11; lit DERARTM,PNT OF HEAI., T 11.5 EDUC"K'T].'ON A N D W E L F A R E Heal-th Senrices ard Mental- Ilc-alth jldr-,-Ii-ii.s'L-Iratioti Division of Regiona'L %Iedical. P-@grains National Advisory Council c@i Beg@onal viedical !?rog-rapjs ,kiinute.s of Meeting February 2f@21, 1969 14atioml institutes of He@,ltla Conference RDorq 4 Puildinty, 31 p, M, @7, @@7 7 p or@ IISI'kT.TH, '@-TCl@TTON, lqaFARF, I' pUE,@_[C SEffVICE National Advisory C(-,unci " on E@eg-i-onal @edical ProFrams M@,-nute,6 of Fifteei-itl@ Meet-I.n-7, I/ 21 l,ebraary 20-2i , 1969 The National Advisory Council on Reo-ioi@al- @ledical Prograny3 convened for its fifteenth meeting at 8:30 a.m.,- "inursd@iy, February 20, 1969, in Conference Rcic,-,,-n 4. Buil.di.-ag 31, Tristitiites of Health, -@thesda, j'4ar-yl,3,mi. Dr. Sta-.n-ley W. Olson, DirecL"or, Divi.s@Lon of Rea,ional 1,4edical- @.@ograms presided for the Administrator, Health .Services and M-Pnt-al Health Administration, who was unable to be present for all of the meeting. The Council members present were: Dr. 1,4ichael J, Brennan Dr. Clark H. Millik@ Dr. Edwin L. Crosby Dr. Ed@d D. Pellegrino. Dr. 1,4ichael E. Deafikey Dr. Al.frc@d M. Popina Dr@. Bruce lq. Fverist Dr. Mack I. S@qoltz Dr. John R. liogness Curtis Treen Dt-8. Florence Wcl@off The Council Liaison member attending was: Dr. A. Earl. Vlalkerl N12MS (2120 only) A listinc7 of DRMP staff members, and others,attending is appended. I. CALL TIO ORDER AND OPENDi(,' RP-,@ Doctor Olson called. the meeting to order at- 8:30 a.m. 1/ Proceedi@@ of roeetin,@s are restricted unless cleared by the Office o .'-ie restriction relates to all material the Administrator, submitted for discussion at '-Ihe-7teetings, the supplemental material, and all other official documents, including the agenda. C> 2/ For the record,. it is noted ",-hat mp-i,-ibers absent themselves from the meeting when @he Council is @,discuss@Lri- applications: (a) from their respective institutions, or (b) in which a conflict of interest might occur. This -o.-ocedure does not, of course, apply to en bloc actions- only when the application i@- under individual discussion. -2- Doctor Olson welcomed Florence Wyckoff and Dr. Mich-del Bre@@ to irp-mbership on the Council. Dr. Russell R,,Dt-h. Dr. Anthony Curr--ri-, and Mrs. Florence Mahoney were introduced and participated in the meeting as observers (these three, plus Dr. Bla:ncl Cannon and Dr. He i - i Braz-ison, have been nominated to beco,-fi@-, Members of ('-he Council begimin(.-, with the next meeting). III. COI@SIDERATIOIL OF 'FJ7JRE DATLS The date of' May 26-27, 1969, for '.-he next meeting was confirmed. Dates for the following tvio meeti@s were changed and are now scheduled for August 26-27, 1969, and December 16-1-7. 1969. The meeting for March 23-24., 1970, remains as previously scheduled. :EV. COIISIDEPLATION OF,, MI@NTJMS Or, -IF, NOVF-@,M,@-@R 1968 P@@ING The Council unanimously I-ecor.,mended approval of the November 25-26, 19685 meeting as written. V. A PROGRPA STAII'US REPORT A. g-=izatioiial Ch es 1. Doctor Olson announced the proposed reorganization of the Division of Regional Medical Programs and reviewed briefly the reassignment of ,Tarious functions under the terms of the new organi- zational arrari,-@,,,Tient. He specifically i@ntioned the reassignment of IIrs. '@tha Phillips, Acting Associate Director for Grant and Contract Policy, whose duties will include working directly with the National Advisory Council on matter@s relatino- to policy and the considerations and recoi=@,er-dations of Council in this regard. @le also introduced Mrs. Sarah J. Silsbee who is Acting Assistant Director for Grants Rev ew and 'vLr. Robert Jo.(ies 'vi.,io is ,f@cting Chief of the newly created Programs Assistance Branch in the Office of Operations and Develop@nt. 2. Dr. Donald Chadwick --@ported on the recoiTriiendat@-Ons of the Task Force on the or,--,ranj-zation of Regional Medical ProgpaTris Serv-ice. Doctor Olson furt-n--r discussed plans for the implementation of these reco,@iendations and outlined the steps by which the ,to Divisions Still be joined in a single administrative unit., working toward a single set of goals. In response to questions raised by members of the Council, a resume .of the present budo-et4,-ni_7 of both Divisions was presented; relat-tno, to the c@,L@)er, b,,-)i-'-. fO st,,@-ff'@Liv one and. central office by contracts. Specific plans for a -i-viti s of the several Bran--hes of the Cl-Lion',- Di,@, E, were discussed. t4 Tll-u-stra, -@V-- of the@.e efforts, Dr. Richard @egol.d discussed the to be provided for the accoill@lish- ment of' resc.@ai,ch.* lie r@ecal-i-,@(,'. of the Presi.dei-it's Conviss-i-on on Fear L' DA Pease r:, a.ri(@ Strok@e; the. ii-to l.usiot-i of research in the ---,.re of' the to the Regional Medical. rc@ade @,,t tire,, of the on the extension of' P.L. to into areas of clinical. research, especially drug studies. As a specific exairjnl-e T,,",-ai,i@@gold presented a Droposal being developed joint].@, by the Dlv'L.si-on of '-@(,@gional Medical Pro,@cins and the Heart Disease Control 'the advice of the National Heart Institute., to estFbi-i-s'-r.) for I.ipi-.d typing.* This is p--o-c-ose(i for sur-)p,)i,i-, ,,3, D'@,i%T contract. The CoiLncil -V strongly en oi-@ed aloi-@c,- these lines and encouraged the staf'f to i-,,-iove ahead earth of a contract proposal. T'ne Council ima-ri@-usiv -Zre i.ir-r@ort.-an(-@e of' thorough assessiTent of this cc,,r,crF,.ct p@,p--,@al. o @i,@s -in this general- cF,,,,t-,eE,-,ory. '!hey expressed.serious concc,,@f-i a:f)out t-,2 ,oain'(,-en-an--e of q@ial-ity in such research and stresse@., @-1he of quality clinical research pro@ams as a mecliarii--@i,. for the and continuing education of p@iysi@c@Laris both inS4 de and outside niajor medical centers. In addition to L-hes- considerations the Division was cautioned to provide for asses,,z,Tyi,-@nt of @)i, ject 0 s of this on a n@er of' other bases: To be ce.,,'-@a-Li-i th@the disease entity involved was one of sufficient --,-P,-porta-nce in socio-ecorio@-c tervis- that the procedures or drugs to be tested have been thoroughly investigated for their potential side effects; th,;L'(-, they be limited to "research.in application" of the k@L,---d that is particularly appropriate in Regional Medical F@,-@o@ar,,Ls; they ii-ivol-@ll-e substantial iT,)jabers of patients tU'4 -ial or t-i-,,-,Iy r@egioi .1 and are inter-inst@L oi 'a. in cortrasL" to the research broadly supported by ;--'.-7e 1,4-,ational- --Institutes of Health which is usually intra--irstiti-,tionalorc@ven intra:-I.al)oratory. The Goimcil was explicit in its recorr@,-,qanda'Ll i.on 'c h-at- prDj ect s of this kind have thorough review by the sl-,ai'-Lr' of -,-,..d of the relevant program components of the Chronic Disease Divi@-'Lc-,n, aryd e,c;T) cj-a--'Lly by the relevant Institute for its usefulness as an "lo It-,istl-. Lute-supported activities. 1) In regard to the specific proposal at hand, the Council recommended that it "-Ic- p@pa.-:@ed final form for review before the contract is actually 1,@t. s and Si-owa F)resei-j4@-e,,d a res-@.irt),e of the pi@ogres Dr. @i@g@3,rell current activities of the on C,@,iicer of the American College of S@g,@on- .* She exoj-ai-ned the part-@l-ci-iDatiori of' the Cancer Control Branch of the Division of Chronic Disease in support of the commissi-on's activities in the -oas+,-. y of the Council me,-,bers were familiar with the v,,ork of this Cor@..-issi-on and the broad i-nvolvei7-,(--i-it in it of rp-any interested group- other Than Col.leE-,e itself. After considerable discussions the Council agreed that @egional ',Iedical Prop@ai-ns participation in future support of th@- Cc)-@T,,T@iss'@n i-s app-c,oi)r,A.ate and that such support might be provided either Lbiaer a contact or as a @nt tinder the newly authorized Section 910 Activities. As part of the agreement (either a grant or contract ) the Council recoiT2rc-rids that the Division insist u-t)ori the inclusion of' some rn!:,,chanism for evaluation of both past accomplishments and future activities and that a representative of the Division of P-Leg-'I,onal Medical Pro-@@-v.-,is be rmed to Membership on the Conmission. At the completion of Doctor SloF-4n's presentation, Mr. Trvino, @wis, Deputy Director, Health Services and Oriental Health Ad-Tiii@.stration, joined the ,@et2!nc.,. ITe 7D--rovi-d-@d further 'r)ac,,'i@roi-inrl on the status of the fiscal year 1970 budget and a report on Preliminary discussions with Secretary Finch arid. his ii.,ri-@@iate staff in re-ard to the place of Regional Medical Programs in the health related activities of the Departr,,ient(f Health, Education, and 'welfare, B. Follow-,.ID on the special , c@tir@@ Doctor Olson reported briefly on the events which followed the special meetinc-- of the Colmci-i held on Januax@y 11, 1969. He described the system of D-riorities developed administratively for the funding of Regional Medical Prograj,-s under the constraints prescribed by the Deriarl@-,,@.ent to postpone obligations in riY 1969 until the amuni-, of FY 1970 appropriation is wore certain. He explained that he will propose, through IL-,he Health Services and Y@ental Health Administration, another plan, rr)akirZ m-axLm-,q use of whatever funds become available to us in the. fiscal year according to mdifications of these same @eneral funding priorities. C> C. Effecil- of' aJ,.@@-n@slrati-v@-- deC4 -I'sions ur)on the recommendation md t y G@j@- 'llie effect of these administrative decisions upon the -,ade by the CounC4 recommend-a@u@ons r -Ll at its meting in November was stL, ized and plans for pos&ible further funding of so,-ne of the approved but unfunded applications was outlined. i'lir's. Phiiiips c-xplai-,,,ed the taL)ie showing the funding level for and fo@@.-, 1.)-r,ojects in each of the 55 Regions, on ti) levels of the i.,equests to be of the Eal@ ef'fe@- IC) @,5 VI. li,@ 3 A. For the a-l@t,(-,ce o-F 1969 A su@ILI-.r,,,@,,ry pre-c-,c,-,,'Ited by 'Llh T,'--Li-ianc-i.aL M@ag@l,@rti@anch of the Di.viL-,@l-on that a IDa!Etnce of Ei.f)p-,c)xima@ely $214,000,000 remained dL,,.rirkp, tlic, balance of the fiscal year. This )a-e ec)ritr@i.z@41-ed w@It'l-@ 'the approx:Liriatel.y 4;60,000,000 request represented by the applications to be reviewed later in the meeting, and wi estimte of the requests to be processed foi, Council review in May. B. For FY 19'@O and beyoiid Doctu@, Olso-,i of the prel@-Lriary plans be' ..,-,o,Juced ino- formulated by tire Divisi("n for posr,-@ible changes in a(Jn@inistration of the Regional Medical Prc)6r@,m grant system. Mrs. F@?iillips -@p-,)ke of the i-ie(--,d for a gra@tin,7 mechanism better suited to the r,equirc-,7i@,nts o' Regional Medical Programs grants. Mr. La-v,@t-on explained the Dl-.@iisi.on's plans to develop a system of "anniversary rE,,view" @,.@,hich would rfiake it possible for the Council to consider each Region in its @Llot,@.,@.ity each year, or perhaps every two or three years, with staff review and special study at the interval anniversaries. In further recc)(-, Li tion of tl-i-i.s new phase in Regional Medical u Pro@@ I development, the Di.visi-on begun consideration of a mechanism to soii-,c-, TDortioti of Medical Prograin funds available to Regions as basic su.- . @,arits A preliminary proposal, resented ,p@-'rt T.)i: by Mr. Lawton oi,it'Li.neCi the cT-rcuTll3,(,ai-ices which generate the necessity for this step in the pr,,-Ii-lffLina-ry procedure for@ carrying it out.* After discussion of the staff' presentations the Council expressed unanimous reco--@, itioti oL@ the need. For changes along these lines and requested that the stal-'@L' continue to develop,, for consideration at the May meetirj., specific proposals in four principal areas: e,-,, of s,,ib,-,i-'Lssion an@'. review ol' ap 1. A syst plicati-ons to @e built around s-n,-,].e amivers=y; allowing CD for annual, or -,,--@rhaps assessment and peer group review ol' entered pn-)Vi,am, along with the review of stippli.-@,.-,P-ntal requests. -6- function 2 A clearer, dc-f-r@it-c)n o4' tijo st@,,,,icti, e and of what has b-cc.,r,-ie id.e@ci-f-!.(:,,d the "core" component of the ReE-ion@S a.C'-!.Vi u -ties a@'I @LSL@essi-nent of its relative contribution to pr,ogrmi goals. ,,Paris of which sorie portion of lIT funds A system, by n@ -L be rclpd-- availa..'t)j-e to the regions as basic support goar,.i,s, in coc.,',)ii-iation with the present system of --n a competitive basis. )4. A means of assigning prioi,iLy ratings to Regional Medical Progfaqis applications which can be based on an expression derived from two scales: One reflecting an assessment of over-all- proFi-,arri accomiDlislment and one for measuring intrinsic merit of individual program components. VII. rRoTE, CTIO!@@@-- A. t-ion@ for hearings on 7@ s-cal- 1970 budget Doctor C@iaC@ @@- reviewed briefly the position to be taken by the Division in defense of its part of the Presi-dent-'s budget and explained the ar,,al,@,a.@,ing of the budgets of the Chronic Disease Division and the Division of Regional Medical Prograins. -o,-- ieqls-La-,lve B. o7r,@-n assessment in pa-ratioonn ffor legislative extension lili,. Peterson outlined the Div4j-sion's preparations for requesting the extension of '-Pitle IX of the Public Health Service Act (P.L. @O 90-574) which ex-o@-i--es Jui-ie , . Mr. Peterson reported on the 1970 creation of an ad-hoc co,,,,nittee to assess Regional Medical Program progress and @.Pi)act, and on the r(-cor,-@iendation which can-eout of iLs f i.rst Meeting on Jarli-iary 25, 1969. * Dr. Bruce W. Fverist represents the i-',.---At4@onal A-dv-!L-,@ry Cg,.)ncil on this co@ttee. n viii. COTI@,iS-T-D, -@TIOTI (j? G@?,PI,TA- A-..DPLICATIONS A. Snecif ically ident-,i-.-I ed 1 ssues re-.oreserited in this "IO@p i.-I @s PI-3 c-l.al-a' t t ent !on ca@--o@r, w,@-i-c r)ul@c During the TDrocess of review of the applications, the staff identified a rtuit)er of questions which were raised repeatedly and the answer to vjhich rec4uired a s'uateint-iit of policy to be Trade by the Division with the advice of the.Counc2Ll. r @e were -,electeci for pr )f th- eseitatiori. All 17 addressed --i,, 'lie and U4 ell present Th.@- --Ci (-),-i ti,14cise and provide a al)l)l- ca,t j.. on of these ,)o'l i-c@@es, by by the Cont@ p is offers the The C,@ on i'@li@ i-c,,cl 0 ci@@ set Jorth the c, ion@,-' in u, -,,@ert i@ieE@ -L ;,,Iedical cer'L,-air crl'-er-a I-., or@ not a,,,,e bel@@i't @-,j actively is to be L)rd training, an L e.g. , acL,-i.-\T-!Lt-@-es Ir ge.,ie,'@,,tl rio'@', (iIesi-@ried principally to qLialify orie -Lor a dp -e, therefore, inte,-nshiT) a@n,@t r@e-,J-d@,T excluded ft.@07ri considera'-bio--@.. The e,@,ication should lead to the of n:--,,,@i :L-.espcn5-.- -s(?n career field, 'I '-i)e -,-Ii-eady chn update k@@,.qledr, . ii -I!, or J ]@-1. n,)t i ic@l health field. In general, 'Ll@ieref'o-i,e, interest-, -'Ls lasl!,-'ori-enLed training. desir Cipa.l@ll,' T)i,e-a,,ra'-ion for a research career 4iied D -n dical. in the b Loiy,@@ c-, -n excluded. has been stated that Regional riot to be used to replace existing sources of siii)port for activities. In i7ener,@.1 Regional 1,4edical. f'w-id@Ll",.@ should 't)c, used in conjunction with other available sources of funding, o@'@-ienever possible. t s It has been i,@,ed f i@-) im e bz,@@i.i-ini.ng that act-Lvi-tie fi.inded. t be fiii@@i.ed other by Reric)i@ .1 i",Ii@"di-cal TY -I - @ c-,- II -@@ .1 LY agE,,r-ic@-.@-es. Cri-terll,,a been developed by which activities are judged with overlappir-Z interest which is 'the area where recruitment and basic I- training re(-,uests usu@-.,-L-I.y fall, f'o-.r: exai-,il)le . . . UTie activity Insist sa'Llisfy a cloci,u,,ierted need of a c-tr-id r,.iii,@t be shc,,v.,@n tlo have a relat@."./----,-, high pr@-ority i'oi- -furi(J,ing,, Oth@r aveiql-zc@,F, o@' fun@dir-i,4 I,,ave been e@plol-ed and found el-tlle.-(, 'oy the Reg:Lu@i or by the Conti-ri,,i2,- (3. , ai zip-, 1,3rwich of .,uca'@,on ar@ -.ni- the Dt-iision o-i-' 7@Leg2,-o-al. Tn mi-iy cases, f.'u-n,.i-@i.ing is rec;tiesteci for projects because of' a look of available funds by other @),i,@cns or the onal. T@ie D c)' 'Sibility Of st also e c)r,e the PO@ ,7,egio3-@i -@d o pha@,,i; i., as r,-Oi]Py becomes -available other SO"rce'3- other Federal aLc-@r-icif@,s such a,,,3 tied Office of @r-@, IL-,he Department of' labor are beF ,irinj-ng 0 si) rc,@nt and training -ppc),@ t of' recruitr t activities affecting the health field. d Train!-ng or the !Education @)n Medical. ProcTr@:iiiis Bran-,@i of' the Divisi@on of 11 -- @.'D I must have explored the @ossibi-lity of joint funding with other interested agencies. ,activity has been shoiTn If the education Iand s of a Regional to be necessary -Go achieving the purpose Medical and the above criteria have been met, then the DrODOsed project i,,LLy be approved for fur-di@ng. for, a,(,t-'Lv-',t:,-os in Areas not 2. Criteria - 11 A. Disease categorical versus comprehensive projects In-ie Council reaffirms its endorsement of the policies in this regard as set forth in the Re@ional Medical- program Guidelines, Chaoter 3, itei-i V. huvever, in so doing, it, emphasizes t t full consideration - v 0 apni-ications for activities which pertain to problems will be cl en t L C>-- strole and related diseases but which also in heart disease, cancer, have an impact on 'Ll@he diagnosis and treatment of other diseases,, and/or fulfill a specified Objective of the Region. B. Projec'Ll@'tax,pLc--"-c-d for specif'ic population groups The Cb@mcil, the diverse Problems of medically disad,,iat-,! a,@@ u -urban and rural, urFes that ps, both _,ed s,oecific planning to the health needs of such @a@oups be a function of Regional @',e,,-iical Fro -atter III In discussing. this r. he Council expressed its interest @,i rotator of the special problems and appropriate role of @LeEj;j.onal "ledicp,.l -,L.3ror-rams in metropolitan co ities, especially !-r, hig@, dens@@t@,r Population -i,reas served by Mary centers I- I b- n I ac ed on the agei ida -9- The Council agreed that, In order to be considered for final ndation by it, all applications which include requests for recoam purchase of rpajoi- items of' fixed and moveaIDI-e therapeutic and diagnostic equipment must include. . . A statement of the rationale for charging any or all of purchase price of the equip@nt to the grant, and of the justification for the proportioning of the shared cost-s among those involved in the purchase; A proposed plan for accounting and fiscal control of the- revenues accruing to the project (see liEW Grants Adniinistration Yjaniial Issuaiice Dis-oosition of Grant--,Related Income)., I Adequate evidence that the project plan, including the acquiring of the equipment, @ias-been reviewed, and if necessary,approved by the appropriate local planning agencies. 44 Establishment of ReLonal and Multi.-Reriona.1 Resources A. Television production and network facilities Council reco@nds that all new operational projects requesting iWor investmnts or funds for equipment and activities in television be thoroughly studied by Division staff and expert consultants for consideration for funding under the new authority for l@lti-program Services provided under Section 910. It further reco@nds that applications for continuation and renewal of previously funded @jor television activities be reviewed by the same group of expert consultants L on the basis of the process being made in the applicant Region toward its television objectives, and how those activities might be related or expanded to a Mull-li-program Service. B. Radiat@ton dos:L.-,etry services The Council accepted the staff's reco@-ndations: A temporary hold on funding of such projects, and expei@6 iii,@iuciirig representatives of' the -10- American College of Radiology and the Co@ttee on Radiation Ynera-Dy Studies (.1,Tational- Cancer T-iisl-.-'L'U-ui,-e), to advise the DI-vi@;@'Lon and the Council. The co@@'ttee's special. attention should be directed .to the possible use of the new grant authority (Section 910) for %'ililti--program Services B. Reco,,r,-rte@-dation for q(,,tion on individual applications A new system for Council review and recommendation on Regional l,ledical- @gram applications was introduced by @Irs. Phillips. . This system provides for individual discussion and action on applications from.Re@ions requesting initial operational grants, applications for . CD major prograi-q changes, and applications which present question of policy requiring special Council attention; and for bloc action on all other@ applications for supplemental activities, according to the recommendations of the Review Co@ttee. The Council was agreed on the value of, and necessityfbr, greater reliance on the site visitors' and the Review Co@ttee's assessment of the merit of' the -@l...'vidual proposals and the validity of the total program approach. A,',-.c considerable discussion however, they agreed to request the staff'to further alter the arrangements for their role in review, as follows: 1. To assign each application to one Council member and to send him, well in advance of the meeting, a copy of the co@lete document. 2. To continue to send to each member of the Council a complete set of the "blue sheets" which include a history of the applicant re@ion, a sunmry of the application under review, and a state-@nt of the Review Co=@"-tee's comments and recommendations; and all re..@- site visit reports. 3. To arrange th,-- materials so that the findings of the site visitors can be easily correlated with the final recommendations of the Review Comittee. 4. To have an oral report of each site-visit made either by a @-',-)uncil member or a member of the senior staff of Dr't@,IP. 5. To have available on the first day of the meeting, certain details. Record of the actions ta.Jcen by the 1,@ati-oiial- Advisory Council, on Regional '@,ledical- Programs applicatio-,,-ls considered by theni at the.meetirg on.Februar,y 20 and.21, 69 1/ I. Approval, as requested, and as recc)rcL@i-i;--nded and co.-miented upon by the Review Cor@ttee: GEF,ATH-R D@@4@T' VAIJF@Y @eratioral = Ol-$587,631; 02-$619,'734; 03-$629,627. NOTE: The Council re(4tiested that staff be assured of the budgeting details on project #4, and that the region be urged to arrive at a satisfactory cooperative inter-regional arrangement with the l@,ew Jersey Regional Pledical Pro&ram. Approval- for extension of the cormitirent for two additional years, at the present annual level., to be -.iv.,@i.rded as the operational core. LOUISIANA ol-$425,300; 02-$400.1186; 03-$412,181 II%TDLANA Ol-$82,03 02-$88,850 1/ All aTnounts are direct costs only and, unless otherwise specified, refer to 12 mnth periods. rfhe designations 01, 02, etc., relate to-ttie first, second, etc., get periods of the subject ai)-oll-catioi-i, not necessarily the bud budget periods which t ei will-ac7@illy--,upplement. -12- MICHTGAI'I ol'$49,135 GEORGI,4 Ol-$309,818 (this six nic. budcet to be expanded for a 15-month period); o2-$659,4i4 NORFH CPliOLINA @01-$50.tIIO7; 02-$145,207; 03-$144,572 MOUNTATN ST[i@n,,S Ol-$256,537; 02-$247,46- 03-$272,301, Oli-$279,037, 05-$273 252 ILLINOIS ol-$184,500; 02-$250,000; 03-$270,000 SUSQUERAI.TIA VALLF-Y 2/69.1 Ol-$129,742 2169.2 Ol-$231,175 (-Nine.months only) 2/69.3 ol-$169,202; 02-$44,ol4; o3-$45,61'i 11. Approval, in part, as specifically reconinended and comr@ented upon by the Revievi Committee ALhBA,@4A, 2/69.1 = Ol-$256>683; 02-$188,500 2/69.2 = Oi.-$5112,3(10: NO@IF,@il NEl HIGLAj\@'D -13- Ol-$1,306,934; 02-$1,386,429; 03--,$I,394,962 OFIIO gi'ATF, Ol-$157,890; 02-$I-34,258; 03-$55,572 OKLAHU,IA 101-$1,2011.,123 (Core 'for ten months only); 02-$1,3o4,159; 03-$839,205 liA@IA 01 $30.$000; 02-$30,000 VJ SSOURI 2169.1 Ol-$3,4oo,000 NOTE: Council recoimiended the one year only, with decision on subsequent .years to be made following the site visit. 2169.2 ol-$74,532; 02-$36,080; 03-$36,084 CF2t@ @o- I YORK 2/69.1 = Ol-$370,obo (of which $6o,o0o is to be reserved); 02-$372,33r@:3-, .03-$376,33- 2/09.2 = 01-@P178,711; 02-$156,957; 03-$113,009 Ol-$127,801; 02-$223 312; 03-$242,520' .1 2 .2 -@Dl--:'396 210- 02-$359 269- 03-$361,789; 011--$11,111.,O-17 .i -14- Mhlt ir@, --03:-$50C).$ 24 5;' C)2-$1193, 6o)i 03 $552, 865 WT/MITS ol-$49,900; 02-$26:-884; 03-$20,3113 14M@OP,r)LITAN D. C. Ol-$752,504; 02-$737,604; 03--$739,445 TF-.W,,SS@ 14TD-SOUITI Ol--$100.%832; 02-$38,361; 03-$33,776 TRI-STATE 2169.1 =-Ol-$72,701 (for ten months); 02-$69,3o8; 03-$72,326 2/69.2 Ol-$204.,321 (for ten Months) wiscoilisill" Ol-$370>080; 02-$275,800; 03-$200>800 02Sl = oi-$163,900; 02-@yi.63,900; 03-$lt'D3,900 02S2 = Disapproved 02S3 = ol-$163,272; 02-$163,272; 03-$i63,272 .02S4 = Ol-$73,172 (ei@-il, mnths) First Operational Ol-$792,251; 02-$686,386; 03-$69o,879 @.)erati-ona @u -Fiat = Ol-$] 'The 1 ooler, -5OiOOO; 02-$150,000; 03-'?150,000. --@OWT, is cippro@ii-al@e and Council dele@ates to staff, the sett3ng of an exact am.,ount. U-or7@,-atment should be for three years.) III. Retti3-n il()i@ revision under the conditions specified -by the Revio-@,q t','C)r TLittee Arkansas 1V. Deferral for further review arid'advi.se as specified by the Review'Co.@,attee Ohio Vall-ey South Carol-ina V. Disapproval under conditions specified by the Review Cbrrtnittee New Jersey *Albany VI. Approval under conditions specified by the Council California (2/69.1) = Council endorsed the recorviendations of the Co,-ffuti-lee on all components of this application except #28 (A Cor@iprehensive Stroke Pro,ra-,@,i). Tn this case they aci3epted the reconipendations of the site visitors. Ol-$556,369; 02-$546,1115; and 03-$547,655 (2/69.2) = Endorsed Cor@ittee recorrendation ($210,000 per month until June 30, 1969) with cb@tted support for two addition@ years, in an amunt to be set with the advice of site (2/69.4) = Endorsed Com,-aittee reco@iendation - Project 23 Ol-$122)050; 02-6yl27,5110; and 03-$123,955. Prr,-ect 22 to be returned for revision. Inter,@,)urta@Ln (2169.1) Deferral., pendin- the development of a o@lic-Fo@verninc,- -orojects of this kind (see Council minutes) (2/69.2 and 3) Ol-$151,26o; 02-$1115,451; 03-$269,319; 04--$265,253 -I:6- Rocl@e.-L;tcr Tiie Council endorsed the roco,-aiiendations of the Corrr@iiti-lee except on project 3-3. In this case they recoirzi-.ended approval of: the project in the reduced amouaL" recoiimended by the site visitors, but that no additional funds be added to the total award to the region. Ol-$253,051; 02-$184,16LI; 03-$190,0611 Western PerLnsyl@, @ia Tiae Council endorsed the genera3- recorniiendations of the Review Corari-Littee with the following specific additions: (a) ll'he amow-it to be awarded for interim support of t@e core (April 1 thru June 30, 1969) is to be based upon an annual level not in excess of the present level plus $100,000. (b) The amo@c, for continuation of core activities under t ope,@atioral grant (July 1, 1969 et se@c,.) will be set by the Council when it considers the entire operational application and has the findings of the site visit. Maryland = Tne Council was unable to arrive at a recommendation becausd of the difference between the recommendations of the site visitors and the recorrnendations of the Cormnittee. Authority for final action was delegated to a referee coninittee of three members. A total award ceili.no- of $1 4LI5,17'T for projects vias set. (NOTE,: A report of the findinus of the three member condttee will be the subject of a subsequent mesa. ix. @oupli4mlIrL adjourned at 1:00 on February 21, 1-969. The meeting was I hereby certify that, to-the best of my knowledge, the fore- minutes are accurate and complete-,. D. D@ector Division of Regional Medical Propm-,@ materials which v,,ere distributed at the @eting are available in the Office of the Oouncil -.ecreta.-@.,, -17- A7fL[4'-DAl,4CE AT qT7t,, 1-@l@TIONAL ADVISORY COUNCIL D=DQG February 20-21, 1969 PT)BLIC @,8@T 'I'H SFR-@TTCE OFFICIA-18 kf@MM)DqG- Dr. Joseph English, Administrator, Ilir. John Francis, Di@-eau of the Budget 14r. A.A. Fudfins, Office of Program Planning & Evaluation, HSak CD 14r. Irving Lewis, Deputy A&.uni-stra-toi@, HSIL'-IA @RS A'rl'v@@DING Dr. Lionel Bernstein @feterw-is Administration Dr. J'.H.U-.Brovm, IIIGI-.,',@S Dr. Wilfred Da@lid, Division of Chronic Disease Control Dr. Lester Evans, Connecticut Regional Medical Program Dr. Homer Hagedorn, Arthur D. Little Dr. ]-an Mitchell, NrlI Mr. John Pendleton, Division of' Chronic Disease Control Dr. W. L. Ross, Div-lsion of Chronic Disease Control Miss Pauly Stephan, I,ICI Dr. Richard Stephenson, l@OD Va,s. Alexandra V,,al,cott, Arthur D. Little Mr. William J. Zukc-,,l NHI DR14P STA.FF ATTENTDRTG Yw. Nicholas Cavarocchi, Financial Managernent Officer Dr. Donald R. Chad-,@,ii-ck., Deputy Director, DE@IP Mr. Cleveland Chair@liss, Assistant to the Associate Director for Organizational Liaison Mr. Edward Friedlander, Assistant Director for Comunications and Public Info @td.on Mr. Charles Hilsenroth., Assistant Director for Managem'ei-it Dr. Clarence @c>den Assistant to the Associate Director for Organizational Liaison @. Robert Lavton, Consultant to DRMP Mr. Gregory Lewis, Chief, Grants l@gement Branch Dr. Richard .',Ianegold, Associa@-c- Director for RMP Operations and Development Dr. Frank York, Chief, Operations Research -md Systems Analysis Branch '4r. Roland Peterson,, -it Assista,. Director for Planning and Evaluation Mrs. Martha Phillips, Associate Director for Grant and Contract Policy Mrs. Tudy Silsbee, Assistant Director for Grants Review Mr. Robert Thorner Assistant Director for Health Data Robert Jones . Chief,, Prograi%Assistance Branch DTUT STAFF li@@O@IDTITG Miss Rhoda Abrams Mrs. Patricia McDonald Dr. Earl @,lue Thomas Nc Miss Joy Finnegan Mr. Rodney Merker 14rs. Mary V. Geisbert Mr. John Miers Sam 0. Gili@fier Miss Majorie Morrill Mrs. Sheila Gould Miss Leah Resnick lip. George Hinkle Mr. Richard Russell Miss Dona Huiseal- Mrs. Rebecca Sadin Miss D4argare- Hulbert ;Mrs. Jesse Salazar Mr. Thomas Kinser Dr. Jack Schneider Dr. Anthony Komaroff Miss Susan Simkins Mrs. Lorraine Y,,yttle Mr. Alphonse Strachocki Mr. Glenn Lamson Mr. Lee Teets Mrs. Edithye Leventhal Mrs. Mary A. Teller Dr. Hubert TIathei@ison Mr. Frank Van Hee "C NATIONLKL ADVI'SORY COTJI-, IL OIN REGIOIAL liEDIC&L PROGRAMS Michael J. Brennan, M.D. (72) Edmund D. Pellegrino2 M.D. (70) rresidcnt, Michigan Cancer Foundation Vice President for the Ilealth Sciei-Lces. and Professor of Medicine Director of the Center Wayne State University State University of New York 4811 John R Stree.t Stony Brook, New York 11790 Detroit, Michigan 48201 Alfred M. Popma, M.D. (70) Edwin L. Crosby, M.D. (71) Regional Director Director Regional Medical Programs American,liospital Association 525 West Jefferson Street Chica-o, Illinois 60611 Boise, Idaho 83702 Michael E. DeBakey, II.D. (72) Mack 1. Shanholtz$ M.D. (70) Vice President for Medical State Health Cmnissiorer Affairs of Baylor University State Department of Ilealth Professo- and Chairman Richmond,, Virginia 23219 Department of Surgery College of Medicine Mr. Curtis Treen (71) Ilouston, Texas 77025 Director Pension and Insurance Department Bruce W. Everist, M.D. (71) United Rubber, Cork, Linoleum, Chief of Pediatrics ana Plastic Workers of America Green Clinic 87 S. Iligh Street 709 South Vienna Street Akron, Ohio 44308 Rusto--i, Louisiana 71.270 Mrs. Florence Wyckoff (72) John R. Hogness, M.D. (70) 243 Corralitos Road Dean, Scnool of Medicine Wats6nville, California 95076 University of Washington Seattle, Washington 98105 Clark H. 1-ilillikan, M.D. (72) Consultant in Neurology Mayo Clinic Rochester, Hiniiesota 55902 Dr. Joseph T. English, Chairman Administrator Health Services & li'ental Fealth Administration 9000 Rockville Pike @-ntbesda, Mirvland 20014.