D. , Chairman of CCInlll (RAC-) C, is ippoi.iited Assistant Secretary for Ilea.Lth ai-id Scientific Affairs, DPEl,!. Dr. James Itic accaii becomes acting Chiii:man. Jul-Y., 1969 Site V i.sit: Teair,: Dr. 11. Lenloii, Dr. B. Decker, Dr. John Johnson, Dr. I-Ililliim Fields, Mrs. Si.l@b,2e, Dr. Koniaroff. Site visitors review 1-3 project propo.c;al-s, ',approve-' 3.1 -at al)pi:oxl--ciatel.y 45% requested level. Projects . I .. 7 .@ . @ @t@.. - -@- 1 7 C) include a nLLnber of stroke proposals. Operational projects approved in Areas III and VII for the first time. REGIONAL CENTRAT, STAFF California Regional Medical Program has a unique organizational structure. The'California Committee on ReRional Medical Pro Lall's (CCMIP) is the Regional Advisory Group, with functions of overall policy-r@iakiiig, and final project review. CCPLMP has 27 members, including: a. Deans of the (8) medical schools b. Director State Department of Health c. California Medical Association (3) d. California Hospital Association (3) e. California Heart Association (1) f. California Division Cancer Society (1) g. Deans of the (2) Schools of Public Health b. Representatives of the public (8) CCP,'L4P has five subcommittees in Heart, Cancer, Stroke, Related Diseases, and Continuing Education, and has appointed several ad hoc subcommittees. These subcommittees also act to consider policy and offer technical project review, and are composed of specialists from throughout the Region. Chairman of CCI@IP was Dr. Roger EQeberg, Dean of the USC School of Medicine, until his appointment in June, 1969, as DHE,14 Assistant Secretary for Health and Scientific Affairs. Acting Chairman is now Dr. James MacLagaan. Executive Director of the Region is Mr. Paul Ward. Mr. Ward has a long background in state and national health legislation. C, Mr. Ward directs a staff of 11 people in the Region's central office of San Francisco. On the staff are three non@zI.D. Associate Coordinators, and one Coordinator each for Evaluation and Administration. The central staff received $291,331 in the 02 planning grant. Grantee is the California Medical Education and Research Foundation (CiIERF). GIERF was formed in 1962 by the California Medical Ass ociation to handle grant funds. DIERF is staff by 15 part-time (4 to 40%) people, all from the CM,%. The director is Mr. Murray Klutch. OIERF has also undertaken several surveys for the Region. @ilERF received $50,291 in the 02 planning grant. The Region is divided into 9 Areas. These Areas were created to operate out of the 8 medical schools and the Charles Drew Postgraduate tledical. School (Iqatts-WI.IloiTbrook) for purposes of planning, and have since also administered operational projects. Each Area has its own Core Staff; many Areas have large voluntary cor.1-i-@iittee staffs. Each Area has its own Area Advisory Group, with a broad representation as specified in the PI.IP Guidelines. Some of these Area Advisory Groups have subcommittees. Several Areas are further subdivided into Districts, and some of the.,-,c Districts also have Advisory Groups. The paid adiainiF;tr,-itive p,@rF@.on-Liel. in o@ll- the California rcc-io,--i--tl- Program offices toL..-il.s 239 people, iliclt-',@iTIC, 110 149 profc,@sio,-iil 4 staff. i OVC]7 500 peopl.e scrvc, on coi,,ii,iitLeos incl subco-i,.i-tilttec-,s tllrc)L!C,IIC)LiL tlt(-- I'@ec i.c)n r(I-cc-liviiic, re-i-vibLIl-SC"@i@C@l-IL on:Ly fo-i- lii-, coi-il)l.ctecl tl-ic fol.1c,,,i.-iig plani-t-t.iig- activities: A study of liosl)ital. discliii-,-,cs 2. A re<-,ic)ii-i.;iclc s,,trvey of sl)cciil- facilities 3. t@ii inventory of t:raiilin- resources A reoi.oii-wide survey of physician attitudes toward C-1 exi.st-iii- forms of contilILtilIc' medical. education 5. A regi-oii-wi-de survey of phyfici.aii attitudes in the c@ttec,oricil- 12 THE AREAS SIZ,6 dli@. x Li 13 14 to Is 17 la to 20 21 22 23 %4 2S i7 1. UNIVERSITY OF CAI.I@Or@t@,IA - SA-@T UNIVERSITY OF CALIFOA,@IA - DAVIS STANFORD SCIIOOL OF 1,[EDICINE IV. UNIVERSITY OF CALIFORNIA - LOS ANGELES V. UNIVERSITY OF SOUTIIERN CAI,IFOIC,"TA VI. LOIMA LINDA UNIVERSITY - SCI!OOTI@Fl.iFDICI'-' SAN DIEGO VII. UNIVERSITY OF CALIFORNIA - V':II. UNIVERSITY OF CALIFOI@NIA - IRVINE CALIFORNIA COLLEGE OF @iEDICINE UC-SF (1) and UC-DAVIS (11) rec-i.oral ss hatches indicate delineation with cro the areas of overlap or joint effort wher final lines are expected to result from planninc effort. sc.1t 11 ,LES 0 !,A c .. .......... . Sl,'t Popul.]!;On City Pcp.'j!!on . I,,,, i AN SE..ARD..@0 IC.) cw u 1 C<.3 T. C." Ilk 14 Area I UC San Francisco Medical Center Statistics: 1. Includes parts of 17 counties 2. Population roughly 3.5 million, urban and rural 02 Planning Level: $559,035 Core Staff: 1. Coordinator: No full-time Coordinator appointed yet. Dr. El.liot Rapaport, Professor of Medicine (Cardioloaist), has been part time C, (20%), unsalaried Acting Coordinator for past two years. 2. Staff of 31, including: a. 13 physicians, located at 5 different University-affiliated, San Francisco hospitals b. 2 MPHs 1 MBA, 2 RNs c. 11 secretaries d. 20 positions are full-time Area A@i--ory Comnittee 1. Appointed by Dean 2. Final review group for proposals 3. Sets priorities 4. Includes 20 members a. Some from each District Advisory Coininittee b. Several (8) at large representatives c. Mostly MDs, 2 RNs, hospital administrators, lay public, minority groups District Advisory@ommittees 1. There are five DACs a. San Francisco County b. Alameda-Contra Costa c. Marin County d. Redwood Empire (5 counties) e. Humboldt-del Norte-Trinity Counties 2. Members represent broad spectrum (Guidelines requirements. for RAG) 3. Serve both in planning and in initial evaluation Evaluation Corimittee 1. Functions to determine whether a proposal has adequate evaluation procedures 2. Advisory to Coordinator, appointed from relevant faculty University Plc--@i-ii-n- 1. Appointed by Dean 15 2. All faculty:of liedical Center 3. Advis es Dean and Coordinator about @ledical Center's support of RiviP r@09rc-so--to Date: 1. Extension meetin-s with health and healtli-related professionals 2. Contacts with representatives of agencies in the poverty areas 3. Operation of three funded projects, with four other approved but not as yet funded projects (see next page) 4. Proposed activities for next two years include: a. Expansion of patient care programs in all the categorical diseases b. Development of a television network c. Special attention to health and urban and rural poor d. Expansion of cooperative relationships e. On-goin'g evaluation. iCst Year @ucl@p-LTotal Descr -ct Coronii- aini.i@2. $321,055 are Tr -- will develop and establish f CCU's throughout northwestern (funded) 'confederation o 'California. Training wil-I be provided for nurses find physicians in patient care and for nurse educators and nurse qdnij-ni-strators. Supportive program s will be coronary care conferences; a reference information tenter and newsletter; and consultation on unit design, management- and specif care problems. -tal Cancer ProAram (Dosimctry in'volved 3.5 $566,901 REZ:L i@ 'itinc, "special" review) will provide assistance. (requested) axvci 'to peripheral aroups, and assistin- these groups to C> develop capAcity for complete cancer management. Three parts: (I-) clinical oncology, (2) data retrieval, and (3) educational services. 18 $47,683 Trainii@ foi.- Pl@, Intensive Care - pilot (funded) project for one year o-,il.y to train M.1).'s to provide intensive care to patients with acute Myocardial infarction in small general- hospitals. $289,543 Intensive Training Course in CR-R for Emergency Resc (requested) Personnel - training courses for -rescue and ewLer,,-,eT-, y area (Redv7ood Empire personnel in a seven--count 27' $132,861 Primary Physician TraiiiinR and. Coiitiniiiii-@E ti@ca-tio, (requested) Rural- Community Hospital D-@monstratioti Co6Deratili& Iroe @a,,a - builds 'on a general- practice residency program at Sonoma Cotp-mun4Lty Hospital -@r@d inVolver-,ie,-@ of the Division of Ambulatory and Community at UCSF i\ledical Center to train "primdry physician, rehabilitation, multidisciplinary approach to rieoplastic disease and heal.th problems of the minimal poor. $333,226 EYP c@nsion - I\Iorthwest Cal.ilorna - demonstration 20 @r, t i -LU@- - (funded- training pro-,ram for medical and allied health earuiarled) personnel in 10 community hsopital-s for referral and follow-up of hypertensive patients. Includes computerized registries. 25 $289,541@ Y, A Proposal for 'Reha',)ilitatio'n, -and Continuity of (requested Card Services - devel.op role of "Liaison Ni-irsc," (nurse Pub. Health trainino, who coordinates "dischar-e planning sc@i-vice-s"). Proposil has 3 components, irivovl-7-nc,, 7 counties: 1) Al.aincOia-Coiit--- Costa Project, 2) llxi-,.-iboldt--Del Norte i@rc!a, 3) Counties. Each of the 3 ar@@@ in its iiietnoclolo,7,y and oL@jectivez-,. Each are@ has a nurc;e coordinator and .7 just no,..i ci n u i, @c; r_ project director and staff to P-di..-iinistE!i: beitit- flood located in San Fr@iiici,sco. Workshops i)-rrii)r;SE-. (I ":"D pi:o!:!o t-2 L@Lii rs of "Di s C II!O-17 APLA I SAI\' FRAiN-Clscc@) Ist year Descr -ption -C, BiLiLdyet.Cl -i@l Ct iii Pilot program. 41 $371,584 Patient Monitorl (requested) demonstrate the feasibility of substituting computer monitoring for selected people in CC-tJ's. Will. offer traini.ng.for M.D.'s and P,.N.'s toward the reduction of manpower and instrumentation iiec-(!!, 42 $ 95,267 ICLI in Shiall Hospitals - Will offer a one-iqeck I (requested) residency at P@@c@ledical Center. Stibsequentl-yl i'n'structors-i-n-res3,dence will be able to teach kc@y care skills. 43 $655,472 'Sti--ol@@P@o@, a@ni - Directed at three major pi.-oblc,.iiis. (1) the absence of readily available educational (requested) programs on the care of the stroke patienti (2) -iade ii quate rel.iabl-e information regarding the' extent of the problem caused by stroke; (3) the lack of a fl.exible health care system that will permit the introduction and implementation of no-k@@ knowledge as well as the development of new i.n'Loi--- mation. Program includes two rtiajor components: educational programs and services available to thc@ entire Area -to meet the needs of a specific community. 44 $338,820 Medical Oncol-@y Pr@Lam ( h@i e 11. @f (requested) Cancer@ro@@liLi - Programs in postgraduate educati(,. manpot-7er, communications and clinical services, related to the total care of the cancer patient. 16a 17 Area 11 UC D@vis ilicdi.c@il School Statistics: 1) Includes parts of 14 counties 2) Population roughly 1 million, urban (e.g. Sacramento) & rural 02 Planning I.evel: $220,184 Core Staff: 1) Coordinator: Dr. Reed Nesbit; Professor Emeritus of Urology, recent past President American College of Surgeons, recruited in early 1968, now full-time. 2) Staff of 14, including 3 M.D.s (tA-o part-time District Coordinators), one Ph.D, 2 ITPIls, and 5 secretaries. Area Advisory Council 1) Membership of 45, including broad representation outlined in Guidelines (no nurses Iniinority representation) 2) Self-contained organization, with established by-laws 3) Meets quarterly to review proposals and advise on policy 4) Contains several standing coir.-iii.ttces, including an Executive Committee and categorical disease committees which help evaluate local needs, stimulate local interest, and review project proposals. District Coordinators 1) Presently, two private physicians are with DIP 25% of the time to act as local catalysts and organizers of two "districts" - Reno (Western Nevada), and Butte-Glenn County. Three other district coordinators are anticipated. History o Dat@: 1) Received first planning arant in July, 1967, at a time when the C, new Medical School had a faculty of seven4and no students. The faculty is now over 70, and the first class bcaan in September, 1968. 2) Planning so far has included surveys of hospitals, nursinc, hor@ies, C> cancer radiotherapy units, coronary care units, physicians and allied health personnel, training facilities; collection of demographic 0 information by aae and sex, and mortality data. Close relati.o-@isilip,,; are stated to exist ,,jith CIIP,. 3) Cont'acts with medical societies & community physicians have been made. 4) Contacts with adjacent areas & Regions has been made, and boundary issues are apparently resolved. No clear geographical delimitation of responsibility with Area I on parts of northern California has yet been made. 5) Staff is apparently engaged in developing evaluation procedures coincident with plannitic,. 6) Main priority of Area seems to be in education'of all- health personnel and the public. 7) One operational project is currently funded (see attached sheet). ARI-"A 11 DAVIS Ist.year Project u@d L-t Total. Descr-t-I)tion 2 $ 89,700 Roseville PiL t@@(,,):am - will be @i living (funded) laboratory for development of programs in continuing physician education, in--sE-!rvice training for paramedical personnel, multiphasic screening, coiii-Tni-ini-ty information and education, tLiiiior board consultation, and cerebrov@iscular disease and CIN'S malignancy diagnosis and evaluation. Applicable to entire area. 45 $155,753 Stroke Prgc,, a@ni - The project will collect d@itt c)-- (requested) occurrences of cerebrovascular disease treated both in hospitals and in physicians' offices. Continuous feedback of information to physicians to create awareness of stroke and upgrade level of patient care. 19 20 Area III Stanford Univer@t)L Ile-dical- School Statistics: 1. Includes parts of six counties 2. Population roughly 2.5 million, urban (e.g. Palo Alto, San Jose) and rural (large migrant farmer population) 02 Planning Level: $247,382 Core Staff: 1. Coordinator: Dr. John Wilson, 75% with P,i4P since mid-1968. 2. Staff of 11, including 5 MDs (including Assoc-'@at-.e Coordinators for C? Heart and Cancer), 1 MPH, 1 @IBA, and 3 secretaries. Area Advisory Committee 1. Composed of 21 persons., including the broad representation suggested in the Guidelines 2. Includes 6 kfl)s, 1 PN, I DDS 3. Includes the Cha-i-rmen of the 5 District Committees 4. Primary functions are polic -makin- and final project review y at Area level. District Advisory Committees 1. Five Districts have been created: a. San Mateo County b. Santa Clara County c. Monterey - Santa Cruy County d. San Joaquin - Calavaras - Tualaiae e. Merced - Mariposa 2. Stanislaus County may join either Area III or Area Vj' (Loma Linda) 3. Each District Committee has a role in policy-making, program planning locally, public relations and the stimulation of local interest and initiative, and initial project rev@ ew. Faculty Advisory Committee This committee, appointed by Dean Glaser, advises the Dean, the Area Coordinator, and the faculty on K@IP activities, and consults the faculty for adivce. History to Vale: 1. Area III received its first planning grant in September 1967, but be-an to develop only after the arrival of Dr. Wilson in July 1968. C> 2. The Area presently has no funded operational projects. Three project requests are in the Division review cycle. 3. The main thrust of the proaram is in two parts: a. The devolop7,ent of coi-t,..-,)rch,--Ps@.ve programs in the cate--cric,@l inc fit 2L ii,-z preventive an C, educational components, involving a large iii-irLiber of 21 hospitals in cooperative arrangements b. The development of co-tkipr@liensive care programs in poverty areas, including multipbasic screening and the use of C> neighborhood hea'j.tli advocates" Ist: Year t No. Bud,let Total. Description $1,086,651 Ilcart Pro@r@iin an area-wide cooperative program -(requested) sti:uctLirecl as sub."projects for: Ilyperteiisioii; Metabolic Diseases leading to Atherosclerosis;, CPII, traininc,; Nurses' CC Education; Physician CC training; Digital Computer Systems for Ilonitorinc, Cardiovascular patients" and Cardiac Peliabil.itatioii. 37 $264 613 K Strol-,e Py-o,.@@iiij a cooperative phased plan to est@iblis. (requested) a stroke pro-ram involvin- education conservation, C> investigational and organizational aspects, eventLI@)ll.y to extend to entire Area and be integrated with relatc, programs in adjacent Areas. 38 ,qll9,692 liul.tii)hasic Sci'cenin& - will establish a I'lultipha-ic (requested) Screening Ce-i'u-,C'r within the Neig,iborliool Ilealth Center in East Palo Al.to-East Ilenl.o Park. 46 $476,838 San Joa@Ll@l@"L@ll.L-i.phasic Screciiin- @,lob I. I e (requested) VIUI.tiFlitis)'.c screening units %.fill help detect and identify pre-cl.inical indications of cinccr, be@ii-t disease, strol,,e and other n,,a'or diseases -r@,on- urban poor and migrant farm f@iiiiil.ies in Joaquin County. 7 $1.45, 571 Coil,,-rlullity I'@caltli Aides - Door-,to-door (requested) L).ori efforts to persuade citizens of depri@-ved section of San j se to seek health screening and medical referral services. Iiid.geiious he,-tlth' workers will. be trained, iiic-lu(ii.i-ic, co,.i.ic,!.iiii-ty education, Fiedical- ex@it.@iiiatioiis in local settings, case fol).o@,,,-tlirot,,oli, etc. 51 $48,325 Pretransfusion Training'- Will offer to clinical lab. (requested) technologists the opportunity to learn new.and improved techniques in pretransfusion procedures thru a seri-es of wet workshops, supplemented by follow-up sessions ancl, wher ..ate' additional instruction for e approprg individual or small groups. Trainin- sessions have been planned by the Calif. Blood Bank System (CBBS), an association of Calif. community and Red Cross blood banks & transfusion centers. CBBS will administer the activities, which are thought to offer,'throuch ReL-,ion-' wide training programs, the possibility of si-riificant reduction of hazards associated with bl-ood processing. -W 22 Area IV - UCLA Medical School Statistics: 1. Incl-udes parts of 81@ counties--part of LA couity is shared with Area V and VIII 2. Populati-on of over 5.1 million, urban and rural 02 Pl n@i-i vel: $689,747 Core Staff: 1. Coordinator: Dr. Donald Brayton has been full--time (90Z) Coordinator since the Area received its first planning grant .2. Staff of 33 incl-udes 10 MDs (8 are District Coordinators), one Fd.D., 2 MSWS, I RN, 16 secretaries 3. Full-time staff (80% -I-) are 21 4. Of the 33 total staff 25 are located at UCLA or affiliated hospitals. Volunteer PlaniiLng Organization 1. Area Council (Area Advisory Committee) 1. Total membership of 44 2. Includes broad representation described in Guide]-ines--apportione'd on a 1/250,000 population basis. The Council includes representatives from District ConLuittees,-.fChairmen of Categorical Committees, 3. Contains 6 task forces for Area Boundaries, Communications, Evaluation Policy Development, Pro-rani Planning, and Resource Development. Membership on thes-a.task forces includes selected experts, as well as !!AC members. They function both as policy-niaking and review bodies. 4. The overall AC functions include policy-makina, review and community relations. II. District Committees 1. There are District Committees in each of the 11 Districts, initiated like the Area Advisory Committee by leadership from county medical associations. 2. Functions the same as those of AAC, only at.a preliminary and local level. IV. Categorical Committees 1. There are 4 Categorical Comr-iittees--Heart and Related, Cancer, Stroke,. Continuin- Education. 2. Membership includes faculty from UCLA Health Sciences Center Schools, chairmen from District Categorical Committees, selected specialists 3. They participate in planning project initiation and development, and offer technical- consultation and evaluation in their specialty areas. Hope to coordinate projects into Area-wide plan. District Coordinators .1. Each of the 11 Districts is to have a District Coordinator (8 are presently active) 2. The Coordinators are locally practicing physicians who work part-time with RMP 3. Their primary function is to involve local physicians and b&al-th facilities in RIP History to Date: 1. UCLA became Area IV with a plannin- grant in May 1967. Prior to that time they had applied to become a separate R@IP. 2. Contact with county medical associations, health acencies, hospitals, and teachina facilities established 3. Lay community, includin- business, labor and minority groups involved 4. Area Coordinator member of CHP 5. Cominuni.cation with other Areas was found to be poor by site visitors in April 1968. -iiiunication with other Regions has apparently centered largely .6.; -;Coi!L around the-TV@proje'ct (se'd projects) 7.. An Objectives Conference has been held including RMP staff from.all over state to discuss PDIP objectives 8. Acceptance of Pi@,'P by academic and community physicians described as improving 9. Data Source Books developed for each District, containing basis for identifying needs and resources. These were developed by UCLA School C> of Public Health which also supplied them to USC, Area V. 10. Monthly newsletter published 11. Four operational projects funded, two are reall planning activities y (see attached sheet). 12. Area IV discusses with site visitors (April, 1969) the possibility of @ei.ng a separate region. 13. Area reorganizes its advisory bodies, streamlining them and making theo7i jr.c@re representative of the community "consiLimers." AVEA TV LOS ANGELES .1st Year Descril)tL@ii -c tL\l o u@d @@t i@l 4 @247,182 A Triiniiif-, Pro@!rani for Physicians in roiiii.-y Care ----------- C(,@dars-Siiiai @le-dical Center) - to provide trainin,, @'(funded) -prograi tis for physicians who will occupy positions as di' ctors or associate directors of CCU's in. re ':4d-oinmttnity hospitals and who iill ultimately prov d:-a el. --leadership in cardiology at tl,-ic- com@Lin-tty lev A'basi trdining course will be given, followed by c Colltiiiuinc, education and consultative services, ci ;and@seminars and @.7orl@shops for continuin- liaison C> e o be'W -n the medical center and community hospitals. 6 $207,230 Watt-s--I,?'illo%,7brook Post-.Gradu@ite Education - joint (joint with (funded) proposal of,UCI,A and USC @ledical Schools, the Area V) County of Los An eles, the Charles Drciq @ie-dical Society, and the Cor,.imtini-ty of Watts-Willoxqbrooic-1. --ope proposal. This A combination planniii rational project wil't- -coordinate the establishment of -I-,Iillo;..,brook distr-ct Re-I.oiial Medical Procra::i Watts ,Yith the development of a postgraduate medical. scho@ 7 $360,941 Ri\T @ieeki.cal TV 'Network A Center for the Coi-,tiiiu@-li-i, (f tinded) Education of Ile-altli Care 'Oroj'essiona-l-s ysj-nc, aucl Television and otILei. -io--visual materials - basec., -ca, -el C, on the UCL.,K itl)us and EI'V station KCF-T, Los Anc -e. the project will support production of medical' -circuit programs and their broadcast over cl-oscd -tel.c@visi.on to rtiore than 70 Sotithern California Ilospite.Is via the L@leclical Television Network ('NIT'\ The best of these pro-rahis then are recorded'oi-, videotape for distribution, by mail to subscri.bina hospitals wherever located (now in 20 states). Partiall-y funded by a PHS contract (expired 6/30/68'. Iff N be o,. an as a cooperative educational venture. by six medical institutions; now to produce and distribute proc,rams throu-n an expanded arranc,ertient v7itliin the Cal-iforiiia Re-i.o-.i, and with other Re@io,-, the IITN fill continue as a cor@i,,iiuiiity educational endeavor; all. programs are approved for credit by American Acadeitiy of Cei-ieral- Pr@ictice. 24 $J.IiO, 124 San Fei:nanJo Val.],U_and Pacoima Ileal.tlll Pliniiiiig (f uiided) r@o@t -- Des,--c,,,ned to --lle-viaLe heal.th car-- difficulties in this area Lor low inco.,tic! and -iii.ies (a.pproxir,,i,-it-zly 800,000) indigent -far, x-.\ just ito-,,., b2i-@@.-I 25 A@'LA TV lif'!,A l,st year Project Bud@et l'OtPl ]Desc)'iptioti $117,763 liedica'l. Library Igc-rvice-To be estiblislic'e! (requested) via a netx,7orlc from th,- I\'T@i! tilrOL,'t@-11 the UCU, Biomedical Library on to -ic Area districts ai I coi,.in,.Liiiity Hospitals in IV. Ilealtli professionals to be. served with interlibrary loan,,;, I)Iic)toct)i,.y reproduction, biblio-rapliicc,, IYDT,AILS searches and otlicr ?.,'C'clicil. anl health information service. 25a Area V - USC Me cai- Scliool Statistics: 1) Contains roost of LA County 2) Population of 4.5 million, ii)ostly urban (including 400,000 Mexican-Americans),, but also with a significant rural area in Antelope Valley 02 Planning, Level: $533,892 Core Staff: 1) Coordinator: Dr. Donald Petit has been with the pro-rain (75%) since its beginning 2) Staff of 17 includes 2 IlDs, I Ph.D., 1 Dr.P.H., 1 RN, 8 secretaries, mostly full-time Area Advisory Group 1) Consists of 29 members including broad representation' of-otlier health associations & agencies, laymen, CIIP, Charles Di-C-,.7 Society (NMA), one nurse, but ? no Mexican-Ainc@ricans I 2) Functions primarily to consider policy, also to review grants Ca.tegorical and Professional Committees 1) The major organizational thrust of Area V has been the development of (currently) 11 Conunittees of voluntary participants, each working with one staff member to develop policy, stimulate projects, and/or revi.ei,7 project proposals. These Committees are in: Ileart, Cancer, Stroke, Chronic Disease, Continuing Education and Health Care, hospital Administration, Library Services, Nursing, ' Social Work, Systems and Computers, and a Committee to advise USC faculty on PMP. 2) Conmiittee Chairmen attend weekly Staff -meetings. District Organization Area V is considering developing 10 Districts for decentralized plaiiniti-., administration, and evaluation, but the organizational details are not. worked out. Histor To Date: --Y-L 0 1) The Area recieved its first planning grant in April, 1967. 2) Cop-uiiuiiicatioii with other Areas, other Re,,ions, local physicians, C, healtli organizations, and health f@iciliti.cs. 3) Liaison has been establis'Lied with CHP to avoid duplication and to enhance mutual efforts. 27 4) Data Source Books have been developed through the cooperation of the UCI,A School of Public Health to sorve-as the basis for planning. 5) A health library is boi.n@ developed 6-) A Monthly newsletter is published 7) Durin,, the suT-.mier of 1968, a Student Ilealth Organization project was funded through Area V 8) Area V, along with UCTA (Area IV), is participating in the- development of the Charles Drew Postgraduate Medical School in the Watts-lqillowbrook area for the training of black physicians and allied health personnel. (see operational project description) 9) Two operational projects, including Watts-Willowbrook, are presently funded in the Area (see operational project description) APEA v usc BIIDGEI' (].St Yr.) PROJ-ECT il@.IICT NU@FP)ER t23 $122,050 Chronic Pespiratory Disease (Breath (recT. DC) mobile) - Will provide physicians of detected with the knowled,,e PAtieilLS to provide proper diagnosis and care. Will demonstrate ways of interesting and Trotivat:Ln- physicians and evaluate various approaches to postgraduate hysician education. p #22 85,800 x x/-- Hospi.tal Study Gro s Will establish (req. DC) experimental. co-iitinuin- education courses for small groups of physicians and other. reyiibers of the health care team. #11 $353,302 Lroc,,r@i@for Training Physicians and (funded.) NursE!s in Coronary Care Tech@qLlo@ The proar@ii,.i will begin with a central C> traiiil-nc, center- at the Los Ancel-es Couiicy--USC Center and three cooperative hospitals (Good Samaritan, St. Josep'n's @nd St. Vincentls). This central pro-- grain will provide a base to initiate training for the entire region and will be expanded to include six additional hospitals in the second year. Physicians nd nurses selected for trainina will a represent their hospitals and will share common trainiii,- backgrounds in coronary care unit techniques and management . $207,230 Watts-1-7i].Io@.7brool@ Post-Graduate Fduca- (funded) tion - Joint proposal of UCL-K and USC (joint with Area IV) Yiedical Schools, the County of Los Anaeles, the Charles Drew iMed4Lcal C> unitv of 1-7aLts- Soci.ety, and the Coris@i Willowbrool,. A combination plaii-.I'ITICI- operational proposal. This project will coordinate the establ-i.sh@-iie-,il-- of a Watts-Willowbroo@- district Rec,,-iloiial 14eclical Program with the developuicit of a postgraduate medical school. x f it n c-I c-- d 28 r,2Lurii for rev I-SI on oil t. @@110,W@,C'f NUIIBER BUDGET (l.st Yr. DESCRIP3'ION 39. $121,860 Y, C@O@lll!ni. ty Ilealth Agency Informa.tion and .(requested) Referral §-Y t- e T-@l (C@ K@S) -seeks to improve the quality of referrals made by health -crs in los Angeles County. Ilealth rl, wo providers will receive assistance in makinc, more accurate provisional. assessment of me clical and social health problems -for p@ nt needing a referral, and will also be given ite Information on public current and accur. I and private health servir-es resources availabl -ii ty ill the commtu 49 $1581342 Infarction Unit (requested) Special electronic and other equipment aboard a Pa sadeiia City ambulance, -,tign@entee-. by physicians specially trained in CCU techniques, will test the feasibility of reclticii),- Mortality of patients with presumed acLite myocardial i.nfarction. 50 Pacerii.@l@r Pegistry--A re istry of paccuakcrs (requested) will. be established an,,onc, participating hospitals; detailed patient histories wil.1 be gathered -for each case. Follow,4-nl-l dischar- patients' attendiric, physician will be contacted every three months for current coii- ditic)iis and information.' xx-Pend;-rtg review 28a Area VI - Loma -Honda Scli ol of Me -i--Ci-nc statistics: 1) Contains 5 counties 2) includes an urban (Son Bernardino & Riverside) and primarily rural population of about 1.5 million, very sparsly populated 02 Planning Level.: $118,000 Core Staff: ite Dean for Research 1) Coordinator: Dr. John Peterson, Associ@ and Continuina Education, is with Ri@'p 33%. There is an Executive C> Director, Mr. Wilton Senecal, full-time. 2) The current staff consists of people; including an epidemiologist (50%), one IIPH (50%), one continuing education specialist (retired internist - 50%), and 2 secretaries. Area Advisory Coiiinittee 1) Consists of 25 members with a fairly broad geographical and C. professional representation 2) Four subcommittees-- Heart, Cancer, Stroke, Plannin- --including one or two members of the AAC, act to stimulate local interest and initiative, as well as participating in project review. Staff participates in their monthly meetings. 3) The AAC has overall responsibility for program policy and project review, and meets monthly. History To Date: 1) Loma Linda received its planning money from UCLA in May, 1967, after it was decided that the two should be separate Areas. The Division and Council have never reviewed the plans or progress of this Area. 2) The planning in this Area has centered around what they consider to be the main problem for a sparsly populated area with few health personnel & facilities: continuing medical & allied health education. Surveys of available medical education programs, and the extent to which they are used by physicians in the area, have been undertaken. 3) Two operational projects were not funded by Council., but not frankly disapproved if the Region chose to fund them. The projects-were in Computer Analysis for EKG, and Library Services. 1,Al AREA VI - LO'% LTNDA u lst Year -ect No. Budget Total Description 52 $168,798 Will extend through widespread application in medical (requested) disadvantaged community a new technique developed at Yale Uni.v. School of Medicine for reducing mortality and morbidity in high-risk pregnancies. Features feta' monitoring system, and administered from Calif. Area VI as a demonstration program for 4 S.E. Calif. counties and Clark County, lic@vada. Is believed that per!-natal mortality and morbidity may be reduced and maternal health improved through the training pro-- cedures envisioned in this app. for the management of complicated pregnancies. 31 -VIII UC San Dieg (La @olla) Medical School. Statistics: 1. Contains 2 counties 2. Urban and rural population of 1.4 million 02 Pl@iLiij@a vel: $148,935 Core Staff: 1. Coordinator: Currently, the Acting Coordinator is Dr. Joseph Stokes (50%), the Chairman of the Department of Community Medicine. In June, Dr. Michael Shimkin will become Coordinator (25%). Dr. Shimkin, primarily a cancer epidemiologist, is currently in Philadelphia. 2. The staff of 6 people includes 1 MPH (continuing education and data-gatherin@ an administrative assistant, a survey director, and 2 secretaries. Area Advisory Committee 1. Contains 22 members, including 16 from local medical societies, health agencies, hospitals,' health departments, and the Medical School. These 15 in turn chose 6 representatives of minority groups, labor, business, and government. 2. The AAC chose from its ranks tl@e Chairmen of 6 §tan ii@ia Committees in Heart Cancer, Stroke, Continuing Education and Communications and Evaluation. Ad hoc committees have been appointed in Pulmonary Disease, Hyperlipo-proteinemi.a screening and Multiphasic Screening. The Chairmen filled their Committees with the appropriate experts. These Committees have done the primary work in stimulating project proposals and cooperative arrangements. They also serve as technical review panels. Particular mention is made of.the close relationship between these Commi.ttees and CHP. History to Date: 1. The staff has surveyed all health facilities and services, and all educational programs, in the categorical diseases. 2. Several project proposals have been developed--none are funded as yet. (see operational proposal list). 3. UCSD Medical-, School admitted its freshman class in September 1968. AREA VII SAN DIEGO Ist Year ,ct No. @ud,,ct Total I)escriatioii 30 81,614 CCU Training for R.N.'s and Cl\'R TraiLlill@ Will (requested D.C.) L@a Area Heart Training Uni.L (AHTU), an'adj.uiict of the San Diego County Heart Assoc., located in Mercy Hospital. 'Y 31 $ 93,933 Mobile Coi7onary Care Unit will utilize and evaltiat (requested D.C.) 6 niobii@ccu i@n the San Diego Metropolitan Arco., will utilize resources of the City and County, the School of Medicine, various community hospitals -iiis. and practicing pliysici@ 33 $67,259 Cervical Cancer educational program based on (requested) preventable factors identified through review of new cases of cervical cancer in the tx,7o-county area of San Diego and Iuiperial Counties, and aimed at eliminating preventable.- factors. 53 $147,209 A demonstration project that will attempt to test (requested) effectiveness of treating essentially health subjectE found to have high blood lipoprotein levels. lqill. seek to persuade practicing physicians of the value of.preventive diet control and drug tierapy for the reduction of cholesterol and blood triclycerides. Treatment to be carried out in a private practi- tioner's office or in a clinic setting. Through public education activities the'project would seek to discove'r those individuals xqitb higher than normal blood li.pid levels 'and uncover undiagnosed disease and reduce risk of coronary heart disease and possibly cerebrovascular disease. xx pendip-- review 33 Area VIII University of California at Irvine California College of Medicine Statistics: 1. Primarily involves Oraiice County 2. Includes a population of 1.7 million, urban and rural 02 Planning Level: $187,500 Core-Staff: 1. Coordinator: Dr. Robert C. Combs, at 80%, since January 1968. Dr. Combs was a surgeon in San Francisco prior to @IP.. 2. Staff of 11, including 4 MDs (Associate Coordinators for categorical diseases at 10%), one RN, one RT and 3 secretaries. Area Advisory Committee 1. Consists of 23 members, with a broad "Guidelines" representation 2. Primary function is in project review, also participate'in policy- making and public relations 3. Includes local medical society (described as very conservative members 4. No subcommittees 5. The District Committee of UCLA (Area IV) in Long Beach also advises Area VIII History to date: .1. The Area received its first planning money directly fro-,ii.CCMIP. The Area has never been reviewed by the Division. 2. The prograii developed only after the arrival of Dr. Combs in January 1968. 3. The Area has done few formal pl-aiininc, studies 4. Area VIII staff have visited every hospital and medical society in the A)--ea. 5.. The main thrust of the Area is described as developing comprehensive Area-wide programs, away from the medical school. There has apparently been little pressure to orient the program more centrally to the-youna medical school. NOTE: The medical school is a relocation at the Irvine campus of the old California College of Medicine which was located in Los Angeles, and which was a school of osteopathy. Because of state legislation in 1966, almost all of the state's osteopaths are now licensed 1,@lDs. @'EA VI@ll ll,,VINE Ist Year @-Le.@ t No.- Budget Total Des@@l oil 21 $272,545 Pedi.atric PLiluionar Demonstration Center will Inoll-- '(Earmarks) demonstrate proper diagnosis and treatment of children with respiratory problems. 28 :$445,581 A-C@iprelionsive Stroke Propraiii - based at l,on,, C, (requested) Beach @leiiiori@il Hospital and Oranae County Reliabi.litation Center, will encompass prevention,' diagnosis, treatment, rehabilitation and lon- L) term care of stroke patients. 32 .$260,226 Y-@, A Community Hypertension Control Pro a i@a r r, (requested D.C.) comprehensive interdisciplinary program in-%,olving all appropriate institutions without duplicating activities of the Stroke Program (Proj.fi'28). Will ultimately include coronary disease. $372,292 @x Conuiu ity Cancer - designed to upgrade approaches (requested) to prevention, early diagnosis, screening, and all modalities of treatment and rehabilitation for cancer patients. Various phases include: public relations, information center, coiiti-nuiii- medical education in chemotherapy, radiation therapy, surgery and dentistry. ,CIO $125,705 Y, S m o'Ll-inR Withdrawal Clinics - will establish two (requested) free si-tiokin- i,7.ithetra%,,al clinics in Oraii-e County and in Lon- Beach. Four distinct wi.tlidrat-ial. pro-rainq will be employed, involving variations in drug therapy. Ilie eight-x,7eok clinics, each limited to 10 participants, will be given six times a year. Results should lead to-,,.,ard-sel.ection of improved methods of helping cigarette smokers to give up the habit. x - approved unfunded xx - pending review AP\.EA TX I,IATTS-@-111,LOI,@,'-,-', ist year iect No. u@d _@tal DescLt 35' @224,760 Watts-14i]-lox,.,brool@ Core will support Eidniini-stra- (requested) @ve core staff to continued plinni-nc-l and program development'. 1,@lill involve, in addition to the coniniunities of lqatts and l@illowbrooi@, the hospital service area of Martin Luther King, Jr., Los An-cles General and five public health districts. 36 Addenduni: Activities in the llatts-lqillo@,,-brook poverty area in Los Angel-Cs are presently supported through two P,,IP grauts: 1) Project #6, funded last year at roughly $220,000, established the Charles Drew Postcraduate School of Medicine. This project was the joint effort of the Drew Medical Society (the M4A affiliate in this area of Los Angeles), and the UCLA and USC Schools of Medicine (Areas IV and V). The Drew School of Medicine will- been by training interns, residents, and allied health personnel, many of them members of the community of 500,000 people. In subsequent years, it will develop a full four-year medical school-. The School will operate out of the 400-bed Martin Ltither King, Jr., Hospital which is being built with funds from Los Angeles County City, and Hill--Burton. Construction will be completed in 1970. PdIP's main support is in providin- the initial faculty for the School. The two medical schools and the local government will provide funds for the faculty after four or five years. 2) Watts-Willoiqbrool,@ has been a District, administered by the staff of the School (under Dean Mitchell Spellman), in participation with both Areas IV (UCLA) and V (USC). All fiscal matters pertaining to the 1-1@itts--Willox,7brook P@IP District have been handled by UCLA and USC. Now Watts-Willoi,7brook has received about $170,000 to become a separate Area.