e * MAY/,llJX 1974. RJ:V Lril? -I" $2,648,439 Reqliesi,: Conuni.ttce I!ecominc!nti;~t.ic,rr: $2 ,028,383 -----l_--- ----.--- Although it is not unique to this region, the Alabama Regi.onal 1$dica.l Program is continuin~~ r to attempt. to equalize j.ts minorj.ty representation cm program staff, project staff and its committee memberships. The reviewers arrived at the reduction in the recommended funding level (from $2,648,439 requested to the recomnendcd $2,028,389) by considering some of the p"o~galns , ?)oth continuing and new, to be of a low priority in a one year time-frame. For example, the Trophob1.a.stj.c Disease request) the -..-- requests for Cervical Cancer Sc.reeni.ng ailil.oi-lourescence for Renal. Eiolsies were consi.d@kcd. of low priority.`-%?%-.. Stage Of -- fuW"devclopment ) the revj.ewers believed the project request for Audio-Visual -- ,kssistance in Educ.ati.ny ~~yi-r,erteJlsives should not be fund.ed and t-m -.- __----- requesF?X--$X51,000 for>SJ&>Xn-be reduced by $100,000. JUI,Y/AlJG'UST REVIEW --. Estimated Request as of May 1974: 1 .lm DRMI?/DOD ' SCOB/6-5-74 MAY REVIEW STAFF SUMMARY ALABAMA REGIONAL MEDICAL PROGRAM 1108 South 20th Street Birmingham, Alabama Margaret Klapper, M.D., Coordinator Full-time Professional Staff: 8 ---_-_I Part-time Professional Staff: 0 Full-time Other : 3 ------- Part-time Other : 0 FUNDS REQUESTED: Total costs - $2,648,439 Program Staff - ($600,494) Continuation - ($565,005) New - ($1,482,940) Prepared by: Joe .lewelJ. _____-_ -.-- On duty since 7/l/73 -------'l'otr~l l'1-opos'd: 11 --------Total I'rc1posed: 9 Target Figure $1,891,872 (7/.1/74- 6130175) Estimated July Request - l.lm Period of Time Requested: Currently all activities are to terminate 6130175, or before. However, if permitted, several activities may benefit by being extended (lag time etc.),in time only,via a contract route. EMS PROJECT: -..--__ No new EMS proposals. There are requests for continuation of 3, #54, & #55. None of tllesc five currently-funded programs: #42; #43, ii exceed by 15% the annualized previous budget. PSRO: -_ ftlO3 is an information and training program for persons who will be required to supply data etc.for PSRO purposes. KIDNEY: -.- No renal activity currently supported.i/lOO,although entitled renal, is aimed primarily at cancer. CHP COMMENTS: The top of Alabama Health Planning Agency (page 77) endorsed a proposal from the Alabama Health Systems Foundation (North Alabama Health Information and Education Program). The proposal was disapproved by the RAC as not a high priority as it relates to the region's current objectives. The district IV "b" agency in Gadsden, Alabama endorsed five proposals which RAG approved. A sixth proposal, (Health Resource Planning), was endorsed by the planning agency but failed to pass RAC who preceived it as being a basic CHP function. Page 2 Alabama May Review Staff Summary The CHP "A" agency director's review, appears on page 84. He is il member of RAC. He noted some of the projects sent to him for review "DO not conform with the current RMP mission; however, that decision is the business of RAC." Staff notes that the current submission did not include all of the 35 projects referred to and since Mr. Blanks sits as a member of RAC, we believe his objection was overcome by the actions taken by the members of RAC. DRMP/DOD SCOB:5/15/74 a- M 974 a d REQUESTED F LISTING COMPONENTS BY REGION - --.- __ hLk3AYA PROG YR. 05 bb/-f4 COUNCIL TH CENTRAL CDXP COHPONENT TITLE DIRECT MO _.- INDIRECT ^. -.. .- ^ _ REQUEST REQUEST coca PROGRAM STAFF 466*984 L33r510 co10 MULTI MEDIA LF-APNING SKILLS LIf?RARY 60,500 0 042 O43 053 054 055 059 C&f+ 066 071 c72 073 c;77 _- .- E M S DEMO BIpM;NGHAH ALAEAMA E M S P E CFNTRAL ALA E M S .- .- WALA EMSSYS N E A-LA E H S , 73r355 7,726 1 449600 0 55,397 0 37,130 0 25,390 0 MOSP ?.ASED CARDIAC OUTREACH 15,420 0 PFDIAT2 It Pi!LX ' 39*779 0 STRENGTHENING LDCAL PLAN 22t764 ; 0 HLTH FXTENSION LFARNING 24,396 71970 `. DlSTRlCT 12 E M S CljUNCIL ORGAN 24,144 0 C!XvT t-D DETECT HYIjT 49,934 161335 ALA TfIKRIG6EE AREAWIOE C H P 56,375 0 SURVEY (3EV HYPT 15 CDUXTIES 5rooo 0 A V ASSIST 53UC HYpT 61991 762 A?:Ftic;:: U'dlV BASED HYPT ED 24,607 7,967 DkF; , STRi5NGT!+NI>!G LOCAL PLNG DIST 12 ANYISTON 18,963 0 C96 ,C;;LL!lk:d CNTY DENT HLTM 14,550 0 207 TELt C>`.:!4 SYS HLTH PRGF 24,760 4,725 islp T&l; NCCYATAL XNT ChkE 37~280 99450 0 9 9 FORMATION STATE'rlICE AGSRY CDCR CDUNCIL HYPT 27~323 1~332 TOTAL REQUEST 6009494 bOv500 81~081 449 600 55v397 37vl30 25~390 15~420 39v779 221764 32~366 249 144 66,269 56v375 5vooo 7,753 321574 189963 14v550 299485 46v730 28,655 . cl, REQUESTED FUN STING C3MPONENTS BY REGION 0.5174 COUNCIL LA&AMA PROG YR 05 c EN?Q AL CCMP COMPONENT TITLE .-... ^ ..-_ NO ..-. - _ . __ 100 IMMUNffFLUORESCENCE RENAL 316 101 ALA UlfR0C,ER.V CA SCREENING _ __.. -- ._- ..-.. -_ 102 WEST ALA MED CARE STUDY GREENE CNTY 103 P S R 0 REG TRNG I 104 GADSbEN STATE JR CCLL HYPT CNTRL _..__ - _... -.. ., _. 105 105A iO6 !4ULTI i-~iSCIPLIh%RY HLTH ED \ MULTI GISCIPLINARY HLTH ED 321, LEV:L CARE HYPT AND HT GIS T 4 ;,: r, `-LTH F.RCFS HYFT T?f.jS t.;!lP.SG !-!Cl'dE PERS CYTCTiCHY3L TRNG SCH W &LA n0SP CF\r ""ci:_: CO CA CC!?EEI4I"IG .-( ?-,;EIieE CO H;Gt! B P EDUC MOSILE CO HLTH EYER CMNC HLT~ I'sP:;IR ~JTTLIZATICN & DEV PL%G ~E;~~E!%i.Siil? Th:.G XUKSG SERV AGMTN REGICN 111 COST CCNTAIN3?ENT CONF RkAF! FACILITY FEAS STUDY 135~ PIL,:T HYPT CrdTRL HCSP FACSUILE IF!FS SYS ItJVEYTCkY PROF hEA I!`iFtl SERV . 49,725 114*010 --- 4,680 151,701 . 3t942 559866. - 561666 17,932 62~546 16,706 14~592 .-' 39,955 75,000 26,620 351610 9,657 259000 142,530 67,403 59,887 DIRECT INDIRECT TOTAL REQUEST - REQUEST _ REQUEST . . . Se730 0 702 0 0 20~372 17,415 0 39564 0 0 0 0 0 0 0 0 0 0 79470 0 169012 58r455 114,010 5,382 151r701 39942 76,238 - 74,081 17r932 66,110 16r706 149592 39,955 - 75,000 68,737 31?000 26,620 35,610 9,657 25,000 15c,ooo 67r408 75,699 -. PLAEAUrA PtiOG YR -05 rh CENTRAL REEUESTE!, F ISTING CO%PCNENTS B? REGXON 06/74 COUNCIL coxp COMPONENT TITLE DIRECT NO INDIRECT REQUEST REQUEST 121 TxcJPH39LAST DIS ENDCCRINE OX & FOLLOW UP 10,788 720 122 INDIVIDUALLY PACED TRNG MCDlJLES HEA ADMIN 36,545 4,050 "123 -~ MAP ABSTRACT HEA STAT ALA i971 8,422 11264 124 ANAL EVAL REFINITION NURSG SERV JORS 37,196 0 ,F CCIHPDNENTS. _ 48 REGION TOTALS 29378,363 .270r076 2,6488r439 . c TOTAL REQUEST 11,508 40,595 9~686 * 37,196 RMI? ALBANY -_I_ c_-- ru4 000 04 -I CrJ.ti.que: The reviewers believed the Albany RMP to have: Excellent program leadership Experienced, competent staff A strong, active, dominant RAG Excellent past performance Goals and objectives realistic and based on identified needs Proposed activities are consistent with goals and objectives (No CHP-b agencies'in this area) _JUJ,Y/AWlST RJ?VIEI{ Estimated request as of May 1974: $455,000 : of the Region RM 00004 l . e ALBANY Regional Medical Program Coordinator: Girard J. Craft, M.D. On duty since: I'!06 -- __-_._ (Coordinator since 1/73 Staff: Full Time Prof. 7.7 Proposed: 9 -7 Full Time Other 10.2 10.2 Funds Requested: Total ................... 1,066,175 Continuation ............. ( 732,461 > (projects>; 333,714 Program Staff Period of Time Requested: July 1, 1974 to June 30, 1975 Activities Proposed: Refer to Management Information Systems (XL'S) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) List any continuation project or staff acti.vity for which substantial incrcasc over annualized current funding is requested. HMO project: ~005 - 11,140 - This activity wil.1 facilitate tl~e deve.iopmeut of an HMO in the Capital District area predicated on capitation and the provision of comprehensive and continuous range of services as a viable alternative to existing health care plans, I EMS project: CO11 - Emergency Medical Servic*ct Feasii)ility Strlrly - 5:!,')20 - This represents a cooperative endeavor which relates to the conduct of Project #45. Project #45 - Upgrading EM Care in the ARMP Area - 138,600 - The goal. of this activity will be to establish and support the expansion and improvement of existing communications facilities I I PSRO: C003 - 15,800 - This activity is to provide technical assistance 0 in the development of four PSRO's in the ARMP region Kidne : 158,157 Project 1'144 - N.E. New York Program for FndTstage Kidney Dise;~sc~ - - This program will provide adequate therapy to patients wit11 end-stage kidney disease by expanding the patient base, facilities and trained personnel for their care, CIIP comments: There are no approved operational CHP "b" agencies exclusive to the ARMP. This application was submitted to the Upper Hudson Regional CHP Agency for their considered information. The application was also submitted to the CHP "a" agency. E0/5/20/74 MA ._ ._ . AL8ANY PROG YR 07 ERN CONP _ _ NO coo0 coo3 -.---- .-- - coo4 co05 to11 -.. .I.----- __- cob CO17 020 _. I --_ --- - - -. 021 .022 --. . 029 -- -.. - -_. .-. .^ 039 044 045 - :.. _ . 047 04s 049 PPDG STAFF PSRO FEAS --CiiP FFAS - -HHO FEAS E M S FEAS _ CO%PONENTS BY REGION Ok/74 COUNCIL - COMPONENT TITLE COMMUNITY HYPT FEdS . DEVELOP HLTH SERV, AGY FEAS 3-4 END CGtWUNITy HLTH CTR CARVER COYPRE COMMUNITY HLTH CTR TRNG DEL HOME CARE CG?l~QyITY HLTH EDUC SERV `-EXPbr!%D CONCEPT HOME HLTH CARE - -NF NY PROG END STAGE KIDNEY `DIS UPGRADING EMERG HED CARE' RURAL HLTk! ACCESS STATION - SUODEN HEATH HLTH CARE COHPUTER RESOURCE _. _ , DIRECT INDIRECT REQUEST REQUEST 222,763 1101951 101250 5*550 -. -. 16,200 6r1a0 7r150 31990 32,700 17r220 ar1501 41140 17,300 9.270 24,833 7t200 . --. ' 24,000 6,000 29rooo lOI ; 57,445 17,018 37e716 106,242 51,955 138~600 0 Llr160 '3,492 10~875 5,775 29,510 91330 REGION TOTALS 783,954 282,221 TOTAL REQUEST 333,714 15r800 2zr3a0 11,140 ' 49~920 12,290 - 26,570 I 32,033 - 30rooo 39*010 74,463 51,856 158,197 138,600 149652 16,650 38,900 X,066,175 . Rcqucst: $l.,351,128 ' Committee? Recommendation: $860,000 @,rcralf assessment by individual reviewers: Below average Critique: Arizona is considered below average for several reasons, none of which is of recent origin. Non-compliance with DRMP guidelines concerning grantee-RAG relationships has made it necessary to withhold certification of the review process of the Region. It appears, also, that individual representatives of the grantee may unduly influence the programmatic direction of,ARMP, includ- ing program staff, activities. Finally, the leadership ability of the Coordinator is questionable. The RAG membership, Medical School, has appears stable. which is 'appointed by the Dean of the recently been increased by six. The staff I To the Review Committee, this appeared to be a pedestrian appli- cation. Future support of the continuing education program is still under study. The region needs encouragement to move out of the urban areas and to focus on rural health problems. The Regional Advisory Group is scheduled to meet on June 20, 1974 to review new by-laws. ARMP staff will be in contact with the Region to determine what progress is being made in this regard. The Committee recommends approval of the application at a reduced level of $860,000, pending final.resolution of the RAG-grantee relationships and verification of a review process. JULY/AUGUST REVIEW Estimated request as of May 1974:$35p,ObO, : -425,000 6/6/74 WOB SmFF SUMMARY FOR MAY 1 REVTEW . ..--.-- ---.- ARIZONA REGIONAL MEDICAL PROGRAM: RM00055-04 University of Arizona School of Medicirrc COORDINATOR: Dermont W. Melick, M.D. - since 1967 STAFF: (FTE) Total - 16 PrQpOSt-!d : 20 Professional: 11 Other: 5 Professional: 21) Other: 7 FUNDS REQUESTED: Total (D.C. & i.d.c.) $1,351,128 Program Staff (Administrative) Staff Components (3) 665,400 389 790 .,-...z- 1,055,130. Projects: (3) total -.. 295,938 total brldget - $ 1,351,128 Continuation: 2 - K28, 29 New 1 * 822 , CHP COMME;NTS_ . CHP comments have been received and have receive-d replies from AKMP, 7% e one "b" agency that has not commented on the application is the Health Planning Council of Pima County. OTNER COMMENTS FOR REVIEWERS ATTENTION: 1. None of the activities proposed appear to conflict with other FPdcral grant programs such as HMO, PSRO, Kidney and EMS. 2. The Program staff budget includes several discrete activities. The largest of these, Expansion of Health Service Sites, is to devel<)p fi network of health services in underserved pri.msrily remote areas of the state. This activity was the result of ARMP's working with CHP ereawide agencies to determine areas of need. DRMPIDOD WOB 5/21/74 Component coo0 ---a COOL coo2 coo3 I Program Admin. 22 (new) Reduction of Strep. Infec. in 2 counties 27 (cont.) Hypertension 28 (cont.) EMS 20 Develop. of Health Inform, Systems REGICNAL MEDICAL PROGRAM OF ARIZONA Funding Information oL& yr , #it y,'3' May request 331,259 665,400 339,690 20,100 30,000 "--a 88,077 26,945 140,261 37,855 67,600 103,526 * $499,585 $1,351,128 Connoents (1) Central Regional Services Activities which include: coo1 - Expansion of Health Service Sites. coo2 - Efanpower recruitment coo3 - Self provider education Total amount invested in these three from 10/l/73 to 6/30/74 was $229,700 for C901; 34,600 for COO2 and 77,000 for coo3. *This is from FY 73 restricted funds WOB- R.Sadin 5/16/74 NAY 15rl.974 REQUESTED FUNDS LISTING COMPONENTS BY REGION .-.. Ocf-74 CGUNCIL iti1 ZONA PROG YR 04 IRN CDYP -_... -_. ._ _._ ., N3 C&l COCL co32 - coo3 022 _ .- .__.__ _ 027 028 ..CDMPDNENTS _ 7' COMPONENT TITLE DIRECT - _ _ ^ ..^ REQUEST PROGRAM STAFF 551~823 EXPAN HLTH SERV SITES 339 9690 EXT MED MNPWR UNDERSERVED AREAS PROG STAFF 20,100 SELF PROVIDER HLTH EDUC 30,000 REDUCTION STREP INFECTION TWO COUNTIES 84,255 COMMUNITY HYPT CNTRL METRO AREAS 140,261 EMS 67r600 . - .-_ -. - . . REGION TOTALS tr233.729 -.-.-_.- _.. _ _ * ^ . _- . INDIRECT REQUEST 113,577 0 . 0 0 3,822 0 0 117,399 ; OSM-PWBOlO-23 TOTAL REQUEST 665,400 339,690 20,100 30,000 88,077 140,261 67,600 lr351.128 RMP ARKANSAS e MAY/JUNE 1974 REVIEW RM 000 52 e Request: $1,830,751 Committee Recommendation: $1,500,000 Overall Assessment by Individual Reviewers: The primary and secondary reviewers rated the overall assessment of the Program as average at this point in time. Critique: This Region had been considered above average while it was under the direction of Dr. Charles Silverblatt. However, Dr. Silverblatt resigned in February 1974. Reviewers were concerned that the present staff would not be able to significantly expand the Program beyond the current dollar level of operation. The Search Committee has not yet recommended a replacement for the Coordinator but has appointed Mr. Roger Warner in an acting capacity. (Mr. Warner is one of the four candidates being considered.) He has been with the Program for four years and has demonstrated expertise in the monitoring and evaluation aspects of the Program. The RAG remains intact with relatively little turnover. Relations with the CHP, the Grantee, the Arkansas Health Systems Foundation (EHSDS~Program) and the other health provider institutions appeared to be most satisfactory. Programmatic thrusts covering the 10 identified "umbrella activities" were considered ambitious. Several new project proposals such as sickle cell, audiology and stroke rehabilitation were questioned as to the possibility of obtaining impact in a one-year period. Twelve other new project proposals were included in the application. A clear evaluation protocol was not included in the application. More information in this area is to be expected in the July 1 application. Also, a clearer staffing pattern is expected in the n&t application. -. JULY/AUGUST REV1 EW: Estimated request as of May 1974: $800,000 MC0 6/4/74 STAFF SUMMARY FOR MAY 1 REVIEW ARKANSAS REGIONAL MEDICAL PROGRAM: RM 00052-05 Little Rock - Univ. of Arkansas Med. Center COORDINATOR: Roger Warner, Acting - since 2115174 On Duty Since J~I!Y I t)h'! STAFF:(FTE) Total - 16.6 Proposed: ;! '-I . 0 Professional: 11.1 Other: 5.5 Professional 21.1 Other: 8 .5 FUNDS REQUESTED: Total (D.C. & I.D.C.) $1,830,751 Program Staff(Administrative) 173,785 Staff Components (10) - 5 new activities 716,715 Total Program Staff & Components 890,500 Projects: (17) total 940,251 Continuation (2) 157,630 New (15) 782,621 CHP COMMENTS: e CHP "A" and 7 of the 8 funded CHP "B" agencies have submitted comments. 'Trarisntitt~~ letter reveals that all activities were reviewed by all CHP agencies since each was involved in the drafting of those proposals within their respective iocal juris- dictions; is interesting to note that of the 6 activitie-s receiving unfavor~~bIe comments from the N.W. CHP "B" agency, the RAG disapproved $ of them and requi.red administrative changes in the other 2 before giving them approval; CHP "A" prioritized activities which can be compared with the RAG's prioritized !isting. ITEMS FOR 'REVIEWERS ATTENTION: . EMS - Project #82, Burn Center and Project #JO, Q.A., EMS Dept. Personnel. might be considered new EMS activities - however, DRMP st!aff has checked-wit11 Dr. Larry Rose and Mr. Reardon and find there is no conflict or duplicntic`rn 1~1 activities being funded with H.S.A. funds to Arkansas. . HMO and PSRO - no problems anticipated; activities labeled C072, 71 and ')O deal with Quality Assurance but are not funded to either HMO or PSRO organizations. Continuation Activities . Only one of the seven continuation activities request more than twice the amount as was funded for a six month period in the l/1/74 award. Project 1171, Quality Assurance, Arkansas Nursing Homes had been budgeted for $49,000. The current request for this activity is $127,630. e Target Funding, Amount (140% of the annualized level) = $2,210,742 . May 1 application requests $1,830,751; expect $800,000 request in July I application. REQUESTED FU COMPilNENTS BY REGION . _-- -.- - . . . _ 06/74 COUNCIL RRKAFISAS PROG- YR 05 CONTINENT cow -__ .- .- .._. NO _.. COMPONENT TITLE `CGSO ADMfhl 167,700 CDORD CUAL ASSUR PROG ACTIV --COOi' LOCAL PLAN PROCESS ACTIV . Ef4.S SUPPORT ACTIV COOP HYPT CNTtiL ACTIV CA SERV SUPPCIP.T AiTIV \ h2TYRIT IS. SE2V SUPPORT ACTIV FHYS EXTENQER SUPPORT ACTIV COOP SYS OEVELcP HT SERV SUPPljRT ACTIV QuhL ASSUF? ARK :JUSSG k:CMES DIRECT INDIRECT TOTAL REQUEST REQUEST REQUEST 75*000 140*000 25,000 30rGOO .SOrOOQ 50rooo 50,000 50,000 150*000 80*000 639300 30,000 1271630 124~925 54,375 54,020 33,475 549950 27rE58 S3rlGO 6,085 1,801 3r352 593 730 1,186 1,186 1,186 lrl86 3,560 I.915 0 0 0 0 0 0 0 0 0 0 0 -. ,-, ,..-_. -a -_ ,- k OSH-WB010-23 173,785 76,801 143r35.2 25T593 30,730 51~186 51,1&6 51*186 51,186 153,580 81,915 63,300 30,000 127,630 124,925 54,375 5c,oto 33,475 54,350 27,ELi 53,lCC 389150 -.------ - .- c 0 15rf914 KEQUESTED FUNOS LISTING COd?!PONtNTS fiY REGION 52 A!W ANSP. S PROG YR C5 kIC CCNTINENT CD!-fP CO?PONFNT TITLE - __. I. _ _ ._. . _ - Na. -I 09(! C:UAL ASSUK EMERGY DSPT PER; 091 SCF: hW."NItA PFIYSlOLOG OYSFUNCT . . A -.-._ . .._ _---- ..-. -_ 002 HLiH SCf! COUNSEL CLINICS EL6ERLY 094 J?9 ATTITUOE C'96 EkTERCSTONAL \ NO CF COMPONENTS ze I SURVEY UTILIZ RN THRPY PT NUtlSG ED - -___ _... -. - _._ - - _ _ _ 1 . _ I C6/74 COUNCIL DIRECT INDIRECT TOTAL REQUEST REQUEST REQUEST 52;656 98,865 54,645 23,115 9,615 39,552 REGION TOTfiLS i,a07,951 22,800 oswwaOiob-23 52r656 9a,E!a5 549 645 23,115 9,615 39,552 l.830.751 __ . RM 000'56 MAY/JUNE 1974 REVIEW _ . . . - . _ Request: $1,129,608 Committee Recommendation: See Below . Overall Assessment by Individual Reviewers: Average to below average Critique: The reviewers were disturbed that the Program has not substantially addressed the problems of accessibility and availability of care except for EMS, nor have they addressed themselves to the needs of minority groups with the exception of Project #55, Health Services Recruitment of Minority Groups, nor to health delivery systems. -It was recognized that the Program was in a very difficult situation because they are attempting to provide a program for the rural area of Southern Illinois as well as the Metropolitan area in St. Louis. The proposed two new project activities do not appear to conform with the document entitled, "The Health Needs of Bi-State RMP Region as identified by Joint RMP and CHP Planning Conference" which met in February, 1974. Reviewers expressed hope that the new activities proposed in the July 1 application will more adequately reflect upon those identified needs. Reviewers were surprised that the Bi-State RMP Regional Advisory Group had disbanded and had relinquished its responsibility to a 15-member Executive Committee. Hope was expressed that a larger Regional Advisory Committee should provide stronger leadership. Reviewers rated Program leadership as minimally satisfactory. Although reviewers did not recommend disapproval of Project #54 - Graduate Follow-up Study, they were not in sympathy with this particular activity. Program staff performance was considered satisfactory. Reviewers felt the Bi-State RMP Program Staff request for additional secretarial/ clerical assistance is out of proportion to the professional staff complement. Recommendation: 7. Review Committee recommended $800,000 which is 63% of the target and $329,608 under the requested amount. -- 2, Review Committee reaffirmed the November 1973 National Advisory Council recommendation that membership of the Bi-State RMP Regional Advisory Cormnittee should be increased in size and become more involved in the decision making-process. JULY/AUGUST REVIEW: Estimated request as of May 1974: $410,000 MC0 6/4/74 STAFF SUMMARY FOR MAY REVIEW e BI-STATE REGIONAL MEDICAL PROGRAM: RM 00056 COORDINATOR: William Stoneman III, M.D. - since March 1968 STAFF: (FTE) Total - 8.2 Additional proposed: 5.5 Professional: 6.2 Professional: 1.5 Other: 2 Other: 4 FUNDS REQUESTED: Total (D.C. & I.D.C.) $1,129,608 Program Staff 553,605 Staff Components 0 Projects: (17) total 576,003 Continuation (15) 532,765 New (2) 43,238 Target Funding Amount: (140% of annualized level) = $1,223,758 CHP COMMENTS: The Comprehensive State Health Planning Agency of Illinois and tk Missouri Office of Comprehensive Health Planning ("A" Agencies) have submitted positive comments. In addition to CHP comments on pages 99-104 of the application, the CHP(b) agency, Central Illinois Health Planning Council, Inc. has not qeveloped Standards or Criteria or a project review mechanism necessary for the review of these proposals and, therefore, unable to provide the Bi-State RMP with a requested review and comment. The May 1, 1974 letter should be included as part of the application and be considered RS page lC5. Items for Reviewers 1. 2. 3. 4. e Dr. Stoneman will be leaving 6-30-74. The KAC Scil rch Commi ttec has nominated Robert ti. Felix, M.D. to be new Coordinator. Dr. Felix was former Dean of Saint Louis University, School of Medicine and former Director of the National Institute of Mental Health. Deputy Coordinator, A Stephen Coburn joined staff 5-l-74. Health needs of Bi-State RMP Region were identified by Joint RMP-CHP Planning Conference February 7, 1974 and are listed on page 38 of app? icatioh. July 1 expected request - $410,000. MAY 15.1974 RECUESTED FUNGS LISTING COMPUNENTS GY REGION _ _. ._-_ ._ .- _ . _ .-_ 06/74 COUNCIL .BI STATE P?.OG YR 05 COYTINENT COW? - ._. NE `COG0 017 ._.- ._._ .-_- ---..- -. 018 021 030 ._ _. _.. ..-._ 036 031 044 _.,. _- --.. . ..- 045` - 047 O/+F _ _ _ 049 C~Y!?PCNENT TITLE PROGRAM STAFF EMS HLTH SERV AIDE EOUC HLTlj CARE STANDARDS AYBULATORY PTS CA CHEMOTHERAPY SUPPORT CC:~IXUNITY 6ASED ttNPd< EDUC COMS3riTIUM CC~PUTERIZEG 8ClJEL SISTRIEUTION HLTH MNP#R ., COMPUTE2 SUPPGRT PSKO DEV PUS PARTICIPATION EUS PLAN USE AUXIL XED FEf'.S IN HLTH CTF. E CGI3:J TCTALS 816,199 313,410 l.lZ9tCC6 DIRECT REQUEST 3589546 78,807 14t685 2ar086 llt750 49,464 15t439 211075 a.455 42 (340 9,082 17,115 33t954 25;570 15,960 51t623 23,;3CI 20,717 . . . I. o- t . OSH-PWBOlO-23 INDIRECT TOTAL REQUEST REQUEST 195,059 0 0 99910 6t120 12t770 0 8t272 21380 26,520 0 6t000 18,14e 2t920 0 15t920 3,467 5.924 553t605 78*607 149685 379996 17r870 629 234 15t439 299347 l-,835 68,bSO 9 , c L. 2 _. 23,lli 52,102 28,890 15,960 67,543 16,597 \ 26,641 lil~ll' California .-- _-_____I -..---.__I This application requests continued support for staff and '75 ongoing projects. Based on an analysis of the application alone, the reviewers noted,that program activities had been developed around six program goals with priorities defined by the IZAG, The staff appeared strong and very active in program development, . The RAG seemed to be'a stable group which depended on the well- * develcped review process and three special committeesn The RMl? has a,good track record regarding continuation of activi- ties after grant support is ended. The reviewers were uncertain about CBP relations and had quest- ions about the effect of the closing of area offices and the I elimination of the area advisory groups. Staff who had recently spent considerable time in California, studying the review process and CHI? relations, explained that relations with most of the,CHP(b) agencies were' good but very strained in the Eay Area and San Diego. The staff also explained the long history of the area offices and the fact that the DHEW * audit recommendation was to close them. Previous site visit' . teams had also stressed the importance of stronger central direct- ion which,is possible under the present organization. Panel D at first recommended that the application be approved at the requested level. Bowever, in its review of actions on 25 . RMPs, changed the recommendation to approval at the reduced.level of $7,353,000. The Committee concurred. JULY/AUGUST REVIEW: Estimated request as of May 1974 $5,8_29,533 _ WOB G/6/74 STAFF SUMMARY FORLaY 1 REVIEW CALIFORNIA REGIONAL MEDICAL PROGRAM: RM 00019 California Medical Education and Research Foundation COORDIUATOR : Paul D. Ward - since 1967 STAFF : (FTE) Total - 54 ?r:>posied : 99 Professional: 38 Profess i ona 1. : 52 Other: 16 Other: 18 FUNDS REQUESTED: Total (D.D. & i.d.c.) $8,170,374 Program Staff (Administiation) 1,309,727 Staff Components 29t, 582 ---. - Projects : (75) -i,601,309- total budget 6,56p,O65 $ 8,170,--3~ Continuation: All New: None CHP COMMENTS: CCRMP has a log of applications mailed to CHPs and comments received. Negative comments such as the following have been responded to: (1) CHP "b" coamients on 146B EMS Statewide Data Coordination req*.lest -- the sddition of Staff for all CHP "b"s throughorft the State. The objective of this project was to help produce a statewide data system by 6/30/75. The addition of steff to CIIP "b"S a? this time would be to plan for new activities which are now not permiss ble, It would also more than double the httdget. CHP and CCRMP arc now in the process of working out agreements. (2) 146E - Central Valley EMS. The Project Dircct.or and the Central Valley CHP "b" Directorand Mr. Campbell, the CCRMP Coordinator for EMS, are now rewriting the objectives and restructuri.ng the proposal. (3) CHP had negative conxnents on 8111, San Bernardino hs/ea; #112 S.rln Diego hs/ea and 8105 Santa Clara hs/ea. A letter of understanding has been worked out between #lo5 hs/ea Director) and the CHP involved. Program audits have been conduted, as requested by CHP, on projects 111 and 112. All the above CHP comments were heard at the tic mee1:i.q: on Apri.l. 17, 1.974. The RAC reconnnended that all appeals be in writing; that they, be presented to the Evaluation Committee of the RAC which meets June 4, 1974; that all involved parties be present at that meeting to rlresent their case. As e noted above, the issues are being worked on by staff and may be res.A. County ,ong Beach . EMS Training 'I Training Instr.Drew Audit Hosp. Em.Depts. Consumer Educ Critically Iii Newbor b feLnhbarhoo.d EMS . I 20,345, 67,730 18,180 . 31,084 32,643 75,000 . 55,252 50,000 25,000 , . 35,000 14,179 -o- 65,248 , Total I 504,590 Begin date REAL-i-~ RESOURCES I l/73 .48,995 PUNNING I 9/71 56,027 "AcceE8" 10173 12,000 9/71 49,789 l/73 71,716 22,270 25,017 70.000 19;910 31,000 Total 238,527 168.197 KIDSEY i Begin date Info. h Etral. System 1 9/71 Greater L.A.Organ Pro@. 9171 106,886 37,484 Reg.Trans. L'CSF tl 11 9/71 42,171 USC i 9171 45,280 II u Organ.Proc. 9171 48,093 8, irvt " Presv. San Diegp 9171 i 9/71 47,578 I, " Proc. USIA 49,712 .68,805 24,646 (2mos.) 8,361 3,023 " 11,506 3,473 8,513 2,838 13,123 4,331 15,654 4,615 11,299 6,650 8,576 3,239 6.663 2,368 I 10173 ..61934 9/n 42,510 Total 426,938 Ital-$3,937,316 Total-$8,170,374 l/74 (MIS) 06 yr. '71,951 78,800 -0 - -o- -O- -o- -o- -o- -o- -o- -o- -O- -Q- 50,000 -o- 215,840* 176,296 42,430 113,000 35,480 65,566 87,220 212,303* 62,028 112,000 19,712 92,675* 27,959 96,647 I 200,751 ,X,4.56,743 150,000 Comente EMS Coordination 146A budget was predicated on 14H dollar award. Budget will be reduced. 1461 - This is the second phase of this project It includes all of Loa Angeles county at-8 has the cooperation of CHP plus the L.A. Board of Supervisors.' 146M - This started with the northern hospital council. It now has extended to includ, the central and southern hospital count to do data analysis of hospital emergen May rec,uest 8,559 (2 nos) 28,008 (2 n-1 100,030(12 nos) 21,578 (2mos) 10,337 (2 mos) 168,482 55,ia3 Project 100 - This two month requeet is for me than level funding. Budget vas back during phaseout and was non approved at a prephaseout level. Except for 87K Regtonal Transplantation at 5% all other Kidney projects wi:l have had 3 year funding by g/31/74 8 $0. - _ 147A D i E P I H J K L H N 0 R S Q s--.- I P : .+ ; il45A B C D /. E I . I F G 11 I o ? 3 K i L '. M N I 0 . :: ,I .e . .: c Co~sor.ent : ikein date IO/l HYPZRTTKSION Coor, " Cont. Pittsburg " Educ.-Arab. Care " Cont. 13 rural ( " Coord. Count. L Clin.Educ. ".;. Vail, Voluntary Action IIyp. Chinese-America1 " Control-Santa Cl.91 Comm.Intervention Trng,.Clinic-Drew Home follosr-thru Dependency Prev. E. Palo Alto ontrol - Drew 1 Hyder. .-. _ - - in ChFLdrene Totals Cegln date 10/L/73 Q?&ITY hSSLW.X:CC ( Pt. Care Audit CbiZ?i idv.Works.-Pacif.Med, Nursf ng Audit CXA kd .records librariar Stanford Comp. Deta 3er!tely Schl.P:B. Iavis-Ed. Conp. JSPC Component ' )rcw " Irvine " + JCLA Schl. P.ti., : . . XL4 Med. School Tan Diego TE" ` Totals 3 n. . .__ OS vr. 17,370 35,965 33,soo o 18,500 . 27,595 41,520 41,487 -o- -O- -O- -o- -o- .' -O- -o- -o- -o- 2X6,237 . rd. 45,000 -o- -o- 79..959 25,000 -o- -o-. -o- . -0.7 . 149,959 06 yr. 84,630 -o- -o- -o- -o- - 0 - -o- ~14.650 13,147 33,174 16.636 52,068 24,958 .42,520 37,697 33,040 352,520 I 60,000 171,565 149:375 -o- -o- 39,';30 34,308 L;n,000 40,000 35,921 39,971 39,987 40,475 39.971 40,000 771,47i , b!ay request 152,X7(12 nOs 1122, x&2 y. 4:400 " 10,094 " 14,409 " 14,433 " 4,960 )1 4,165 13,270 " 2,329 " 51,826 ,;; 7,924 12,383 'I 11,964 m 11.013 m j40,hOS 129.164 345,933 291,067 163.373 76,423 s 94,520* 80,856 84,186 . 102,737*, 75,603 90,314 91,891 89.059 81,119 84,927 1,981,308 -1's" ` I) . Cormnts _ i Except for 147A, all hypertension requests are for two months only. The Hypertension Program Committee requested that all proposals be rerevieved.and , resubmitted July l/74. :t * . . . . e ,145P,Im ceflect high indirect costs to the universlties. H-ever, these are DHFZW negotiated rates. . Cc=~ont?nr 3 HS/ms R. Cxeer Retention Redwood RS/ea Santa Clara San Joaquin Valley San Fernando *I Is&L. A. San Xereardlno San Diego hs/ea Coordination Kern Co. Superfor Calif. . lhmna South Central fnglcwood Orange Co. Tri-Counties ' . Z.CCtiiS to cafe L..P., ioCa?S Prograz Staff : . . . _' 04y r. Begin date ?/l/72 793,759 273,533 60,131 269,367 157,406 14L?,290 20&,650 112,136. . 55;525 65,351 54,434 -o- . -o-. -0; -o- ,2,211,563 05 yr. 10/l 173 28,054 -o- -5- 78,000 -o- : -o- It;, CSQ 133,000 101 .coo EO.OG3 95,895 8S,OGO 73,000 -Q- -5- -o- - * 753.995 2.283.501 c 06 1-r. 11x174 -o- 145,943 1d:,m `-o- 105,000 68,717 -o- -o- 52,000 -o- -o- -o- To- 25.CC3 25:GOO/ 25.C33 3?4,6%w 1,029,aeo \: ., 1 -. : Kay recuest 59.,oao 8 ' 426,242 393,790 164,510 221,550 233,430 211,000 250,630 146 334 .115,030 ' 200.450 lL8,048 154 ,C?O 8,334 (2 nos. 9,:oo (2 30s. 8. 750 (2 IT.?+,. 2,763,,378 1,601,309 ) I .' Conx?n:s . . (I) Budget requests ate approxfcately 2117. of the 1st 6 Ironths budget for each ?.s/ei n(2) 6104 budget includes forcer project ;?27S, Facily Practice, Ll of C uhich hs Seen transferred to the Redoood hs/r;! for fvo (3) $105 includes a $164,030 subcontract. Applicant vi11 mail odditiocal icforcatic (4) i-IS/U cotxittce eectieg Yay 15 vi11 SOSC likely trltz.budge:s. +(2j liltI bndg& COY incluc'cs a indfan health trainbg activity in Eureuka. (6104 regu, $350,000 : the rest of the budget if for \ There are a total of 75 prefect acrivirics. : - -' or* tit of ,FY 73 restricted funds. CCRMP MAY 1 APPLICATIGN - Staff Summary Executive Director - Paul 3. War:] - has be.on with REP since 1967 RAC Chairman C. John Tupper, M.D. .i&anl U.C. %.vi.c; Chairman for one year; Vicnc Chairman for three years Grantee California Medical Education and R?se;-rch E'oundation Fundinq History L/1/74 - Q/30/74 - $3, 938, 316 ( ~llCll!C.l~~S $340,910 unexpended funds from 05 year plus FY 73 restricted funds of $ti7'7,651) l/1/73 - 12/31/73 - $3,453,274 FY 73 annualized budge-t prior to phase- out $8,700,000 (10.96% of all IWP funds) e Background Information CCRMP has been on triennial status since August 1.971.. Prior to June 30, 1974, the organizational structure consisted of :iin2 area offices, one at each of the medical schools and a c:i.!n :: (-`I 1. office in Oakland. CCRMP had always been considered an inno- vative avant-garde region with a 70 percent record of con~Cn~-;:ion funding from other sources after RMP funds have been tcrminat,::t'l. However, there were some concerns identified by an HZ%7 audit team, SARP and others. CCRMP had the capability of becoming its own gral!'l-ce an':2 did not require CMERF, which served only as a fiscal agel;.L, to be the grantee. (2) CCRJ%P RAC was too small and JXCI~ representative enough of the Region. (3) RAC rcvicwetl projects on an individual rather than on a proyrammatic basis. (4) CCRMP was sometimes unaware of projI'?ctt-' being developed in the areas until they reached the :;i:C. This sometimes resulted in the unnecessary expense 02 developing projects that were not feasible. (5 ) Tiler-2 was inadequate coordination between area offices and `> . lack of attention to regionwide impact 02 proposals. (6) Proposals were not being monitored and evaluated or1 ct systematic basis. (7) CCRMP had decentralized most manac_icment responsibilities to the nine area offices and permitted th~rr! to operate with minimum central cjuidancf?, direction or coordination. (8) CIIP and RMP relationships were a proi-)lcm in some areas. The abolition of the nine area offices 6/3rj/73 resolved those concerns (4, 5, and 7) relating to the area offices. RAC memh<::r- ship was expanded from 35-44 and the nine additional members are representative of the former areas. The present LRAC includes seven members of the public. All proposals are now reviewad on a programmatic and regionwide basis. An Evaluation Committee of the F!AC has been established which rev' L~~~ all ongoing activities and a director of Evaluation has been added to central staff to assist the Committee, CHP-RMP relationships are being addl:r!ssc implementation of the "Section 1122" program. The procjram ~l.tc;-- ment addressing access to care will be included in the July J. application. Health Manpower Element (Section IV) Request is for $2,763,378 to continue 12 projects for an addi- tional 12 months and to continue three projects for anotl~z two months. Eleven of the fifteen requesting continuation sup-- port received initial fundinc; through FWLPS earmarked funds Jul.1 1, 1972. Fourteen local consortia have been formed, ten of wl:.i.cI~ are incorporated; four are in the development staqe. ip 11 c) ;-;&j-e-. wide project coordinating the hs/ea network of consoctia i1c7c been used to improve the manaq2ment capability of the hs,/',?a'r: and to design a statewide data and manpower in'c~ell_igence :-,ys.lcn,. e CCRMP has invested approximately $3.35 million in hs/en's in the past two years. CHP concerns regarding projects 111, San Eernardinc) hs/e~, 11.2, San Diego hs/ea and 105, Santa Clara hs/ea were discussed at the April 17, RAC which decided to defer action on thz a?:ove proposal"; until these issues were resolved. This has been accomplished by letters of understanding between hs/ea project directors and the CHPs in those areas. Quality of Care (Section V) Request is $1,881,308 to continue 15 ongoing projects. .Prior Lo phaseout, CCRMP had funded a pilot project in Area I for one year to develop medical audit workshops. When supplemental funds became available in the fall of 1973, CCPNP formed a Program Committee on Quality of Care proposals to develop rfoals and to monitor funded programs. This resulted in the submission of 15 projects which were funded between 10/l/73 and 6/30/74, for a total of $921,433. Activities included a Regional Planilins arc concerned about their roles in this EMS effort. They have requ ?s-t:icl that CCRMP pay for a staff position for each of the "b" agencies. This would more than double the present project budget. .kt its April 17 meeting, the RAC directed that decisions on the state- wide projects plus #146X Central Valley JMS., be deferred ulltil the issues have been resolved by the parties involved. 1-t requested that appeals brought before the Evaluation Committee be in writing. Division of-Regional Medical Programs has since been informed by CRM.P staff that the issues raised Ly CZ may be successfully resolved before the June 4 meeting of the Evaluation Committee, at which appeals will be heard. Hiyh Blood Pressure Control(Section VIII) Although CCFWP has previously funded several small feasibility studies in hypertension, this has been essentially a new program area for California. A Statewide High Ijlood Pressure Council was formed last fall, which decided that projects in the followin; areas would qualify for funding: (1) establishment of community councils for HJ3P control (2) organization of ambulatory care scrv- ices to manage persons with ilBP and (3) development of innovative education and training programs in HBP Control for consumersand providers. Sixteen projects have been funded between lo/73 and 6/30/75 for a total of approximately $570,000. The present request for $340,608 is to continue this statewide coordination project for 12 months and the others for just another two months because of the decision by the High Blood Pressure Control Committee that all project sponsors submit new proposals for complete local and technical review before the July 1 review * cycle. Section 1122 Program (Section X) Since September 1973, CRMP has been involved in a State :lc;lltll Department Task Force study to determine how Section 1122 of Title Xi, of the Social Security Act should be implemented. It has invested approximately $82,000 to date in this effort. :j'hc Program Evaluation Committee of the P&C has recommended that this activity be continued from 7/l/74 - 6/30/75 at $100,000. Access to Care (Section IX) This includes a request for $168,482 for continuation of Section 1122 for 12 months and two months continuation of four ongoing projects: #69, Respiratory Disease; #83, So. California Council of Free Clinics; #lOO, Ventura Health Network and #137, Tel-bled. Projctct 69 reaches the end of its 3-year authority August 31, 1974. ?'he others may request additional extension on July 1, 1974, in which case they will have to undergo new review and evaluation. WO,'5,'16/74 Critique: Reviewers found the CNYRMP RAG to be active and effective. The Region was noted to omit its Goals and Objectives from its current application and presented its program in terms of thrusts. The present number of staff relative to the multiple number of activities raised serious questions concerning the Region's monitoring capability. . However, proposed staffing patterns seem adequate. The Region's accomplishments in the North County in reference to recruiting sixty physicians was cited as a remarkable gain.. Also the local matching identified in the CNYRMP l?MS activity was consider&d deserving of credit. The hypertension project's lack of CHP 'comments was found to be an oversight on the part of the Region and will be corrected by the next submission. . . -. JULY /AIJGUST REVIE\J JULY /AIJGUST REVIE\J Estimated request Estimated request \. \. as of May 1974: 1,150,000 RM 00050 CENTRAL NEW YORK Regional Medical Program Coordinator: John J. Murray On duty since: 1972 Staff: Full Time Prof. 5 Part Time Prof. 1 Full Time Other 2 Part Time Other 1 Total 9 Funds Requested: Total . . . . . . . . . . . . . . . . . . . 796,986 Continuation.......U.... (444,755 1 Proposed: 8 1 3 --I 1 13 New....,...,........L.... ( 36,284 ) Period of Time Requested: All projects core and activities are requested until 6175. Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . RMooo50 Central New York List any continuation project or staff activity for which substantial increase over annualized current funding is requested. 1, Although Project 22C EMS Communication was funded at $107,250 & g9,455, the Region is requesting 147,515. The Region now plans to equip rad OS in volunteer and rescue squads. *2. (See Below) F HMO project: NONE I EMS project: All facets of the EMS Project 22B, C, F, request increase in funds. PSRO: Kidney: NONE NONE CHP comments: Note: No CHP comment received on new Project 57 Model Hypertension Program. The Coordinator indicated this as a core staff activity and felt it was not new to the region. It should however, had CHP comments. "2. Projects j/35,36,37 (mis. numbers 58,59,60) - Health Education Network. If one refers to the region's efforts in continuing nurse education, as noted on 15 of the application as the forerunner to the HENS and if one analyzes the core staff budget & project efforts, the following funds have been set aside for these types of activities: Proj. 1 Nurses Continuing Education COO1 Program Staff Community Based Manpower Proj. 18 Area Health Education Cooperatives Proj. 30 Health System North AHEC Proj. 45 Health Education Network $639,500 s.t. 31,047 109,024 30,104 52,382 222,557 s-t. *Q&3 nr;-l + f---*lA \ RM 00050 Central New York e Continued To invest an additional (19,296, 18,295, 28,000) $66,221. to support projects which should have been developed a few years ago, most of what they proposed to do now would seem to be an unwise investment. The thrust of each project also appears to have deviated from the major mission of DRMP health service education activities. CNT NY SYR PRDG YR 06 ERN cow - ..- ..- .-^ .- _...._ NO _ coo0 022R - --.-_ --. . . ..- _.. _ 022c`- .- 022F 040 --I- --- ___ 044 ~. --....__. - .- - . OS5 . _ 056 - --- - ..-. - -. 057. - 058 _ 059 . .-.__- __._. .._._ 060 --- COlr,PONENTS 12 ---- .-- _----._. _- . REQUESTED FUNDS LISTING COMPONENTS BY REGION 06/?4 COUNCIL COMPONENT TITLE DIRECT . - REQUEST PROGRAM STAFF EMS R COUNCILS EMS C kADI0 COflHUNICATIONS . .. ~PRT GEORGETOWN SATELLITE CLINICS -COUNCIL COORD HLTH SERV . NO ~IXJNTRY CHILDREN'S CLINICS ADULT SCREENING EXTENSION CLINICS MODtL. HYPT COMMUNITY NO COUNTRY HLTH ED& CONSORTIUM NY PENN AHEC ioiiAWK VALLEY HLTH 'ED&COUNCIL - __-.-_- -. . ._- _ ._ _ 248,486 861065 .- . _ .._ '147,515 41t331 27*000 I 24~386 29 *zoo 23,037 _ . . 30,880 28 rOOD 18,925 _- 19,296 REGION TOTALS 724t121 INDIRECT REQUEST 6fr461 0 0 0 0 0 0 0 5,404 0 0 0 72,665 OSM-PWBOlO-23 ' TOTAL REQUEST 315r947 86 9065 147t515 411331 27,000 24,386 291200 23 t 037 369284 28~000 18t925 19~296 796,906 a . . .' . nrn. ""#"I UU", rr.y"lllI,,r - ,., . : . ,.. . .`; . RM 000 40 1974 REVIIIW . . : -_ _,.'.' Request: $1,879,646 . . Cornn$ttcc Recommendation: $1,587,644 Overall assessment by. individual reviewers: Superior - Above Average . I. ,' . . . . . . Critique: The Committee concurred with the staff analysis that Dr. Thomas Nicholas, Executive Director, has provided excellent leadership for the Program. Past'performance of the Program has been very good. The goals and objectives have remained constant and have been adhered to by the Program. Health resources within the region have been utilized and projects are directed toward health resources planning. This was considered a commendable feature by Committee. Concern was expressed regarding theccancer activities in the application, especially Project #48, Colorado Cancer Registry, which had been funded by NIH through June 30, 1974 with additional funding anticipated from NIH in the late fall. The kidney projects, #29, Pediatric Hemodialysis Center for Zhe Rocky Mountain Region, #47, Diagnosis/Treatment, Kidney Stone Disease, and #50, Pediatric Nephrology Center, raised questions as to any overlap of , activities. JULY/AUGUST REVIEW Estimated request as of. May 1974:' $227,000 MC0 6/4/74 c I STAFF SUMMARY FOR MAY REVIEW Prepared by: M.E. Murphy COLORADO/WYOMING REGIONAL MEDICAL PROGRAM: RMP #40 COORDINATOR: Thomas A. Nicholas, M.D. - since 7/72 STAFF: (FTE) Total t7.63 (18 persons) Professional: 13.63 (14 persons) Clerical: 4 Requested pos itions: 6 (5 Prof., 1 clerical FUNDS REQUESTED: Total (D.C. + I.D.C.): Program Staff: Staff Activities: Staff TOTAL: $1,879,646 673,351 1,012,271 1,685,622 Projects: Continuation (2): 98,191 New (13): 769,184 Projects TOTAL: 867,375 0 CHP COMMENTS: Received from 'A' agencies in Colorado & Wyoming and responded to by RAG. Both agency directors sit on C/W RAG. Two funded 'B' agencies, Big Country CHP Council, Inc.(Montrose, Colo.) and Denver agency (without a Director). Big Country CHP Director CONCERNS: on RAG, also,, And comments good. 1) EMS Activities: COO5 Quality Control for EMS, Rural Areas - 15,000 COO6 Regional Planning for EMS, Wyoming - 25,000 COO7 Regional Planning for EMS, Colorado - 35,000 COO8 EMS Systems Development, San Luis Valley - 35,000 2) Kidney Activities: f29 Pediatric Hemodialysis Ctr.,Rocky Mt. Region: Continuation 60,000 #47 Diagnosis/Treatment, Kidney Stone Disease: New 35,511 #50 Pediatric Nephrology Ctr.: New 23,510 Target Funding Amount (140% annualized amt.) = $1,543,284 Application request ($1,879,646) is $336,362 above target figure. Anticipate July l,+)q&&request of additional $227,000 for 4 new activities. ` . Mid-Continent Operations Staff Analysis: Mary E. Murphy Colorado/Wyoming RMP: ii40 The Colorado/Wyoming Regional Medical Program application requests funding from July 1, 1974 through June 30, 1975 for Program Staff, 2 ongoing and 13 new activities. Application Request for $1,879,646 includes: Staff Program COO0 Program Staff COO1 Strep Awareness Ed, Prog./Chfcanos COO2 Health Program in &io. Schools COO3 Maternal/Child Health & Family Planning COO4 Hypertension Screening Program COO5 Quality Control for EMS, Rural Areas COO6 Regional Planning for,EMS, Wyoming COO7 Regional Planning for EMS, Colorado COO8 EMS Sys. Development, San Luis Valley COO9 CWRMP Grand Junction SRO Activities CO10 Western Health Educ. Center. CO11 Expanding Primary Social Services CO12 Extending Primary Care to Rural Communities CO13 Health Resources Development Project 0 CO14 Primary Care Development, Western Slope CO15 Continuing Education & Training Activities $673,351 5,000 4,000 1,600 29,500 15,000 25,000 35,000 35,000 33,500 3,000 16,840 6,480 104,000 20,000 5,000 Projects Total P.S. Activities 1,012,271 TOTAL PROGRAM STAFF 1,685,622 c #29 Pediatric Hemodialysis Ctr., Rocky Mt. Region 60,000 c #35 Quality Control for Ultrasound Facilities 38,191 #38 Pediatric Oncology Ctr. 53,013 fi39 Quality Control Diagnostic Radiology Facilities 58,566 #40 Electrical Safety in Hospitals 53,030 #41 Bone Pathology Ctr. for Ca. Diagnosis 26,325 #42 Core Prog., Primary Health Care Nurses 72,957 #43 Diagnostic Ultrasound Training 40,172 #44 Quality Control for Ultrasound Facilities 38,191 #45 CEIS Automatic Confirmation System 170,280 #46 Train. Prog./Prim. Care/Inheritable Dis. 79,547 #47 Diagnosis-Treatment, Kidney Stone Disease 35,511 #48 Colorado Cancer Registry 31,688 #49 Colo. Hosp. Assn., Shared Educ. System 20,000 #50 Pediatric Nephrology Center 83,510 TOTAL PROJECTS $867,375 -2- The Colorado/Wyoming RMP goals for the request year are: 1) to improve availability, accessibility and the quality of primary health care; 2) to improve accessibility and maintain quality of secondary-tertiary care to the people in the C/W region; and 3) to assist in local planning of health resource development. The C/W RMP plans to submit a July 1, 1974 application request for approxi- mately $227,000 for the funding of 4 new projects. An Arthritis application was submitted for review and requests $362,621. The proposal is to be critiqued by an assigned body of reviewers. Analysis of the Colorado/Wyoming Regional Medical Program The Colorado/Wyoming RMP is in the second year of its triennium. Present funding (l/1/74 - 6/30/74) is in the amount of $694,541. Project activities number 19 at a cost of $335,346. Dr. Thomas Nicholas has served as Executive Director of the Program for almost two years. He has exhibited excellent leadership and is supported by a competent staff of 18 persons (17.63 FTE - 13.63 Prof. & 4 clerical). The C/W RMP staff prior to phase-out numbered 19(14 Prof. & 5 clerical). Therefore, staff number has remained stable, but with a slight change in personnel. The Regional Advisory Group of the C/W RMP has remained active, maintaining supervision over all projects and program staff activities. This has been accomplished through the cumulative information received through three mechanisms: 1) Quarterly reports received from project directors, 2) site visits and subsequent staff reports, and 3) site visits conducted by sub- committees, and/or technical review committees consisiting of members of th e RAG, or appointed by them. RAG recently increased its Executive Committee from 6 to 9. Total RAG membership has been increased from 40 to 55 members This was accomplished for two reasons: 1) to provide more experienced peop for health care planning and implementation, and 2) to provide a more comprehensive and better geographic distribution of membership. The RAG le distribution is uniform throughout the two states, and every planning region is represented. The RAG's relationship with the grantee, the University of Colorado Medical School, remains good. The C/W RMP has acted as a coordination point for EMS planning activities in Colorado. The Program developed a statewide EMS plan and, in addition, has assisted local communities with their individual planning and coordination activities in accordance with the state plan. The C/W RMP has extensive experience in assisting with local planning for health resources, as well as data collection. Community organization in rural areas, as well as health planning, has remained a major Program thrust. It continues to be apparent that plans must be developed locally, based on an assessment of local needs. In Colorado, a wide variation of planning - -3- capabilities exist. CHP 'B' agencies are mostly small, understaffed and underfunded. C/W RMP has an excellent relationship with most of the planning organizations. In the Western Colorado area and the Western Wyoming areas, these activities will be accomplished in cooperation with the Intermountain RMP and Mountain States RMP. Comprehensive Health Planning Agencies 'A' Directors in Colorado and Wyoming are voting members on the RAG. There are only two funded 'B' agencies in the two states, located in Colorado, and Denver is presently without a Director. Comments received were responded to by the RAG. The negative aspect related to the brevity of the Form 15s and the short time period allowed for review of the projects. Colorado comments alerted the Program to the relationship of the Grand Junction Sub-Regional office to oil shale development in Western Colorado. Much previous activity had been expended in that field through the efforts of CHP and the Colorado Department of Health. Several of the new project activities are variations of formerly funded projects: #38 - Pediatric Oncology Epidemiologic, Diagnostic and Surveillance Center and #15-Regional Pediatric Oncology Center for Research and Training; #maining Program/Primary Care/Inheritable Diseases and #30-Rural and Urban Genetic Counseling and Screening; #43-Diagnostic Ultrasound Facilities and 'ieTJ-Tralnlng in Dlagnostlc Ultrasound in Community Hospitals (unfunded). - Assurance was given by C/W RMP that the new projects are not mere extensions or requests for continued funding. On all activities to be conducted in areas which overlap with Mountain States and Intermountain RMPs, written assurance will be submitted that projects have been reviewed and approved by the three coordinators and their respective RAG chairmen. MA REOUESTEG COMPONEN 06/74 COUNCIL _ CCL0 WYCHG ' PROG YR 06 3 CONTIN EN1 CCMP - -. - _ _ ..- NC - coo0 COO1 CC02 coo3 COO4 coo; cod , -coo7 COO8 COD9 CO10 - - --.---_.-. co11 co12 . CO13 CCLS cc.15 COMPONENT TITLE PROGRAM STAFF COLCRAGO WYClMINd RMP PROGRAM `STAFF DISCRETE. PS 75-01 PROGRAM STAFF DISCRETE PS 75-02 -- .. PROGRAM STAFF DISCRETE PS 75-03 PROGRAK STAFF GI-SCRETE PS 75-04 -PRLLRAX STAFF XSCREiE PS 75-C5A -PROGRAM STAFF GISCRETE PS 75-058 `. PROGRAM STAFF DISCRETE PS 75-05C PUGGRAM STAFF LISCRETE YS 75-05D - ___. PPr-jGiiAM STAFF DISCRETE I'S 75-6A P4C(;.I(:t! _rT4FF ;ISCkETE PS 75-66 PROGRA?? STAFF DISCRETE PS 75 6C PRsG?hV, STAFF GISCRETE PS 75 bD PRC;,kA.% STAFF CISC?.ZTE PS 75-7 ?;\2E?.L:4 STAFF GZXRETE PS 75-8 p.h3SR.LM STAFF 3ISCRETE PS 75-9 DIRECT REQUEST 592~200 5,000 - 4,000- 1,600 29*500. 151000 25,000 35,000 35rooo 339500 31000 16,840 69480 91,580 _. 20,000 5*000 029 ' PEC:IPTRI' i. HE!!I>DIALYSIS CENTER GOCKY MOUNTAIN REGIO 52,872 G35 CU:.LITY CI':.T-!i;L2SY C%TER/Ck%CE?. DIAGNOSIS 23,220 INDIRECT REQUEST 81r151 0 . 0 0 0 0 0 0 0 _ 0 0 12,420 0 0 71128 99038 9,826 12,408 . 10,293 3,105 TOTAL RECUEST _ _. _ _. 6739351 5,000 4rooo -- lr600 297500 15;ooo 25,000 359000 35rooo 33t50G 3*000 16tb40 69480 104r000 20f000 5,000 60,000 44,585 53,013 58,566 53,030 269325 MAY 15r1074 REQUESTED FUNDS LISTING COMPONENTS RY REGION .-- _-_ .-_ _ . _ .-_ _. 06/74 COUNCIL `XL3 WYOMG . PRDG YR 06 3 CONTINENT. COMP COMPONENT TITLE DIRECT -- - ._.___ _ ._.. NO REQUEST 042 CORE PROGKAM/PKIMARY HEALTH CARE NURSES 57,963 043 DIAGNCSTIC ULTKASOUNO TRAINING 36,518 __d_ -._- .-__._ --_ - .-__ _ 044 QUALITY CONTROL FOR ULTKASOUNd FACILITIES 30 9247 . _. .- _ __.. 045 AUTOMATIC COMPUTER ASSISTED CONFIRMATION SYSTEM 154~800 04h TRAINING PKOGRA%/PRIMhRY CARE/INHERITABLE DISEASES 67r685 - - .-I -.-.. -.. .__- 047 DIAGNCSIS-TREATM'NT KIDNEY STDNE DISEASE 359511 -- 048 CCLORADO CANCER'REGISTRY 319688 \ 049 CHA SHAKE0 EDUCATIONAL SYSTEM 209000 _.- _.._- - _ . -. .. 050 PEDIATRIC NEPhROLOGY CENTER 65 9276 31 REGION TOTALS lr662r109 ..- -. .I . . .._._._ .._._. -. _ _ _ ._ _. . INDIRECT TOTAL REQUEST REQUEST ._ 14,994 72,957 3,654 40,172 7r944 389191 15,480 170t280 ' 119862 79,547 0 35,511 0 31~688 f 20,000 18 9234 83,510 ; 217~537 OSM-f'WBOlO-23 * 1~879t646 o JULY/AUGUST REVIEW Rcquesi: $636,220 -- Comr+tee Recorruncndation: $510.000 ~vcrall assessmnt by- individual reviewers: Below Average to Poor i . Critique: This application, requesting 12 mont,hs support for an expanded staff (from 5 to 8 professionals) and two months support for ongoing activities, lacked substance for the reviewers. It was agreed that needed staff competencies in the 'area of fiscal management and evaluation were much needed, in fact, the Committee noted that the absence of evaluation staff had been a concern in previous reviews. The unique characteristics of this Regional Medical Program, with its emphasis on building long-term university- hospital relationships was dis.cussed, but the application lacked information regatding the outcome of the linkages. While grant support for full-time chiefs of staff in community hospitels has been discontinued, the support of, and dependence on university resources, including students, still prevails, Staff leadership was'not apparent to the reviewers, but the argumentative tone of the RAG Chairman's responses to CHP comments, as well as the CHP comments themeelves, indicated that the RMP-CHP relationships remain a problem in Connecticut. The role of the Regional #;ihrisory Group in relation to the Committee structure was unclear, as well as the criteria used in priority ranking. Because. the Committee realized that concerns of staff leadership, RAG functioning and cumulative impact of this RMP's unique characteristics have been delineated by Committee and Council in previous years with little apparent effect on the RMP, the Committee recommends that reduced funding of this continuation request may be a more patent message. The Committee . recommends, therefore, that this application be approved at the reduced level of $510,000. Estimated request as of.May 1974:' $1.963,780 RM 00008 e CONNECTICUT Regional Medical Program I Coordinator: Ed Morrissey Staff: Full Time Prof. 5 Part Time Prof. 0 Full Time Other 3 Part Time Other Total Funds Requested: 8 On duty since: 7/73,: _ Proposed: 8 4 1 n 12 i Total . . . . . . . . . . . . . . . . . . . 636,220 Continuation............. ( 157,040 ) - 9 projects *'k flew e ,*....I..**.*`.`...... ( -o- ) Period of Time Requested: Projects until 8/30/74; program staff until 6130175. New projects will be requested on 7/l/74 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) * Was Deputy Coordinator from 1967 - 1973 ** Represents 2 months extension only; new proposals will be requested 7/1/74 RM 00008 e Conn. List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: EMS project: no significant increase; 2 months extension PSRO : Kidney : no significant change in support; 2 months extension CHP comments: At best, CRMP/CHP relatio%s can be described as strained, particularly between CRMP and the Connectict "a" agency. In the application, it appears that all CHP comments were received in time for consideration bq CRMP. Copies of correspondence indicate that CRMP appropriated addressed concerns submitted by the "b" agencies. The Deputy Director of the "a" agency submitted some rather salty comments (supposedly representative of the agency, but this is under question) making general statements charging."waste of money and pork barreling." , oi E0/5/20/74 .-.- ,___ C@NN _ REQUESTED FUNDS LISTING COHffONENTS BY REGION _ 06/74 COUNCIL PROG YR 05 . ERN Cl-IMP __ NO COMPONENT .TITLE DIRECT -_ - REQUEST coo0 PROG STAFF 395,727 _-.- _ coo1 EMS 17,092 -.. _-_ ____ - ..__._ co02. -. REb kYPi CNTRL -. _. _ ..-. -_ - _ ._ - _ ..-.. 38r261 _. ._ 02E2 C~MWJNITY s TUDIES PERS 8 9493 02R3 COMYUNITY S TUOIES PERS 5~398 -- .- -.._____ .- _._ 028 CONN KIDNEY DIS YALE-NH ME0 CTR 11,281' 044 STATE 6 REG HLTHM,ANPOWER DEVELOP CIHHR - : 15 q669 06A1 UNIV BASED REG FACULTY 12q215 -. _I T _ _- .- 0681 UNIV BASED KEG FACULTY -' `. _. . ' 19,286 : COMPONENTS ~_ 9. ' .._ REGION TOTALS 523,422 ---. -_-- .-.-.- -- .___ ..__ _ __ ..- .- 1 ._ ---. -- I. .^^^ -..-. - __. I _ .- ._ _ _ - -._. I ` OSn-PWBOlO-23 % INDIRECT REQUEST TOTAL REQUEST - _. 83 q 453 lr548 0 39753 2r859 2,219 2 q453 fq 247 9t266 479q180 18q64o 38q261 - _ _ 121246 -* .- -.- 8r257 131500 - 18q122 19q462 28q552 '-- li2q798 636q220 . . .- a FLORTDA JUXIONAL, l%DICAL I'ROG!?N RM 00024 I\nfY/,JUW 1.974 RJXTIIW .-._ Request: !&COO,791 Committee JXecommcndation: $2,700,000 Overall Assessment by Individual Reviewers : Superior - Cri.ti(e_: Considered by reviewers to be well organized with good leadership, program staff f exccl.lent MG, excellent past performance and accornpli.shrnent., good Cl IP rcl.ationships with program activities that a&tress key issues that are congruent with the region's explicit priori.tics and areas of emphasis. Jieduced recommendation made on basis of whether all new activiti.es suggested could.be successfully completed in the time-frame l.eft for life of the program or could be continued under other funding. JUI>Y/NJQJST JEVIEW Estimated Request as of May 1974: $1.,500,1100 -- DNP/JXN 6/6/74 I #L MAY REVIEW STAFF SUMMARY FLORIDA REGIONAL MEDICAL PROGRAM 1 Davis Boulevard, Suite 309 Tampa, Florida 33606 Prepared by: Lee E. Van Winkle Grant /I: RM 00024 H. Phillip Hampton, M.D., Coordinator (20%) On Duty Since: 1969 Granville W. Larimore, M.D., Director (100%) On Duty Since: 1969 CURRENT STAFF PROPOSED STAFF Full-time Professionals - 14 Full-time Professionals - 18 Part-time Professionals - 2 Part-time Professionals - 2 Full-time Other - 7 Full-time Other - 9 Part-time Other -1 Part-time Other -' 1 FUNDS REQUESTED: (Target Figure $3,232,398) Total Cost - $3,000,791 Program Staff - $398,792 Continuation - $845,121 New - $1,756,878 Period of Time Requested: 7/l/74-6/30/75 CHP COMMENTS: No problems noted. See page 61-62 of application for working relationships. All activities were reviewed by CHP (a) and (b) agencies. Thirteen projects were recommended for disapproval by CHP agencies and were subsequently disapproved for funding by the FRMP Review Process and the FRAC. Twenty-six applications for multi-media ROCOM which were approved by the CHP (a) agency director were deferred for action by the FAAC since the CHP (a) Council had not submitted a disapproval action. ITEMS FOR REVIEWERS ATTENTION: ii267-A: MAST Program for West Central Florida. This does not conflict with the Emergency Medical Services Act as interpreted by Mr. Reardon. Discussions have been underway between FRMP and the civilian Coordinator of MAST since December 1973 in the development of the Logistical Emergency Transportation Support Activity. DRMP/DOD SC0B/5-17-74 HAY :LORIDA PROG YR 05 i C%TRAt C@!",P YCI coo0 PROGRAM STAFF C235 FLA PERXNATAL !lAST PRCG `d CENT 04bS HDSP INF SURVEIL 124 -. _- - -._ _ 126 COMHlJrJIlY BASED HYPT CNTRL PALM BEACH - _-. _. _.. 131Y - -I-. --_...__ 134Y. 162 - 169 CYS FPUSTPRCIOF AREA MIGRANT WORKERS SITUATIONAL ANAL HYPT H&P INFECT SURVETL -AREA WIDE HLTH PLNG SUPP REG VIII A .-. - - ___ CHARACTFRISTICS HOME CARE NURSG SERV T'U9:J RESTSTRY EST STDS CARE . CCUKU'4XTy GPCAN UONCR 29~645 177 179 C31?wNXTY HLTH ADVOCATE 67,000 . -~ _. SD DADE HLTH 71,080 SYS COKT .::D NURS _ ._ - . - -. -. -. .-. .-. - - .- -- . . 100,000 193 -- ._.. . ..__._ --. I.94 '-, .- 15'6 CV RISK FACTOG REVERSAL PUB hLTH N`URSG TRNG .__ !-fAR?IING SIGNS STSCKE 200 - -.-- .- _ 207- 210 CLINICAL NUTRITION . 7,784 CQMMUNITY DIETARY SERV 36,547 PT FD IN FAU.ILY PEAC SETTING - - -. _. _ - _ 339288 BILINGUAL CYNC SYS 85,000 . iOHPONEMS BY REGION 06174 COUNCIL C0MPCJNEN.T TITLE DIRECT INDIRECT TOTAL -.. ._ - _ REQUEST REQUEST _ _ REQUEST __ _ 398,792 212~482 FLA . ._. -. ..-.. . _ 9,740 TAMPA .- 21,493 32,653 _. 40,860 :42,356 66,718 - - 'L5,OOO 33,533 111,695 90*000 20,000 _- 41,645 . . . 0 398,792 0 212,482 _ -_. D 9t740 - 2,011 23,504 '~ .. 2,552 35r205 -- '.- .- 0 40,860 - 17.644 60,000 13,343 809061 -. .. 0 15tooo 16,467 5OtOOO ; 25,876 137,571 -. _ _ _ _ 129827 42,472 28,763 959763 0 71~080 -. 100,000 - -. 0 3,605. 93,605 -. 0 20t000 - - 129355 541000 2~980 LO.764 2r421 389968 6,658 39,946 - 36t317 121~317 (111) REQUESTED FUN STING COMPONENTS BY REGION 06/74 COUNCIL CENTRAL CO'IP COMPCNENT TITLE NO . 223 230 232 _.. ._.. -.._ 236 241 243 _~... 24; 249 25c . 269 MED ONCOLOGY DRUG INF A>D PUAR RES CTR --. VISITDRS NEEDS- FOR-HLTH CARE- - - HLTtl CARE D3LLAR Ftr)W STUDY , . iAL:ILy PRACTICE SATELLITE itiP HLTH CARE ASSESS I SI,!RGI CTR STU(;Y STATEItIDE RES HLTH YNPWR .-.. - kC'5EL 33lT SERV NURSE HIDbfIFERY SERV 3CL :+ATE?kIAL !iLTH CARE SfRV CC!?\`T Es C!?AL CA nCUTE CRITICAL CARE SERV STATEWJDE'PCCIL ?4ECH TEACH EQUIP AV AIDS - _. REGICN TOTALS 2r690.344 DIRECT INDIRECT TOTAL REQUEST REQUEST REQUEST : 55r924 19,076 lot321 37,793 75,000 32,474 42r795 150,932 20,000 ifsr589 287,010 10,000 539750 49v675 77,175 69,800 16,600 89,104 125,000 0 69847 0 0 21~250 4~655 101249 5,541 0 101896 0 310,447 _ 188,725 .' .~ 20,000 929436 287,010 '-. lOt0ao ?5*000 54?330 87~424 75,341 lb*600 100,000 125.000 3r000.791 Request: $3,629,757 Commi.ttcc RrJconunendation: ApprOV31 at the reyucsted level of $3,629,757. Overall Assessment by Individual Reviewers : Eioth reviewers rated t-.he -- Gc0rgj.a R&P as "Superior .`I : CRITIQLJE The reviewers beli.eved the Georgia l?MP to have: - An excellent experienced coordinator - A strong Regional Advisory Group and Committee structure - An adequate experienced program staff - Good CHP working relationships - A. well managed and a well administered Regional Medical Program. * JUL,Y/AUGUST RJXIEIg Estimated Request as of May 1974: None - RMP/DOD SCOB/6/4/74 0 MY REVIEW STAFF SUMMARY / Georgia Regional Medi.cal Program 938 Peachtree Street, N.E. Atlanta, Georgia 30309 Prepared by: Joe 6 projects On duty since: 11/73 Proposed: 17 11 0 - 0 28 Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . *Is on leave of absence from Hahnemann Medical School, where he served as this medical school's R&iP "unit coordinator" for several years. . `4 RM 00026 Greater Del. Valle} List any continuation project or staff activity for which substantial increase over annualized current funding is requested. #39 Community Hypertension Control HI40 project: NONE EM project: Continuation at same level-of support PSRO: NONE (new). No other resource available Kidney: 847 - Cont. Ed. of Kidney Disease for this expanding field. #52 - Reg. Kidney Disease (new). This is the operational phase of extensive planning done in the past for coordinating the development of a total kidney program. CHP comments: Eighteen of twenty propoI!?als were reviewed and commented on by CHP in time for RAG consideration. Time did not allow for comment on the other two, but the CHP agencies involved stated that their comments would be available by June 1, 1974. There appears to be no problem with aspect of the request. E0/5/20/74 GREATER DELAWARE VALLEY Temple Unit Regional Medical Program Coordinator: Daniel Hall, M.D. Staff: Full Time Prof. 0 Part Time Prof. 2 Full Time Other 0 Part Time Other 1 Funds Requested: Total . . . . . . . . . . . . . . . . . . . Continuation...,...,..... ( a New,..,.................. ( RM 00026 On duty since: 1972 _I Proposed: 0 2 -- 0 1 Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975,) . RM 00026 . GREATER DELAWARE VALLEY Regional Pledical Program Jefferson Unit I Coordinator: Willard Krehl On duty since: 11/73 Staff : Full Time Prof. 0 Proposed : 0 Part Time Prof. 3 Full Time Other 1 Part Time Other 0 Total 4 Funds Requested: Total .,*.,*.*.*....**... Continuation............. ( New...................... ( * 3 i Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) RM CC026 GREATER DELAWARE VALLEY Regional Medical Program I Univ. of Penn. Unit . Coordinator: John M-n. Staff: Full Time Prof. 0 Part Time Prof. 2 Full Time Other 1 Part Time Other 1 Funds Requested: Total . . . . . . . . . . . . . . . . . . . Continuation...,....,.... ( Period of Time Requested: Activities Proposed: approv. On duty since: 1967 Proposed: 0 2 i i I Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) 0 RM 00026 GREATER DELAWARE VALLEY Regional Medical Program Medical College of Pa. Unit ' Coordinator: Gerald Es-- Staff: Full Time Prof. 0 Proposed: 0 Part Time Prof. 2 Full Time Other 2 Part Time Other 0 Funds Requested: Total ,.................. . Continuation,..,......... ( 0 -New...................... ( I approx. On duty since: 1g68 2 2 Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . I e m 000Qfj GREATER DRLAWARR VALLEY Regional Medical Program I Hahneman Unit Coordinator: Bean Roberts. M.D.* On duty since: 1967 Staff: Full Time Prof. 0 Proposed: 0 - Part Time Prof. 2 Full Time Other 1 Part Time Other 0 Funds Requested: Total ,,....l...,l..l.... Continuation..,.....,..... ( * -New................l...... ( 2 i - Period of Time Requested: Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) *On leave of absence, Bets as Coordinator GDVRMP . ,+ HAY 91974 _ -I II_ ..__- .- GR DEL VAL. PRUG YR 05 COMPONENTS BY REGION 06/74 COUNCIL STERN- -. COMP --. NO - ._ cc00 coo1 -I-- .I_--- -. c003" .~.. coo4 -. CF05 . --- -_ - I .._ .- 029 030 _- .- 031 -- . -_.- 03;. __ -. 036 039 ~ 043 044. 045 - ---__-__ ._ 046. 047 048 ---_.-__.--_ __.__ 049 -' 051 052 053. 056 _.. COMPONENT TITLE PRCGRAH STAFf HAHNEMANN BASE0 PROGRAM STAFF -HE0 CDL1 BASED PROGRAM STAFF . TEMPLE BASED PROGRAM STAFF UNIV OF PENN EASED PROGRAM STAFF CONT EDUC CA NURSG . PSDIATRIC TUMOR REGISTRY REG COUNCIL CDNT EOUC COMMUNITY HOSPITAL ME0 EDUC WORKSHOP COYMUNXTY URGANXZ EMS SO N J COMMUNITY HYPT CONTROL - COMMUNITY HLTH EDUC CTR DIAG AND EVAL CHILDREN WITH HANDICAPS LEHXGH VALLEY AREA HLTH CONSORTIUM WEST YETRO CONSCJRTIUM CONT EDUC KIDNEY DIS QL'AL ASSESS PMEIJLATORY CARE ., COMMUNITY SERV UNIT IMPRDV-ADVISORY BOARD SKILLS REG KIDNEY SEG-R-ADIATIDN ISODOSE MEASUREMENT FAYILY HLTH CARE ASSISTANT ._ DIRECT INDIRECT REQUEST REQUEST 801.17~ 294~448 45r53t 25,136 64*066 31,677 - 439296 219999 63,743 37,266 7,5;4 842 12r020 2,941 44r327 21,482 539532 13,104 44,283 0 1761336 22,243 68,709 14,742 28~492 3t524 6Pt800 26r628 50r000 6r750 26,348 15*150 103;9&3 15~262 79,487 36.705 32,464 139718 1279698 66,677 559840 18r85C 37,225 0 OSH-PWBOlO-23. . TOTAL REQUEST 1,095,623 70,667 95,743 65r295 121r009 8~356 149961 65,809 669636 469283 198,579 83,451 32~016 899428 569750 41,498 139~250 116~192 469182 194,375 749690 37~225 0 . MAY 15.1974 REOUESTED FUNDS LISTING OSM-PwBOlO-23 1 COMPONENTS BY REGION 06174 COUNCIL . ,R DEL VAL PROG YR 05 ERN COMP COMPONENT TITLE - - _ --.. _- NO . _ _ __ I__ - _.. 058 EXPANSION HOME HLTH THERAPY SERV 059 HYPT SCREENINWPT EDUC L CONPONENTS 24 REGION TOTALS . .- DIRECT INDIRECT TOTAL _. - - REQUEST REQUEST -REQUEST _..I. . I 34r67tj 0 34~678 22,419 11,993 349412 * 2r107r951 701?157 2rB09t108 -- .._.. _.. -- - _ ._ .._ -. .- * , I JUVIP . Hawaii -WC_ lu4 000 01 Jkqucst: $ls-s7,7og Comn!l.ttcc Iiecommc:~dat -I on: $1,100,000 .$ 0vcral.l assessment by individual. revicwcrs: Average Critique: On April 1, 1974, Dr. Satoru Izutsu was appointed as the new Coordinator of the Hawaii RMP. Since that time, many positive changes are occurring in the direction of the program. The staff of the program is stable,having remained basically the same during phase-out. The Regional Advisory Group is being oriented to its role and responsibilities to the program. The reviewers, one of whom had been on the January 1974 site visit were much encouraged by the f.orward direction the program now seems to have. This particular application, however, reflects activities developed prior to the changes in leadership. The Committee anticipates the "new flavor" in the July application. The Committee recommends approval of the application at a reduced level of $l,lOO,OOO with the condition that the reduction be ' equitably applied to the Pacific Basin and to the Hawaii portion of the program. Thus, the proposed figures are $889,602 for Hawai and $305,107 for the Pacific Basin. 3ULY/AUGUST REVIEW i Estimated request as of- May 1974:' $;6&~,000 _ . WOB 6/6/74 . STAFF Sl!MMARY FOR MAY 1 KEVIEW REGIONAL MEDICAL PROGRAM OF HAWAII, AMERICAN SAMOA, GUAM AND THE TRUST TERRITORY OF THE PACIFIC ISLANDS - RMOOOOl The Research Corporation of the University of Hawaii, Honolulu COORDINATOR : Se toru Izutsu, Ph.D. Since - May 1, 1974 STAFF: (FTE) Total - 15.75 Proposed : 19.25 Brofe8sional 10.75 Other 5.00 Professional 13.25 Other 6.00 FUNDS REQUESTED: Total (D.C. & i.d.c.) $1,567,709 Program Staff Administration - Hawaii 541,315 Projects Hawaii (10) 7 new ones 568,287 Total Hawaii Program 1,109,602 Pacific Basin Administration 110,225 Pacific Basin Projects (10) 347,882 Total Basin Program 458;107- GRAND TOTAL RMPH 1,567,709 CHP COMMENTS: Hawaii has no CHP (b) agencies. The comments submitted by the CHP (a) agency were not only considered by the RAG, but influenced the final decision on a number of projects. The CHP agencies for the Trust Terri- tory, Guyam and American Samoa were involved in the development of the proposal8 from the Pacific Basin. ITEMS FOR REVIEWERS ATTENTION: . Past history and change8 occurring as a result of new coordinator: . Staff, RAG, CHP, Hawaii Medical Society, University of Hawaii Schools of Medicine and Public Health. . Continuing problem8 between St. Francis and Kuakini Hospitals over Renal Disease Programs. (Project8 1147, Dialysis and Transplant Center - St. Francis - page 81 and #56 Kidney Dialysis Training and Education - Kuakini - page 94). RAG will not fund until hospital8 have unified plan or justify separate programs, . Project 842 - Health Screening for Elderly - P&G must rereview prior to funding, . Project #68 - Cervical Cancer Detection, Trust Territory. NCI has similar request from T.T. DRMP and NC1 staff working with RMPH so that WH will assist T.T. in further developing NC1 proposal. , Need to "earmark" PSCifiC Basin Fund8 a L Page 2 HAWAII - staff suaaaery e CONTINUATION ACTIVITIES : Of the 10 Hawaij projects only three are continuations. 0f the 10 Pacifjc Basin Projects all are "new", in terms of location. Health Assistant Training, Otolog& and Cervical Cancer projects have been conducted success- fully in other districts of the Trust Terri.tory. DRMP /DOD WOB - 5/m/74 5.1974 0. 01 HAWAII PROC YR G6 YESTERN COMP _. -.. _-. ._. NO cuno _~ CC01 I. ,-_ _._-- ._-. -- .-.- coo3-. con5 _. COO6 _I _._I_-. - - _. _. 005 042 045 ' - _ - ._ 047 048 049 _ _ - . - _ _ _ _ _ 052 056 062e 063 .- 064 CC5 COMPONENT TITLE PROGRAM STAFF PACIFIC 6ASIN AOMIN . FACIL PLAN RES C ANAL . PROJ DEVELOP MONITOR C EVAL FUTURE PRDG PLAN STRENGTHEN DUAL ASSUR EFFORTS HLTH SCREENING ELDERLY IMPROVE HDSP HNPHR USE & RESTRAIN COSTS ' REG RENAL DIAL & TRANSPLANT CTR HABAII CTY HLTH SERV EOUC CLINICAL ENGINEERING SERV & TRNG CTR ORGAN PKdCURE SUPPUYT TRANSPLANT ACTIV `. KIDNEY DIAL TKNG & EDUC f+AttI CTY HLTH S.ERV C' EDUC ACTIV CDORP NURSG EDUC PRDG OT@RliINQARYNGPLDGY TRNG COMPUTERTZED WLTH INFP SYS FEAS STUDY P T TRNG IMPRCIVE ICU SPECCH r, HEARING NUTNITIDN EOUC HLTH INFO SYS DIRECT REQUEST 1921183 105?128 1291765 90,375 99,044 47r890 73,193 84,550 b3r204 74,222 57,192 59,556 44rlll 11~674 7r836 37176Q 81975 311500 3tat508 33,440 13,240 13r394 ; -. TNDXRECT REPUEST 81113 5r097 79355 7r288 7,192 8,716 4~462 0 22,678 41223 0 0 4t411 a 589 a 0 0 0 0 a 0 OS 010-23 c P- TOTAL REQUEST 2013~296 1101225 137r120 97,663 * 106,236 56~606 77r655 t ., 841550 65*1182 ?8*445 57rl92 59,556 48~522 111674 a*205 17t749 BtWri 3l$SOD 3br508 33r440 13r240 13,394 . - .: a I1974 COMPONENTS BY REGION M/74 COUNCIL - . `1 HAWAII PROG YR 06 ItSTERN COMP COMPONENT TITLE .-__ ._ - _.. . NO - 066 - OTDLOGY AND CLEFT LIP AND PALATE 067 HLTH ASkJST TRNG -_.-.-__.- .-_. -_. - --__. _ 068 CERV `CA DETECT -PONAiE E HARIANAS I ' D. OF COMPONENTS 25 __,-. _.-. -__ ._ .__._ .., _ _. __ __ _ -., _ -. . _- .___ - ._..^ . .-. -_ __ I ._.. _. I -_ ._-----.. _ -- -.. . -- - -. - - .- _..- - _... -_ .- ~. - _. DIRECT INDIRECT REQUEST REQUEST 31,237 0 124,000 3,828 . 34rooo ' 0 REGION TOTALS `1.483.98f 839722 .* . .._ _. i 0 - OSM-WBOlO-23 Lq- ?.- ' TOTAL REQUEST 31,237 1279 828 . . - 34rooo lr56ft709 ---I_-.-- -.--- - _ _. .-..._,.-._. - ___ __..__. ,...^_. __ _,, I . _ -_ . _ I __ ,_-_ ..- .-_ _.. -.- . - __.. -. ___ RBCIONAL MEDICAL TRUST TERRIT(~!IY OF ' Current (l/74-6/74) and Propos NO. Component 100 303 304 305 306 Hawaii Program Admin. Staff Facilities Planning Research & Analysis Strengthening Area Quality Assurance . Project Develop., Monitoring & Evaluation Future Program Planning (Total IIawaii Progra: Staff) 28 Health Information Network of the Pacific 30 Waianae Coast Comprehensive Eealth Center 42 Health Screening for the Elderly .' 45 47 ,_ Hospital Manpower _ Dialysis and Transplant Center (funded l/73 - 12/73 $lO,OOO)(St. Francis) 48 Hawaii 'County Health Services/Ed. 49 .Plenning for Comunity Based Clinical Eng. SO Quality Assurance Trng. Seminars :3 * Organ Procurement in SlIpport of Transplant Hypertension Detection & Treatment 56 Dialysis Training & Education (Ruakini) 57 Maui County, Health Services Educ. Activities 58 Coordination of Nilrsjng Educ. Programs Total Iiawaii Projects Total State of Hawaii Program . Total Pecific Basin Program Available Unbudgeted RXPH Funds CRANDTCTALRXPH Funded (6moa.) Proposed (12 mos.) l/74-6/74 7/74 -- 6175 147,846 200,296 40,946 137,120 32,143 -Q- -O- 97,663 -O- 106,236 (220,935) (541,315) 16,840 58,665 -O- -o- 77,655 * 84,550 85,882 - 1 -o- 1 -o- I -O- I 14,642 4,490 7,500 -o- 4,500 ,- 0 - -o- -O- I (106,637) 327,572 108,518 169,756 605.846 . . . 78,445 57,192 56,606 59,556 -o- 48,522 11,674 8,205 * (ShS,iS?) * 1,109,602 458,107 1,567,709 . Paw 1 c . Remarks RAG must review again `prior to funding 847 & 56 must jointly prove to RAG need for 2 programs or present unified plan before fundi'ng. Funded W/73-12173 $35,000 - See P47 above 5/u/74 RLR /wOB/k!! . P I . _. -3 . . . . * . . . . , I LLINO I. S REGI GNAT., MEDI CAL 1'IIOGRA.M RM OOOGl fiequcst: $2,816,935 Conmxittce licconmmclldati.on: $2,816,935 --I__ Overall. Asscssmc_t by Individual lievi.ewers : Average/Superi.or critique : --- Members of the Rcv%ew Commi.ttce agreed that the leadership of the IN/i' is strong and the program has remained i.n good order inspitc of the phase-out threats. There was a discussion of a possible leadership lag when, on July I.st , the current coordinator wi.11. devote 25% of his time to the Illinois I&P. The Board has established a search committee, It was agreed that with the obvious strength of the Creditor team, coupled wi.th the short time-frame, that the decision to continue the coordinator on a part-time basis was a wise one, To bolster this, the region has been successful in re-emp1oyin.g many of its former staff members who had accepted other employment at phase-out. The RAG has remained in tact and are the decision-makers. The region has demonstrated a unique ability to initiate programs which have continued under other than I&VI' dolla.rs. Illinois has had a history of joining forces with the QP agencies in their objective type pl.a,nning efforts. The reviewers agreed that the program proposed may begin to solve some of the urobl.ems of the Health Care Delivery Systems in a very complicated ared of the country. ,JULY/AlJGUST IUW'IEW Estimated Request as of May 1974: $l,OOO,OOO DRMP/Ix)D SCOB/ 6-6-74 f, -4 MAY REVIEW STAFF SUMMARY Prepared by: Lorraine Kyttle RM 00061 ILLINOIS REGIONAL MEDICAL PROGRAM 122 South Michigan Avenue Suite 939 Chicago, Illinois 60603 Morton C. Creditor, M.D.,Coordinator CURRENT STAFF Full-time Professionals - Part-time Professionals - Full-time Support Staff - Part-time Support Staff - _ 11 0 7 0 (total) 18 On Duty Since: June 1970 PROPOSED STAFF Full-time Professionals - 14 Part-time Professionals - 0 Full-time Support Staff - 10 Part-time Support Staff - 0 (total) 24 FUNDS REQUESTED: (Target Figure $3,814,015) Total Costs - $2,816,935 Program Staff - $656,833 Continuation - $1,155,128 (7 activities) New - $1,004,974 (6 activities) ACTIVITIES PROPOSED: Continuations - Two of the "continuation" activities (18 and 24) are traditional continuations. They represent major concept thrustsfor the program in the fields of hypertension and the problem oriented medical record, and activities aligned to these thrusts have been sponsored by IRMP since 1972. The remaining continuations are activities funded from the October 1973 or January 1974 awards. New - The "new" activities (beginning with 135) continue the conceptual thrusts in several areas. CAM health trust is the result of an effort to demonstrate the more efficient delivery of existing health services. Fostering the design of new or refashioned health care delivery systems has been one of IRMP's objectives. The state- wide hypertension control program is an activity growing out of 2 years' preparatory activities. Having demonstrated the viability of the role of the computer in treatment of some chronic hypertensives, and with data concerning the epidemic proportions of hypertension in the State, IRMP had developed a conceptual attack on hypertension beginning with local "bs" and culminating in a state legislative package. This is the typical IRMP approach -- to precede a major statewide effort with political subdivision entires throughout the State. Problem-oriented medical record activity was handled successfully in this fashion. Renal disease activities were less staisfactory. Dr. Creditor is listed as the Project Director, but this is an interim arrangement. Page 2 - Staff Summary Illinois RMP CHP COMMENTS: All activities were submitted to appropriate CHP agencies and the comments are attached. ITEMS FOR REVIEWERS'ATTENTION: As of July 1, 1974, Dr. Creditor will no longer devote 100% of his time to the directorship of IRMP. He will be joining the University of Illinois at Urbana and will devote 25% of his time to IRMP leadership. The Board of Trustees of IRMP, Inc. have discussed arrangements with Dean Bloomfield at Urbana and have concluded that this is the best of immediate arrangements. Dr. Bloomfield is a member of the RAG, is deeply committed to the program and assures the Board of IRlQ that such arrangements will be honored at least until December 1974. At one point following phase-out orders, IRMP staff was reduced to four professionals and two support staff. Its current complement of 18 professionals is almost entirely composed of former IRMP staffers who left other employments to return to RMP. It is a competent group, with experience in working together under stress. DRMP/DOD SCOB/5-17-74 m MAY/.JIJM 1974 Rl'VIIll\i Request*: $1,221.,159 Cormni ttcc Recommendation : $1,121,159 --- Forall Assessment by Individual. Reviewers : Average/Below Average - : Critique One of the major CO~KX~~S of the reviewers was the apparent inabi.lity of tire region to wri.te a proposal - - to tell their story (at least the current document) . The program staff was considered satisfactory- - "Everyone of the current staff have been in RMP for over four years and they have experience ." The RAG was considered to be in order with appropriate back-up commit tees . During January 1974, the region poll.ed its RAG, committee members an d other health i.nterested groups to re-evaluate the IlWP objectives and priorities. Based on this, the region plans to move ahead utilizing a series of contracts to accomplish some of these objectives . The Indiana R3# envisions an umbrella approach of improving the quality of medical care in the re- maining limited time-frame. The region is extending its sub-regional de&.opmcnt by working closely with'existing (b) agencies. In arriving at the reduced funding level, the committc?e believed that the support of the contin.uation of the EMS activity would be low priority or at least open to question - - based on the ifl.formation presented. Estimated Request as of May 1974: $400,000 DRMP/DC)D SCOB/6-6-74 MAY REVIEW STAFF SUMMARY l \ INDIANA REGIONAL MEDICAL PROGRAM 1300 West Michigan Street Indianapolis, Indiana 46202 Steven Beering, M.D., Coordinator George Lemnson, A.B. Executive Director Current Staff: 5 Full-time Professionals 1 Part-time Professional 3 Full-time Supportive FUNDS REQUESTED: Total Costs - $1,221,159 Program Staff- ($265,775) Contracts Supported From Funds- ($616,760) Continuations- ($338,624) Prepared by: Joe Jewel1 Grant #: RM 00043 On duty part-time since 5172 On duty full-time as Exec. Director since 11173 Proposed Staff: 10 Full-time Professionals 2 Part-time Professionals 6 Supportive Target Figure: 1.4m Estimated July Request: $400,000 Period of Time Requested: All Program Staff and Operational activities are scheduled to terminate 6/30/75. ACTIVITIES PROPOSED: See Printout ITEMS FOR REVIEWERS ATTENTION: EMS Project: Project f/32 is a request for the continuation of EMS activities in region 7 (6 counties in west central Indiana). The total request of $95,000 is for equipment. During 1974, the state legislature passed the Indiana EMS Act with $75,000 to be initially provided for administrative purposes for a new EMS Commission. The funds requested from IRMP are to be used to establish a demonstration model for the' State. The region has requested $616,760 to support contract activities as a part of the program staff component. The area of proposed activities are listed on the last page of the application and are described on the program form 15 (page 33). The broad areas are: 1. Emergency Medical Services System Development 2. Family Practice Program Development 3. Integration of Comprehensive Health Planning and FRMP Activities 4. Hospital Accessibility 4 B Page 2 Indiana RMP Summary The IRMP review process has been approved as has its management and administration processes. CHP: This is an. application for continuation of presently funded program staff and project activities. The region did not seek formal review and comment by the Comprehensive Health Planning bodies. However, CHP's throughout the state, including the 314 (a) agency and all areawide agencies have participated fully in the reassessment of priorities on which the application is based. Further, they have participated in formal discussions with the IRMP Program Staff of the concepts that are embodied in this application,The CHP (a) Director is a member of the RAG. DRMPjDOD SCOB/5-16-74 INDXANA _ . PROG YR 06 * ITH CEMTRbL. tom. - _.__ __- .._ ----. -.-. NO ._.. _ .-.- - coo0 PROGRAM STAFF _' _.. * 024 -RENAL AL,LOGRAFT -.-. _-- .---. _.- -- 032 EMS`- REGION- VIT --- 035 HYPT __... ~_..-- _ 037 SPECIALIZED HED -_. ~_-----I .-.- - .-.... - 038 TEL-I& -. SERV ' 039 \ PERINATAL AND INFANT COMPONENT -TITLE _- ^_-_- . -. - __ _ _ ._ _ .-. - -- OF CCWONENTS _.._ 7 - _ . . _.. ..__ REGION TOTALS . . ..- _. ._-... --. _ DIRECT -. REQUEST 816,535 7~446 95,000 141t822 2fdiOO 4lt170 23~766 .- 66rOOO-`- 882,535 -1,320 8,766 _. .- _ _ ^.. _. 0 95rOOO a. 141t822 0 27*500 .- 0 41,770 0 23,766 1.153r839 6t.320 .le221~159 - . 0 `, INDIRECT -- TOTAL s REQUEST REQUEST .- _ _ _ - - _-- ._ _ ._ . I _ _. .- ^ . Committee Recommendation: $2,000.000 Overall assessment by individual reviewers: -am . . Critique: Concerns were expressed by the Committee regarding the failure of the region to add more minority members to staff. The Program's efforts in this direction were thwarted by the planned phase-out in February 1973. The IRMP insists that the minority effort continues. Support for reductions in the amount requested is based on past experience with the region's habitual "inflated" fund proposals. The Program has demonstrated its resilience in the past and will continue to react positively with a restructured program based on the funds awarded. This positive ability to react has been one of the Region's outstanding talents. Project #63 - Health Information .Assistance to Regional State Legislatures ($111,894) raised concern regarding its increased budget. Past funding for 6 months was $19,349: I Estimated request as of May 1974: $' -900,000 - 500,000 STAFF SUMMARY FOR MAY REVIEW INTERMOUNTAIN REGIONAL MEDICAL PROGRAM: RM 00015 COORDINATOR: Ward B. Studt, M.D. - since February 1973 STAFF:(FTE) Total - 18.87 (19 persons) Adaitional proposed: 3 Professional: 8.87 (9 persons) Professional: 2 Clerical: 10 Clerical: 1 FUNDS REQUESTED: Total (D.C. & I.D.C.) $3,849,425 Program Staff 667,153 Projects: (49) total 3,182,272 Continuation (11) 948,167 New (38) 2,234,105 CHP COMMENTS: Received from "A" agencies, (Nevada, Idaho, Montana, Wyoming, Colorado, Utah) and "B" agencies (Colorado, Montana, Utah). Agency directors attended 4/15/74 RAG meeting and responded to projects impacting their areas. RAG members responded, by deleting 2 and adding 1 project. CONCERNS: 1. EMS Activities #40 - #89 - 2. Renal #96 - Emergency Medical System, requests funding ($78,550) for third and final year. Utah Aero Ambulance Assistance, extension of #40, requests $3,000. Activities Kidney Disease Prevention, Rock Springs, new - requests $5,600. 3. Funding Request 50% above 07 award #62 - Health Information Assistance to Regional State Legislatures - 39,349 (6 months) - requests $111,894 Target Funding Amount (140% of annualized level) = $3,500,000 Application request $3,849,425 which is $349,425 above target amount. Plan to request an additional $400-500,000 on July 1, 1974. Mid-Continent Operations Staff Analysis: Mary E. Murphy Intermountain RMP: RM 00015 The Intermountain Regional Medical Program application requests funding from July 1, 1974 through June 30, 1975 for Program Staff, 11 continuation activities and 38 new activities. Application Request for $3,849,425 includes: PRO@AM STAFF- f:$;blTCj-S Continuation $667,153 #33 - #34 - #35 - #40 " #118 - #60 - #61 - #62 - #69 - #75 - #86 - New #78 - #79 - #81 - #82 - 883 - #84 - kda5 - k'87 ,- #b8 - xi89 - #90 - #91 - #93 - #94 - #95 - #96 - #97 - #99 - #loo- #102- #104- Health Systems Quality Assurance Nurse Practitioner Infectious Disease Control Program Emergency Medical Systems Intermountain Regional Platelet Typing Community Organization Health Manpower Intelligence Health Info. Assistance to State Legislatures Radiology Quality Assurance Standards Hypertension Control - (Reservation Indians) Modeling the Utah Health Care System Sub-total Hospital Study - Clark Co, Nevada Idaho CHP "A" Assistance (SICHR) Utah CHP "A" Assistance Shared Service Study - Montrose, Colorado Montana CHP "A" Assistance Colorado CHP Assistance - Western Colorado Nevada CHP "A" Assistance Rural Hosp. Management Consulting Service Small Hosp. Management Engineering Utah Aero Ambulance Assistance Multi-Disciplinary Allied Health Training Regional Pediatric Service Study Regional Self Help Medical Care Training Indian Clinic - Henela (Montana) Urban Indian Clinic - Salt Lake Kidney Disease Prevention - Rock Springs Dental Health Training - Helena Medical Consultation for Rural Communities Migrant Health Center Development Urban Poor Health Clinic Rural Medical Technology System Rural Quality Assurance Rural Medical Practice Management - #105- I #106- i #707- Home Health Care - Idaho Bill- Indian Health Delivery System, Montana 100,000 70,000 123,795 98,023 21,240 126,000 90,455 111,894 74,827 47,433 7,100 !mJn 47,433 85,000 100,000 6,500 49,750 50,000 24,000 120,000 24,412 3,000 98,000 88,900 100,000 15,000 100,000 5,600 20,000 40,000 20,000 12,000 115,900 126,900 114,900 23,940 40,000 Intermountain Staff analysis - page 2 #117 - #119- #124- $5126 - #127 - #128 - #129 - #130 - #l)l - #132 - #133 - #134 - #135 - Multi-Hospital Inservice Training, Idaho 26,310 Master Health Plan for Univ. of Utah Hlth. Science Ctr. 86,100 Physician Comm. with the Deaf 105,600 Indian Dental Health Screening 59,652 Congenital Heart Study - No. Cheyenne 15,000 Lung Disease Patient Resource G&ii& 4,500 Rural Primary Care Demo. - Wyoming 55,760 Quality Assurance and Utilization System 100,000 Education for Action 70,575 Regional Health Planning Assistance 63,901 Health Planning Communication Project 58,093 Technical Assistance for Health Planners 100,464 Multi-State Health Planning Liaison Project 96,908 Total 3,849,425 The Intermountain Regional Medical Program's thrust has been to improve the availability and accessibility of full spectrum primary health care to all persons of the Intermountain region. The Program presently places emphasis on these areas and plans to: 1) facilitate the transition to the general kind of health resource planning mechanisms and efforts envisioned by the pending legislative proposals; 2) increase the availability of and improve the access of primary care services for medically underserved populations and areas; 3) lead to greater coordi- nation and/or sharing on geographically integrated bases of expanded secondary and tertiary patient care resources and services. The requested application is approximately $350,000 above the target figure (140% annualized level) of $3,500,000. The DRMP has stated that it plans to submit a July 1, 1974 application requesting an additional $400~500,000. An arthritis application was submitted for review for the requested amount of $385,463. body of reviewers. The proposal was to be critiqued by an assigned ANALYSIS OF THE INTERMOUNTAIN REGIONAL MEDICAL PROGRAM The IRMP is in its second year of triennium. Present funding (l/1/74- 6/30/74) is in the amount of $1,118,238. Project actiiities number 22 at a cost of $564,562. Dr. Ward B. Studt has served as Executive Director of the Program since February 1973. He followed Mr. Richard Haglund who served in an acting capacity for almost one year. Mr. Haglund ran a "tight ship," had a very reserved personality and was an excellent manager. Differences arose with the grantee, the University of Utah Medical Center, due to conflict of personality (Haglund vs. university officials). These differences precipitated themselves in the grantee/IRMP relationships, procedural interpretations, etc. With the appointment of Dr. Studt. . the grantee relationship problems disappeared. Dr. Studt is a personality quite opposite to Mr. Haglund. He is openly and enthusiastically agressive, and moves in all directions. It appears that a stronger managerial quality would be beneficial. Dr. Studt is a "driver" and expects an enthusiastic response from Intermountain Staff analysis - page 3 staff. Staff's reaction to him is "mixed." Several staff members have stated that they feel a lack of assistance and understanding when problems are discussed with Dr. Studt. The Regional Advisory Group with a body of 37 members, composed of the Coordinators of Mountain States and C/W RMPs, as well as CHP directors (2 'A', 1 'B' agency) has been active during the past year. A new chairman, Mr. Kenneth Knapp, was appointed, He has been meeting with select IRMP staff and RAG members on a weekly basis, Minority representation on the RAG continues to be carefully monitored and efforts have been expended to secure minority RAG Members. The IRMP staff is a competent body of persons totaling 19 persons or 18.87 FTE (prof-8.87, clerical-lo). The staff is supported by project staff of 27 persons or 24.87 FTE (Prof.-19087, clerical-5). Many project- staff are in reality Program staff, serving a dual function under the Matrix Organization system of management. If assigned to a project as director, an employee is carried on the project staff roster and payroll. Staff formerly occupied three separate office areas on the University medical campus. The separation of staff members, as well as the high indirect costs rates (39%),encouraged IRMP to relocate at Research Park,which adjoins the University of Utah,in April 1974. The new facility has provided a more adequate working area and is believed to e have improved morale and production. Indirect cost rates are presently at 28.7%. A non-profit corporation, known as the Health Development and Services CorpOration (HDSC) has been formed within the IRMP structure. It is viewed as a project which is expected to become self sustaining in July 1974. It is the concern of Mid-Continent Operations' staff that the separation from IRMP will be a complete one with no further sharing of Program or Project Staff. Assurance was given that Dr. Studt will not leave IRMP to direct the HDSC at this time. Dr. Ray Beck&t and Ray Miller, Project Staff, and Mr. Lynn Davis, Program Staff,plan to go with HDSC. IRMP has shared an excellent relationship with funded CHP 'A' and 'B' agencies within its region. All of the agency directors were invited to attend the April 15, 1974 RAG meeting. In attendance were 9 directors. The representatives in attendance were given ample opportunity to respond to projects impacting their areas. RAG responded affirmatively. As a result, two proposals were deleted and one proposal was added in response to CHP input. Absentee Idaho and Wyoming CHP State Directors responded by letter. IRMP is to supply action taken on the written negative comments received from CHP. On all activities to be conducted in areas which overlap with Mountain States and C/W RMPs, written assurance will be submitted that projects have been reviewed and approved by the three coordinators and their respective RAG chairmen. The IRMP is considered a good program but it is felt that the region is overfunded. 0 HAY/JUNE 1974 Rl':VTEW Request: $?,061,349 ' RM 00027 Committee Recommendation: $1,061,349 Overall assessment by individual reviewers: Above averase to Superior . Critique: '. I The Review Committee considered the Iowa RMP continuation grant applica- tion request of $1,061,349 and recommended approval as requested. Reviewers continued to be impressed with the imaginative Coordinator, strong Regional Advisory Group, good program staff, and a well administered and managed Program. On May 28, 1974, DRMP received favorable letters of support from the Health Planning Council of the Midlands regarding project #'s 55 - Homemaker - Home Health Aide Training and project #56 - Family Nurse Practitioner for Use in i?iZil Iowa. -- 1 I JULY/AUGUST REVIETJ Estimated request as of May 1974: $200,000 MC0 6/4/74 7 *I t STAFF SUMMARY FOR MAY REVIEW 0 IOWA REGIONAL MEDICAL PROGRAM: RM 00027 COORDINATOR: Mr. Charles Caldwell - since October 1972 STAFF: (FTE) Total - 18.8 Additdonal proposed: 2 Professional: (FTE) 14.8 Professional: 2 Other (FTE) 4 FUNDS REQUESTED: Total (D.C. & I.D.C.) $1,061,249 Program Staff, 622,234 Projects (11) Total 439,115 Continuation (4) 172,898 New (7) 266,L'l I Target Funding Amount: $1,285,5X CHP COMMENTS: As of May 16, 1974, only the Tenco Health Planning Agency had responded to IRMP eontinuati'on'application~for review and comment. Dn May 20, 1974, DRMP received a letter from the IRMP contatning infor- e mation on the following five CHP agencies. The Northeast Iowa Health Planning Council recommended that two of three projects be approved. Project #60 - A Planning Study of Primary Medical Services in Iowa was recommended for disapproval. The Health Planning Council of Central Iowa had favorable comments. The Siouxland Health Planning Council raised tw questions concerning project numbers 55 and 56. The Health Planning Council of the Midlands and the Health Planning Council of North Central Iowa have delayed the review of the IRMP activities. The Iowa RMP has not yet responded to the negative comments or questions due to the short time frame. : 4 91974 _ _ -.. ..- _ _ _ ._- ._..._ .-. !7 ,IOWA PROG YR 05 .' REQUEST& FUNDS LISTING COHPONENTS BY REGION 06174 COUNCIL - 110 CONTINENi COMP .- COMPONENT TITLE _- - DIRECT _. . _ NO REQUEST _.... _-- _. . too0 PROGRAM STAFF _ _ _ __ - __ . _ . 038 MODEL RkG PRIM CARE ---.- ----I- -I- . ..-. --.-.. 040 SIUUXLhND AREA ilLTH EDUC. .. " ._- .-._ -. -.. _ 041 RENAL PT SOC SERV 1 . . 044 YODEL REG EMS CMNC SYSTEM -. .__. --.- -__-- ._.-. 050~ FAMILY PRACT COMMUNITY EDUC FILM _ 0%' UNIMRH RECORD SYS QUAL CARE IMP'AOV __. - _~. _. . 052 Ht?SP COST STUDY PROSPECTIVE REIMBURSE . 11,065 0 11;065 - 4,430 0 49430 . -I-.. .._-. .- -_.-.. _. . 054 -. -HCDEL .PERINATAL CARE CTR .AND EDUC 05s - .HOMEiAKER-HDNE HLTH AIDE TRCJG -056 FhM NURSE PRACT RURAL ._ - 100I000 .-- ____. -_ .___. --.. . _ _ _ _ 060 CRIH CARE PLAN - `- .- IO OF CEttjPONENTS 12 REGION TOTALS 84lr276 _ _ _ - _ _- __ _ . - - _ _. _ ` _..__ ._ __ ___-_ _._ -_ - - - . - - - . .____. ._ -...- .- .-.-. . _ .: __ _ . --- __ .__.. __ _.--.. .- .--.- I --. -- - .-. -- --- - -._. . . INDIRECT .- TOTAL REQUEST REQUEST - 443rll.O 179~124 622~234 -- 38~293 14,659. 52r952 33,213 .- . . O- -- -. 339213 ._ _ _.. _._ 12r172 - 0 - 12,172 .. 74~561. 0 74~561 . _- __ -.- 91871 0. 9~871 22,044 68 r302 24r215 . 101517 110?51? 5*349 279393 0 689302 .- -- _ 101424 349639 220,073 1.0619349 _. _. ..-. , ..___ -...- - _. ml-iIT .- . ..-. .- RM 000% -_ -,- . Rl?.Cp~Si : . $1,733,380 ., Committee Recommendation: $1,633,380 Overall assessment by kdividual reviewers: Above Average - Average * * I. I. Critique: Critique: The.Review Committee felt that the recommended amount would allow the Program The.Review Committee felt that the recommended amount would allow the Program suffic'jent financial latitude and require them to take a more careful look suffic'jent financial latitude and require them to take a more careful look at the overambitious project #91, Regionalization of Perinatal Care ($325,808). at the overambitious project #91, Regionalization of Perinatal Care ($325,808). The Committee felt that the Kansas RMP has received good leadership from Dr. Robert Brown. He has received support from a talented staff which has been -reduced considerably in size since the planned phase-out (February 1973). Concern was expressed regarding the absence on the staff of minority -' representation. With the phase-out, an outstanding black professional staff member found other employment. The staff is well populated with female professionals. Another concern centered on the lack of documentation regarding the anticipated funding for the continuation of new activities beyond June 30, 197?. Project #91, Regionalization of Perinatal Care ($325,808) was a very ambitious Project and reviewers felt that some issues were not adequately (addressed.' Dr. Brown is enthusiastic regarding the future of the project and the prospects for continued funding of it. JULY/AUGUST REVIE1q Estimated request as of- May 1974:' $300,000 MC0 6/4/74 . c' STAFF SUMMARY FOR MAY REVIEW KANSAS REGIONAL MEDICAL PROGRAM: RMP #02 Prepared by: M.E. Murphy COORDINATOR: Robert W. Brown, M.D. - Since 1966. STAFF: (FTE) Total - 11 Professional: 9 Clerical: 2 Note: 2 additional staff positions (1 Prof., 1 clerical) carried.Assigned to project #51 (Wichita HS/EA) Requested PoSitions: 7 (5 Prof., 2 cierical) FUNDS REQUESTED: Total (D.C.+I,D.C.): $1,733,380 Program Staff 623,632 Projects: 1,109,748 Continuation (11) 679,244 New (4) 430,504 CHP COMMENTS: Received from 'A' & appropriate 'B' agencies & included in application. Comments reviewed and responded to by RAC. CONCERNS: ._,I 1) Project #70A: EMS Training Programs; extension of #70 was initiated from Program Staff funds and is a continuation of the activity. 06 Award 2) Project #51: Community Health Educ.(Wichita) 7-1 07 R,eqUeSt $24,840 $117,976 3) Project #52: HS/EA-Capital Region 20,000 112,327 Target Funding Amount (140% annualized amt.) = $2,170,000 Application request ($1,733,380) $436,620 less than target figure. Anticipated July 1, 1974 request of $300,000 will remain $136,620 below target. Estimate 8 additional new contract activi+inc fnr .IIIJU 1 submission. Mid-Continent Operations Staff Analysis: Mary E. Murphy Kansas RMP: #02 The Kansas Regional Medical Program application requests funding from July 1, 1974 through June 30, 1975 for Program Staff, 11 ongoing and 4, new activities. Applicati'on Request for $1,733,380 includes: COO0 Program Staff $623,632 Continuation P$ojects #46 Health Services Training-Marymount 46,480 #51 Comnunity Health Educ.-Wichita 117,916 $$2 HS/EA- Capital Region 112,327 #53 HS/EA- Northwest Region 94,667 #61 Dental Assistant Program 50,000 #66 Juvenile Diabetes Project 59,743 #72 Rural Health Service Delivery 11,000 #74 Pharmacy Education 25,000 #77 Indian Health Service 55,000 @31 Hypertension Screening 97,051 #70pEMS Training Programs 10,000 '._ P86 Quality Assurance of Ambulatory Diabetic Care 28,500 #89 Primary Health Care in Rural Area 26,288 #90 Berkeley Health Education 49,908 #91 Regionalization of Perinatal Care 325,808 The Kansas RMP has regrouped previous goals and objectives to conform more closely to the Public Accountability Reporting categories. Projects are grouped as: f, Health Care Delivery A. Primary Medical Care 1. Professional performance - improving existing skills 2. Professional performance - new skills B. Primary Medical Care - increasing the availability of and improving access to services C. Regionalization of Secondary & Tertiary Care II. More Effective Use of Health Manpower;Greater coordination on a geographically integrated basis, to improve the produotion, skills, utilization and distribution of health manpower. III. Quality of Medical Care Assurance IV. Disease Control Program direction has shifted from the early priorities which emphasized the "information gap," to those project activities which are more directly concerned with expansion of new services, regionwide -2- e projects for categorical diseases, quality assurance, subregional development of manpower, education programs and public education. The KRMP expects to submit a July 1, 1974 application requesting approximately $300,000. Eleven projects are in the review stages and it is anticipated that additional projects will be completed. An Arthritis application was submitted for review and requests $390,013. The proposal is to be critiqued by an reviewers. Sumnary of the Kansas Regional Medical Program assigned body of The KRMP is in the third year of its triennium. Present funding (l/1/74 - 6/30/74) is in the amount of $856,786. Project activities number 15 at a cost of $557,667. Program staff numbers 11 full time, consisting of 9 professionals and 2 clerical members. Pre-phaseout staff numbered 46 full time employees (23professiona1, 23clerical). The present staff appears most competent. The Program Director, Dr. Robert Brown, has served as coordinator since the start of the KRMP in 1966. He is now serving in a full-time capacity. Dr. Brown has provided strong leadership for the Program. The Regional Advisory Council of the KRMP has remained most active in the past year, having met six times, as opposed to the four meetings required per Council By-Laws. \--0' The RAG'relationships with the grantee, the University of Kansas Medical Center, remain excellent. The State of Kansas Coordinating Council for Health Planning endorsed the KRMP application for the funding period July 1, 1974 through June 30, 1975. Approval was given for the continuation of thirteen projects, all of which had previously been favorably reviewed by the CHP agencies. In addition, approval was given for four new projects, Quality Assurance of Diabetic Care, Primary Health Care Project for Desoto, Kansas, and the Berkeley Health Education Project in Wichita, Another project, the Regionalization of Perinatal Care, has been favorably reviewed by the CHP "B" agency in Wichita and is currently under review by the 'B' agency in the Greater Metropolitan Kansas City area. Dr. Brown expressed much enthusiasm regarding the Perinatal Care project which he felt has excellent potential. The application request appears acceptable for funding. M 1974 ..-* _ . 2 KA!!SAS PRDG YR 07 REQUESTE $I WW LISTING COMPUNE S 6Y REGION 06174 COiJNCXt - ru CONTX~JENT CO+p -- -' - .CO!4PbNENT TITLE DIRECT . ..^ .--- ..-.-._ _-. NO ._ -. . . . -_ _.. .-. _ REQUEST coo0 PROGRAM STAFF .. .' 492,Sti 046 HLTH SEW TRNG 41,500 . ----.--.. _- .__._- _,. ..- ._.. 051 CCN?IUNITY HLTH ED " . _ _ . -. 109,529 - _... - -... ._ _ .~_. C52 --- l-!L~ti SERV ACT+CAPITAL REG 053 HLTH SERV ACTIV NW REG . ..- _- -_-. _ 061 `- D&l ASSIST 06a itLT!i #TN ED JUVENiiE OIAB - 072 - RURAL HLTH SERV DEL MODEL .- -.- ___ _._ __--.. _. __. _. .-_ _.... - 074 PHhRM .E&c' - -.-. - -. -. 077 `IVZIAN HLTH SERi - . _ . - 82r300 at341 50,006 59,743 111000 18r659 .. 50,000 87,000 131r098 4~980 8,447 309021 13,326 0 0 0 69341 srooo lOr051 021 HYPT SCREENING --_ -... -- ---- .--.- .-. -- _ _ ,. .__ _, _. _ I _ _. _- I . .__ __ _. . 07oA EMS TRNG 10,000 -. 0 -. 086 &AL -ASSUR. AMBULATOR+ DIAB CARE 21r900 ' 6,600 '089 PRft4 HLTH CARE iURAt AREA DE SOTO 26r288 0 . .6 0% o-23? __ . .I INDIRECT REQUEST _. _ _-.. _.__. -_ __ 090 _..__. ^_ _ SERKELkY HLTH EDUC 47~568 2~340 ' _. 091 RiGIONALIZATION PERII'iATAL-CARE STATEWIDE 2881893 36,915 . OF.C%??l?NENTS- 16- _ - ^ _ _..-_ _ . ._ REGIGN TOTALS . 1.478.255 255,125 _. --.. - TOTAL REQUEST 6239632 -- 46,480 Ill*976 1121327 -- 949667 _. 50tooo 59,743 llrOO0 , .- 25*000 -.-- 55rooo 971051 GO00 ._ _ - . ..- 28r500 26t288 _ -~9r906 - -.- - ~- - 325,808 ~ 1,?33,380 LAKES AMA RMP Lakes Area ml 00013 bNY/mNE 1974 REVIEW Request: $2,072,000 Committee Recommendation: $l,OOO,OOO Overall assessment by individual reviewers: Below average - average Critique: This application requesting two-year funding for five of the 13 projects was discussed in considerable detail by Panel B, The Regional Advisory Croup and review process was considered democratic, elaborate and complex. It was noted that the current staff is quite large (45 total, 20 professional) but apparently lacking in some needed areas of competence since funds for six additional professional positions are requested. Staff leadership seemed superior. The reviewers were concerned that staff-directed projects overshadowed activities sponsored by other agencies, a ratio of five to one in terms of.funds. Based on the review and comments, the CHP-RMP relationships appear healthy and continuous, although the two groups did not agree on all the pro j ects , The RMP's ability to attract other sources of support is quite good. Of particular concern was the request for two years additional funding for two projects that have been funded by the RMP for a number of years --the Telephone Lecture Network and the Tumor Registry. The Committee's recommendation was to approve the applica- tion at the reduced level of $1 million; this level represents about $400,000 less than the current annualized figure. The Committee felt the .R&P needed a strong message about the practice of continuing to support projects beyond three years. ,JULY,`AUCUST RJ5VIEX' Estimated request as of May 1974: $520,453 LAKES AREA Regional Medical Program Coordinator: John R.F. Ingall, M.D. Staff: Full Time Prof. 18 Part Time Prof. 2 Full Time Other 24 Part Time Other 1 Total 45 Funds Requested: Total *.*..**..*****.*I*. 2,283,635 Continuation .,.,..***.... ( 662,778 ) New o ???????????o????????? ( 343,755 ) RM 00013 On duty since:1966 Proposed: 6 0 2 1 9 Period of Time Requested: The period of time requested in this application is for FY 1975; however, a number of projects are perceived as being supported through FY 1976. 'I M Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) , , ~00013 Lakes Area List any continuation project or staff activity for which substantial increase over annualized current funding is requested. I HMO project: NONE EM project: EMS project is being carried over and they hope to acqutre funding from the EMSS program at the donclusion of F'Y 1975. As of the $pring of 1973, this activity was making significant progress in meeting its tated objective. PSRO: The application makes no reference to such an activity. Kidney: No activity in this area. . CHP comments: Received from Western N.Y. CHP, but not from the Western Pennsylvania CHP. The W. Pa. CHP had more than adequate time to respond, i.e., 45 days, and failed to do SO. The LARMP did react to the CHP comments provided by the Western N.Y. CHP and this reaction is reflected in the current application. E0/5/20/74 -... _ _ . . t LAKES AREA ___ PROG YR .-06 _. ERN COMP -.-..m --- .- COMPONENT iITLE . - . _ - -...1.. .- - - - -. coo0 PROGRAU STAFF cors RURAL- LA; IMPRbV `. - _._ -_ -- CblI ._. RURAL EXTERN -^--. -.-. ___ __.. _ COlJ TWO CNTY NUTRITION . - -- ._ -..-._ -.._ 001 TELEPHONE LECTURE NETWORK --we-- -.. -.- ^ _._. 010 TvHoR SERV REGiSTR? .- - `- ~.-.- -.--_. _ 025- .. __ __.. ALLEGANY HOBL HLTH, UNIf 028 --- EWSS - ---- -.---- __- ---. _. 029 LAKE A H E C - - .^ ._ -.--... - .~____ _ 032 REG HYPT - .._- --_. .__..._ 034. - PREPARATION NURS PRACT -.--.-- .-.-.._ _ _.-_.- --. _ _ 035 HLTH RELATED FACIiITY iTA& TRNG .. -- - . - -..---- .-_ -- 036 AU&LAThRY CARE SERV PLAh -037 -- HOVSEHOLii SURkY ELDERLY. - 2-w-...-. -_---.- - _.^__ - .-_.___ __.- ..____._ _ _ ___ ._._ . . . . . JXHT!NENTS -14. - .- -_ _ ._ _ _ _ REGION TOTALS -I_- - - -----... __- ------.- r_ . __. . _._ _ - ..-- .- - .- _ ._.-_, -_ ,_ . -- -.- -.-- . . . . _ _. .___ .._.- . . . _. : -I,---- .---. --- --. - .-- ---- . - _ _ ..-. - - . . -_ - .-.. . _ . . - - --. .-- ___ - -_.-. _ _ . DIRECT INDIRECT ~. TOTAL R EQUE ST REQUEST REQUEST __ 777,110 0 7n.110 62,800. __. - `. 0 621800 40tooo - C 0 40,000 c _ 30,870 0 30ts70 ; `154.400 0.' 154r400 c" . ,- 2OOt700 ' ..^- .._ -_ _ -- 0 Zoo.700 c- 17,000 - 0 -27,000 --- - 217tOOO -0 ~217,000 I .L. .- _. 265rOOo -. 0 - . 265,060 .._ .-- .-_. _ _ 140t000 38,320 5t200 0 ; 140,000 ._... 0 38t320 . .._-._ _ . _. _. .^ . -_ __. 0 St200 88t800 ..- 0 .- -.- 88t800 25,000 0 - 2stooo - -. . ,.._. ._ . ^.. -_ 2t072t200 . ..o - 2t072t200 - . ._ _. . .__ ._.. . -...- ..--_ .-_-. .._. _ _ _ _ _ __ _ --.---.- .- .- _ _ ._ _ -__ _ _.__ a J.u LL WV." . - . -..v -- e MAY/.JUi\' 1.974 RI:VIEI*I RM 000 33 Request: $985,212 ' Committee Rccommcnclation: $985,212 Overall. assessment by individual reviewers: . BELOW AVERAGE Critique: Review Commi'ttee considered the Louisiana RMP continuation grant application request of $985,212. Reviewers noted that Dr. Sabatier, Coordinator has increased his time and effort to 50X, Program leadership and Program Staff were rated satisfactory, The Programs past performance and accomplishments have been spotty, However, the present application includes some outreach programs in some of the rural areas and they have begun some patient care program activities. Efforts are being made at bringing services to people who are denied services at the present time. Reviewers believed that the conditions the New Orleans Area Health Planning Council - CHP (b) agency imposed or tried to impose on the Louisiana RMP were totally unrealistic in demanding that they come and present their proposals for review. The Program has good relationships with the grantee, Historica.lly, the The Program has good relationships with the grantee, Historica.lly, the financial management has been excellent and the Program has kept indirect financial management has been excellent and the Program has kept indirect cost rates at a low level. cost rates at a low level. JULY/AUGUST REVIEW Estimated request as of May 1974: $250,000 . .' . MC0 6/4/74 STAFF SUMMARY FOR MAY REVIEW LOUISIANA REGIONAL MEDICAL PROGRAM: RM 00033 COORDINATOR: Joseph S. Sabatier, M.D. - since 1967 STAFF:(FTE) Total - 8.6 Additional proposed: 1.25 Professional: .25 Full-time - .25 Other: 1 Professional: 7.6 Other: 1 FUNDS REQUESTED: Total (D.C. & I.D.C.) $985,212 Program Staff Staff Components Total Pro ram Staff & Components 4 Projects 15) total Continuation (6) New (9) 242,632 12,890 255,432 729,780 324,732 405,048 CHP COMMENTS: April 29, 1974 letter from David M. Smith, Chairman, Louisiana RAG to Dr. Pahl addresses two situations which involved the New Orleans Area Health Planning Council and the Northwest AHPG. For example, the New Orleans Area Health Planning-Council sought to conduct more than a "need assessment," notified project proposers the Friday evening before the CHP Monday meeting that they must be present to "defend" their proposal or the proposal would not be approved. The Northwest Louisiana AHPC, took exception to the fact that they were not sent the entire projects with a line budget and that a member of the Louisiana RMP Regional Advisory Group did not attend their meeting. It was impossible for LRMP to have responded to their requests when the Northwest AHPC did not ask LRMP for additional data nor for a RAG member to attend their meeting prior to its occurrence. The RAG is taking affirmative action to clarify these matters with the concerned agencies. Extensive CHP comments are included in pages 79-102. ITEMS FOR ATTENTION: 1) 2) 3) Four proposals amounting to $390,013 have been submitted for Arthritis. During the DRMP phase-out period (February-June 1973), the Program Staff was drastically reduced to a part-time Director and a business manager. In attempting to respond to DRMP telegrams and letters for the rebuilding and strengthening RMPs nationally, Joseph A. Sabatier, M.D., Director, has re-employed his Deputy Director and two Associates for Program Planning and Development. Dr. Sabatier has increased his time and effort from 25% to 50%. The Louisiana RMP's continuation request of $985,212 is lower than the 140% target funding amount of $1,241,212. JuJy 1 request - $ZW,OOO. f -. -. *I974 -:- _' 33 LOUISIANA ..,- P.RO6 YU -04 __ MD Cbl'JllNENT CDHP .-I.- .._. -_. I .__~ _ ND ._ __ -- .-- ..- _.-__ _ . COO0 PROGRAH STAFF ------. .L _..-_ ~. COt4PONENT TITLE -. - coo1 UED ED t PHY UTILIZATION --,.--_ ..--.- -.-..- -- - . - - - - _ coo9 027 -- _" __. -_ .___ _ ose .042 043 - - -.. - - 044 ' _-. --..-. ._ ..-__. _.._ _ : 047.' -. 049 -... G50 --- . - - . -_ - _-. _ -. __ OS1 .- - .~_~... . . . _ _~ 052. - _ _. _ _ . 053 - '-... -. ..-_ -._. -__. _ 0s; -. 055 656 -.- . .---- _- .__ .__ ___ 097 i0. OF COMPCN ENTS _ :8 e--.--e -.-- ---. -__ ..I ____._ NON EMERG HE0 TRANS STUOY . T&G EHS PERS OUTREACH NUTRITIONAL COUNSEL DIABETICS `E M i HICki RISK NEONATES & ILL INFANTS GUAL ASSUR IN MEDICAID PED CARE. .. ' ' PT FOLLOW UP HYPT SCRNG C&T CONTAIN CRITERIA .HOSP.HLTH FACIL - -FAMILY NURS PIL3T PROJ . ASSESS CIUAL ME0 CARE CONSULT SERV `ACADIANA DEN SERV 8 ED ~ - . DEMO-.PRIM DENT SERV HDaL DENT BUS rmT HYPT THRU hluRs DUTREACH . . _ . ^. .___ ._. . . _ DEMO `FRIH CARE MID WA'Y ASSESS CTR . - _- DEMO- ACCESiIBLE PRI!4 CARE INDIGENT ROLE FAiHLTH NURS PUB HLTH SETTING .D&O- PEO NURS ASSOC IN'PRiV- CARE PRAC -. .-. _. __- _ a . _ . -. .- _ _ _ REGION TOTALS -_-. -- ___ .- .- -.. - _ .-_ DIRECT INOIRECT' TOTAL REQUEST .REOUEST REQUEST . 2421632 4T800 8,000 lOlr270 16t130 6ltX45 bOr000 421740 17,400 32t90.0 34,000 40,606 24t881 451226 84t015 63t974 lbt250 38,800 94Ot769 0. 0 0 - 0.: 0. 2Oto4-r 0 0 0 : 0 0 -. .- _ 0 0 0 17~328 0 0 Tt068 4w3 - . . , 2429632 49800 -- -- - ---- I 8tOOO i0?,270 16t130 81t192 _. . 6OtOOO I 42t740 -- 17,400 32t900 34t 000 40t606 24t881 451226 lOlt343 63t974 16t250 45t868 985t212 Crj tfrl~ic?: Panel B reviewers concurred that the Maine application was out- standing among those reviewed during this cycle. There was no question as to the strength of leadership, competence of staff or dedication and leader- ship provided by the RAG. It was noted that MRMP had gone to considerable expense and beginning years of the program to develop a sound data base care delivery systems needs could be accurately identifi.ed, objectives and priorities established. effort in the from which health and program goals, MdMP,has had excellent success in attractiag and utilizing non--WI? funds in support of its program and has been one of the few in the country to receive an appropriation from the state legislature to continue i.ts operations after receiving phase-out notification from DRMP. In addition to state funds, MRMP has also received support from the VA (joint funding) and,from private foundations. I Relationships with CHP were considered to be good although there was some question as to the stage of development of CHPs, in Maine. This region was considered to be superior in all aspects and Committee noted that no application is expected.from Maine in the July-August cycle. JUI,Y/AUGlJST REVIJllJ I__- Estimated request as of May 3.974':' -o- - t * RM 00054 MAINE Regional Medical Program Coordinator: Manu Chatterjee, M.D. Staff: Full Time Prof. 11 Part Time Prof. Full Time Other 6 Part Time Other 0 Total 17 Funds Requested: Total ,*..,.............. 2,020,875 Continuation ..*..*a*...*. Ijew .,,.....~..~,,........ e Period of Time Requested: ( 227,940 ) 3 projects (1,156,071 116 projects approx. On duty since: ~67 July 1974 through June 1975 Proposed : 13 1' 231 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities.which extend beyond June 30, 1975.) . List over moo054 Maine any continuation project or staff activity for which substantial increase annualized current funding is requested. ! HMO project: NONE EMS project: Continuation without sidnificant increase PSRO: No problem indicated, proposal is for development. Kidney : . NONE CHP comments: Comments support the rqquest E0/5/20/74 -. - --. - _ _ MAY 0 4 -. MAINE * P ROG YR .06 REOUESTED F 8 ISTING COMPONENT EGfDN 06/74 COUNCIL ERN cow COMPONENT TITLE Me-.- -.-_ I __- -___ _. NO __..- ._- -. _ ._ ___. _. _ _ .__ .._ _ _ _.__. . . - .~ _-_ __~ -. coo0 PROGRAM STiFF - -. -_. _ - ._ . 0268 - EwS COnT 8 ----. -- --__. __ - __..._.. 0293 FAMILY `iRACT1Ci R&lDEtiCY . --. -- - - _.... --.__ 03&C SCHOOi PREV HLTH I O&A &AL COWWNITY HLTti CTRS -_l_l --- ---.. -. _ 067A MODEL OUT PT CARE DEL SYS ---..-.- -_. -_ 06RA .t COST ANAL HFO CARE Ot9A DESIGN STATEwIDE MED TELE CMNC ---.-- ..--.. -.-:... ._. 070A BLUE HILL STONINGTON EVAL DSN-P 8 23 I : * DIRECT INDIRECT TOTAL REOUEST REQUEST REQUEST -. _ 6361664 53,044 -- .__. . 909246 849650 1801992 . -. 54,200 50*000 SYS 55,200 . _. 69,737 O71A HYPT CONTROL RURAL MAINE 85 *500 072A EXPERTHENT RURAL DENT HLTH 28,200 -__ -.---.--.. .073A - HLTH CARE DEL SUPPORT BANGOR AREA . . 61~765 0748 FAHXLY HE0 COMMUNITY .67r7BO . - . 0759 EDUC RESOURCE DEVELOP E MAINE 102r500 -._.---__- . 0763 MULTiDISCIpLINARY PRECEPTORSHIPS 51,300 _ _ 077c NURSG t ALLIED HLTH 80 too0 - 07BC - ~OGULAR INSTRUCTIONAL srs EMPLOYEE TRNG 511709 -._ __. .--. _. _ 079c EXPERIMENT SLOW SCAN TV CHNC -. `.' 26~588 OBOD `P.ROF STANDARDS REV 130 t600 oa1D QUAL ASSUR PHYS EDUC 60 to00 __ .._ COMPONENTS 20 ' REGION TOTALS 2*020,875 a -6361864 0 .- -. 53t044 _ _ 0 90t246 - 0 841650 - 0 180,992 . . __. 0 54t260~ -. . 0. 50tooo 0 . 55t200 0 69t737 0 85t500 0 28t200 _. o-. 61t765 - 0 67t-780 0 102t500 0 51t300 0 BOtOOO 0 511709 0 26t588 0 - 130t600 0 60tOOO 0 2t020t875 a RMP Maryland -- RM 00044 Request: $762,663 Committee Recommendation: -O- Overall assessment by individual reviewers: Poor Critique: This application was its initial deliberation and on recommendat ions were reviewed. discussed at length by Panel B, both in the final day when all the Panel's The reviewer had served on the site visit team several years ago when concerns about staff capability, RAG functioning, grantee over-influence, concentration of program effort in the Baltimore area, and emphasis on data collection were noted as problems. These problems for the most part seem to persist except that activities are noti being proposed for areas outside metro- politan Baltimore. The Maryland RM? does not appear to be a vital force in Maryland; there is no progrxmmatic focus and the funds seem to be supporting a series of separate activities. The Committee concluded that the Maryland RM? did not appear to be a vital regional medical program in the traditional sense nor a useful vehicle for transition for the future. The Committee recommended this RMP be phased out. No funding recommendation was made but the Committee assumes that any needed funds for an orderly transi- tion would be made available. JULY/AUGUST REVIEW Estimated request as of May 1974: $400,000 MARYLAND Refzional Medical Program Coordinator: Edward Davens, M.D. Staff: Full Time Prof. 4 Full Time Other 1.50 Total 5.50 Funds Requested: Total **...,.....,.*..... 762,663 Continuation .,..,,.....*. ( 216,445 e New .~~,.~.,.,..,~....~... ( 129,394 Nprojects); 1 Period of Time Requested: Nome beyond June 1975 . RM ooou On duty Since: July- Proposed: 7 3 Activities Proposed: 9 416,824 Program Staff Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1375.) I " RML Maryland List any continuation project or staff activity for which substantial increase over annualized current funding is requested. * KM0 project: NONE EMS project: NONE PSRO: Project 51 though not a proposal to establish a PSRO, deals with matters of concern to PSRO interests. It would demonstrate feasibility of performing quality assessment claims review consistent with requirements of JCAH and PSRO using a centrally managed uniform reporting and review process. Kidney: NONE a CHP comments: Review and comment letters enclosed in application. No adverse comments. Reaction varies from moderate to enthusiastic support, *Project 56 "Data System for Manpower Planning & Criteria Determination for Process Review in Hospital OPDs" - The amount requested would represent an approximate doubling of the annualized figure.. The project would establish an encounter data system aimed at "planning the more effective application of community-based manpower and designing crit&ria and standards relevant to PSRO legislation." E0/5/20/74 . . _ .~ - MhY 0` 4 .- _ _ _. MARYLANO .`PROG YR 05 ERN -. coup COMPONENT - ._.. -- ._... r.-__ _ NO...- ._ _. . REQUESTED F d TSTING COMPONENTS EGION 06174 COUNCIL TITLE coo0 TOTAL PROGRAM STAFF 051 OEHONSTRAtION OF A MODEL HOSPITAL QUALITY ASSURANC .------..--.- -. _.- _.. - 055 THE HEALTH PLAN FOR MARYLAND `, . 056 DATA SYSTEM FOR MNl'WR PLM'NG & CRITERIA DETERM.' 057 GERIATRIC NURSE PRACTITIONERS IN NURSING HOnES 058 MODEL PRIORITY RANKING METHODOLOGY \ : XOHPGNENTS . 6 : - ._ REGION TOTALS -_ _. _ - - _- _ :._. _ -__ -. . _ _ ._ -. ..- .-.. _.. . __. _ _ I -...-- - .-.- ._ --_ -_ .- - .___ _ OIRECT REQUEST 3369467 l37,OOO 25,000 57,569 `51,543 529851 ' 660,430 _ . . - OSM-PU 63 t . - _. 1 INOIRECT .- TOTAL REQUEST _ REQUEST `.. _ 80,357 416,824 6 137,000 -. 0 -25,000 21~876 .- 79,445 - 0 519543 0 52~851 1QZr233 762,663 MAY / ,JIJNII 1974 IKVIl~\;' -- -I Kequest: $3,385,158 -- Connnittcc kxonuncndation: $2,600,000 Overal 1 Assessment by ! ndividual I?cvi.ewcrs : -me__. F--.-..- Above Average _I_.. Cr.i tiquc: : . ..--- *Ws region's proposal was rcvicwed in depth by two reviewrs, both of r&xn haj f0rmcrl.y site visited the program. This .region was considered to have cxpericnccd, strong `I eadership, conrpctent staff, experienced strong JIG, exccll.cnt (I 1P rel ationships , and the ability to gcnerate health data that rcfkcts the heal.th care needs of the region. `1lri.s data was used in estnbl.ish:i.ng the goals, objcctivcs and prioriti.es of this region. Rcvicrwrs commended. the region on i.ts past pcrfor-mance in bringing MINDRITY HLTH NEEDS URRAN EX?A;r RE; HLTH PROFILE TRENDS REG VITAL STAT HLTH SERV EDUC ACTIV - _ __ f5vEutPME~T9t COMPO~~ENT - HIGH ?ISK INFANT REG RLOOD GANKING & TRANS t:+PRD'/ (:,UAL ASSUR DEATH STAT rias AUDIT E IXPR0V UTIL NURSG MNPWR POST GRAD EDUC INTENSIVE CARE . -- _. HYPT CNTRL AUDIT Ci-NTEKSG POST GRAD EDUC .. - HOME HLTr! CARE C HLTH EDUC CRITTENDEN cL1Nrc ~0~6 HLTH CARE OIRECT REQUEST INDIRECT REQUEST 608,212 899078 69626 lr165 6,826 19165 48,393 2r447 4,500 0 ?*300' 0 39600 0 2r250 0 13,706 21621 25,865 31192 16,365 3t192 500,000 0 300r000 0 230,960 53,553 2399750 44,512 60,529 19~324 58;767 10,462 559073 ., 0 21,681 1,087 643470 31,354 1529368 0 24r490 0 * TOTAL REQUEST 697~290 . 77791 ?*991 50,840 4t500 _ 7,300 3~600 2r250 16,327 29,057 19,557 500r000 300,000 284 t 513 284,262 79,853 69t229 ' 551073 22t768 95,774 152~36% , 249490 . _ MA e. 974 . MEMPHIS PRM; YR 06 IUTH CENTRAL CDMP NO COMPONENT TITLE DIRECT . - . _ .._ _ ..- _. REQUEST 050 EXPAN MID SO EYE BANK 159560 COMMUNITY HOSP %ED AUDIT SYS 17r912 --MULTIPHASIC SCREENING EVAL - -- - 71 r686 053 GIBSON CTY HLTH SERV t MNPWR UT11 28.924 054 055 056 057 e5 4 @bCt 061 ARLINGTON HLTH SERV t MNPwR UTIL "IED HELP PlEIGH95RHOOD HLTH COUNSELORS EXP NURSG ROLE \YALDPUSHA GRENADA LEFLORE CHRONIC OXS . . flSIoN HOSP LEARNING CTR HOSP EED ilTILIZ REV DIET CSNSULT f'r9UG & TOXICOLOGY INFO CTR .-- `. -' 339227 6rOOO 469026 105,195 ' 259250 37,116 II.240 -. 38,498 063.- 065 -1. --- . 066 PRIM HLTH CkRE REG IX HLTH :W?YR EPsUC 51~600 16~020 _ __- ._ STAFF c SUPPORT TV FUNoi PUB EDUC -- .- . . .._ . 499023 067 SHARE0 HO$P AND EXT CARE FACIL CONS~J:~ER EDUC . - - _.. . . _- ,_._ .._. 329219 18p350 068 REQUESTED 6 LISTING CO~PONEN Y REGION 06/74 COUNCIL OF CDMPCNENTS . _ 39 REGION TOTALS 3eO55.577 329~581 3,385 w 158 . ._ INDIRECT TOTAL REQUEST REQUEST 0 0 8t866 4p697 6r 105 0 0 79718 0 6,897 ; 0 14t 171 0 39733 11,962 0 2,330 15,560 17~912 80~552 339621 39~332 6tOOO 461026 1129913 25r250 449013 119240 529669 51,600 19 9753 60,985 .. 32rtl.9 201680 osn a O-23 RJvJP Metro Washington, D.C. Rbl 03D31 --___I Request: $1,272,3135 Committee Recommendation: $l,lOO,OOO Overall assessment by individual reviewers: Average - above average Critique: This application requesting support for staff, eight ongoing projects `and four new projects , appeared to the reviewers to be a cohesive request in line with the objectives and needs of *the region. The Regional Advisory Group appears to be an active body 1.11 contrast to the situation several years ago; the revi.ew structure is well orga- nized and the relationships of the RMP to the CHP agencies have %een strengthened. The activities, both proposed and ongoing, appear to be directed at major needs for the population served, with a strong emphasis on improving cli.nical services for non-emergencjr patients and kidney di.seases. The RJ@ has been effective in developing joint funding for a number of the projects. The Conutittee believes this region has improved. The Committee recommends that the application be approved at a reduced level of $1,100,000. JULY/AlJGUST REVIEW Estimated request as of May 1974: $450,000 RM 00031 e METRO WASHINGTON D.C. Regional Medical Program Coordinator: Vaughan Choate Staff: Full Time Prof. 8 Part Time Prof. 0 Full Time Other 2 Part Time Other 0 Total 10 Funds Requested: Total .,.....,,..,......I 1,272,385 On duty since: 1972 Proposed: 9 0 4 - 0 13 Continuation............. ( 1,100,083) - 8 projects New.....,,............... ( 679,067) - 4 projects * Period of Time Requested: Thru June, 1974 Activities Proposed: Refer to Management Information Systems (MJS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) , m 00031 Metro Wash, D.C. List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: NONE EMS project: Previously planned, second phase for communication system. PSRO: NONE Kidney: No increase , phase-in of previously planned components. cfip comments: Until within the last year, this Region. CHP (b) agencies did not exist in The newly formed agencies participated in the development of this application, The MWRMP has also assured these agencies that should comments be forthcoming, until June 1, 1974, they will be forwarded to the National Advisory Council. E0/5/20/74 _. _.. - - _ MAY - _. _' - DC METRO PRUG YR 06 ' TERN COHP NO --. _ _ _ COMPONENT TITLE DIRECT _ _ _" _ REQUEST INDIRECT TOTAL REQUEST REQUEST coo0 PROGRAM STAFF 136,339 359963 CO09 REG EMS CHNC SYS lOOtOOO 0 __ _. REQUESTED LISTING COHPONEN REGION 06f 74 COUNCIL -__-.- - _.- _.__._ _ Colt--`-- NtiRsE NJDWIkE MATERNITY NURS ', __ ..- _. _ . 57,260 co12 HLTH CARE SENIOR CITIZENS CHRONIC LONG TERM ILL 1289300 I coi3 HYPT DETECT AND FOLLOW UP i29,540 -- --.-.- _ co14 .- HYPT DETECT ANO FOLLOW UP _ _ . .- 20rooo* 0377 ' CHRONIC OBSTRUCT PULM DIS 44r471 049P COMPRE K'IDNEY DIS CHTRL CENT TISSUE TYP FACIL 12,730 -----_-.-. 2 . 049C'-- . CC'MPRE.KICNEY DIS CNTRL COMMUNITY HOME DIAL CTR . 21,660 04?f C~HPRE KIDNEY DIS CNTRL KIDNEY TRANSPL 21~850 049G COMPRE KIDNEY 0Is CNTRL,OUT OF CTR HOME DIAL TRNC 259000 .---.-__ ._.._. _. . 055 PRIM -CARE FACIL- ._-. _ -. . _ 332rOOO , .-- ..- .- ___. _ 056 .ASSIsT CHPS -. - _. _ ~. - _- - .^, o 132~000 ?????*?????????????????? ?? ??????? ? ? ??? ?? ? ? ?? ?? ? ??? ? ? REGIDN TOTALS . _ . lr16lr150 .._ 111,235. 1.272.385 .~. .~ - . 14,216 21,630 0 0. 209666 4t462 5,000 9~298 0 .O . 0 8 ---I- - ----.-- --_ - ..i-. _.- _--.__ ._. ___.-.._ _ ._ . - - __.. - _ -- . -. _ --. . osn 23 P 172,302 100,000 _-. 71,476 1499930 129,540 20,000 ^ .- 65,137 176192 26,660 319248 25,000 332,000 132pOOO t. -8 MAY STAFF REVIEW SUMMARY MICHIGAN ASSOCIATION FOR REGIONAL MEDICAL PROGRAMS 1111 Michigan Avenue East Lansing, Michigan 48823 Prepared by: Jeanne Parks RM# : 00053 William Graham-Welke, Ph.D., Coordinator Since September 1973 hc has been with MARMP as Deputy Coordinator since 1969 Current Staff: Proposed Staff: 8 Full-time Professionals 12 Full-time Professionals 0 Part-time Professionals 0 Part-time Professionals 5 Full-time Other 9 Full-time Other 0 Part-time Other 0 Part-time Other Funds Requested : Total Costs - $3,777,341 Program Staff - 346,582 Continuation - 1,675,271 New 1,755,488 Target Figure : $2,889,404 Estimated July Request: 800,000 Period of Time Requested: All activities will terminate 6/30/75 Activities Proposed: See MIS Printout (attached) Cl IP Comment : Page 46 of the application describes the regions procedures for involvement of the CHP "b" agencies and the "A" agency in the review and comment process. All projects in the application were sent to the appropriate "b" agency or council of the "b" agencies for review and comment and the entire application was referred to the "A" Agency Health Advisory Council for review and comment. Due to time constraints, however, few of the projects had received review and comment by the time the application was processed through the RAG. The Program Coordinator met with the "h" Council following the RAG meeting and prior to the issuance of project contracts; MARMP staff and the "b" agency staff will meet with the approved project staff in an attempt to accommodate the "b" recommendations. A and B agency comments will be forwarded to DRMP subseoLuent to this submission. Page 2 0 Michigan RMP Summary Items for the Reviewers Attention: Project COO2 - EMS Planning and Coordination, is the continuation of a pro of 36,325. $ ram staff activity which was funded l/1/74 - 6/30/74 for a total The current request of $750,000 represents quite a substantial increase in funds. Essentially it proposes to provide the continuation of linkages and relationships between and among MARMP and non-M/W@ programs. COO3 - Michigan Hypertension Services Coordination Program This is the continuation of a program staff activity which is currently funded for a total of $22,677 through June 30, 1975. Current request of $124,694 represents a substantial increase in funds. Project #55 - Health Careers Resource Center for Southeast Michigcan, was funded for $46,600 through December 1973. The region is now requesting $88,200 to continue this activity through $ , , Pr0fe $ .,J.A C. : 0 `) c7, 1 . * 21 Professional: 1C Ful 1 --ti;:;e E Full -time 5 Part-time 9 Part-time 5 Other: 14 Other: 10 Full-Time -vi .-- Full-time Part-time B FUNDS REQUESTED: TOTAL $3,010,113 (IDC =349,908) (exceeds est. target of 2,364,333 by 645,000) Program Staff 744,679 Staff Components (26) (includes 7 new planning) 710,880 Total Program Staff & Components 1,455,559 Projects: (46),total 1,554,554 Continuation (16) 692,031 New (19) and (11) EMS subcomponents* 862,523 * 11 subcomponents are extensions and expansions of ongoing EMS activities, to facilitate the implementation of Missouri State Law - Senate, 57 which sets forth standards for vehicles and training requirements. The application identifies the "new" locations. Total requested for these 11 subcomponents =$290,205 CHP COMMENTS Complete application was furnished "A" Agency and appropriate portions to 6 Agencies; practically all B agencies responded favorably. A Agency responded "no comment", leaving decisions to B Agencies. Questions and issues requiring additional clarification were discussed on the telephone and RAG responded to comments. B Agency comments received for practically all project proposals. ACTIVITIES EMS - Major expansion and additions to implement the State EMS legislation focus on improving EMS services, to meet minimum standards and promote training at various levels. RMP is applying to D/EMS (HSA) but understands that planning funds are limited this year. a . PSRO - Quality Assurance, continuing ongoing activi,lies involving criteria development and data evaluation. ' Kidney - Continuing ongoing; one new project involves training and education Concerns: ---II Coordinated nlanning for health i'esources - Program staff activity ..-. L..----__I-- .__.____ I_I_-..-.--_--_ ?%r develop:aont of model fsr healCi-1 resources planninq, in antici- pation of legislation; propose a central staff'activity and six District liaison officers, to work with CHP and local areawide planning bodies. Total request for activities is $306,000 identified for 7 "new" program staff components. Program Staff - Request increase in staff from present 30 (full-time equivalentjto 45 FTE and other expenses, for total program staff funding of $744,679. This is exclusive of the $710,880 requested for the 26 program staff components. Summary of ongoing projects, compared with request: The application requests 1,554,554 for 46 projects. Sixteen are continuation, 19 are new and 11 are new subcomponents of EMS activities, representing expansion and extension of ongoing activities, at different locations. Among other new'activities are high risk infant care projects (CPR), education and training of burn center team, improve quality of data (establish criteria and training activities). Several studies and surveys deal with manpower needs and utilization, for "health resources planning" purposes. July 1 - Expected Request is $500,000. L. Resnick MC0 Revised 5128174 .- ,. . . 0 _ . _ - - - .- .._ _. -_ - MAY A r1974 --. _ _. _ - . _ _. . _-. - - ^. :D CONTTNENT COMP --11 - .--- -_ _._- ^_ NO _ .,.. -_.... - -. _ . _ ._ -- coo0 PROGRAM STAFF 581,732 1621947 7449674 . . Ib _ ._ _ _ REQUESTED NDS LISTING.. COMPONENTS BY REGION .-.._--_ ._-._. . . __ . W/74 COUNCIL _ _.... . . .._. ,... . _ _ COMPONENT TITLE' .' . ,. _ _ . .-. ". . -.. DIRECT .. INDIRECT .' TOTti REQ'J'ST - _-. .- _ . . . _-a. I . . ..,. ,. .._ I" .^ I".- REQUEST -.. ..,. REQUEST . . . . _ -*_. ,." 0x6 PROG EVAL GROUP ' , ' . 25t350 6t495 319 845 _ -... -. - - ..- _-_ .---.- t0;14-- ..- _- ._, . .- . ..-.-... ,._~ . _._ . . . .-. ._-_.- .._-,.. HLTH PKFFILE PLAN STUDY 9,000 0 9,COO _- . ..____._ -.- -I co15 &AL' HOSP SYS " I _ - .--____- . 9t05q 2,314 11~364 co21 .- DIAL ACCESS NED CONSULT -' `. --". - _..- ".. _. ._ -. -... *.- 1. 2,100 540 -' 2~640 _--I-. co22 -' .. __-_ _ .,... ST~;E' RENAL DIS SUPPORT * ___. .-- . . ._._. . . . . . . . . . _ -,, .I..__ * ..I. . 47 t300 , -.-..-. .x2rlx7 . . 59,ct17 _ ._ ) __-. ._ Co24 -- C&T KFG CMIK RESOURSE UNIT _ __. .,_ _ _... . - .- -_. . - _ - ___ . _ ,._ .- -- 23,400" 5,997 29,397 PLXTGRAI) EOCIC PROGRAMMING .-. . _. - _-. .._. __-__ .-..- - . ,__..~ co25 -- 17t300' -- 4t607. 21,907 '. . ,,*-, .--". 1 ."I **.- .,. . . . . ..-. .*w ., . .-, I co23 JCAH AUDIT UEVtLOp 39350 *" 892 `.. . 4,242 ___.- ..__ -... _.- .-.. co29 -.- SHARED TRANSP CHRCN ILL ISOLATE6 -- 39750 .' 996 4,746 NORS CLlNICAL TEACH PKGS -. co31 I- . . - _ _.. . __ . . - .._- _.--.- -- . 101775 ~ '. X.536 -'- 12,311 _ _., _ .-_ " ___,_- -_.. -.-..- ..----- .-.--- ..-. _-- -... _ _ . . . . _ ,. ____-- ._---_----- --.. - co32 INNER CITY CONSuME'R HLTH EDUC -`.' 26t600 7,075 33,675 ,_ __ __ _ _._ ___.._._ -. ._.- ._ .- ..---.- __.._- -. _~_- ------ .- co33 - .I' CE.NT~DA+A BANK' END .STAGE KIDNEYPTS ' 179575 ..-- . 4,503 22,078 __. _ _.-..- _ _..__ ___._. _- :. __ .-. _.- . _.-___ --_-.---- .- _-_.. __ _._ __ CO34 HYPT- OATi ACTION- AND `.EYAL 43;250 .-.- 11,080 54,330 ,-.--.-- -- ...-.I-_..I .-.. 30,200 .'-. 8,030 - -- - - _ _... . -. _. co&- N-ET\&%- HLTH "- ...- _. __ ___,_ .."_- _-..-. .._...-. -- _ ..- 389230 . f __,._.._ _ I .__-..-._.- -._ - . - - _ . _ - . _____ .-_. __ .--- _._. EVAL- COkl4UNITY ACTIONS . _ co16 . ltOO0 0 1,000 - .. ..- . . ..-..-- .- --- ___ __._ .._.. . ._ 7tb00 . -- _ -_ _ C02d HLTH CATA SERV _ ..__ -._ _...... _ 0 7,050 * b ..- ._._ "_ . . . . -...--. ._ -- . . _... _ ,_ . _ _. __.--. _ - _ _- . . __--.-_-_---... _. .-- . . ._ .-. -I . . .._ c . _ co39 EMS SYS KAN CITY `. 11875 498 2r373 _. _ _ ___ ! .___ .._-__ . . -... -_ - 101400 .._ ..-_ ._. _ co40 -' Mb HLTH PROFILE ikiN BOOKLET 0 lOT400 . . _. ._ _. ._ -_ .- -. . CO41 STATEWIDE PKOF NURSG-STUDY ..' 48rOOO 0' -.. -48,000 _.__, ..-..-. -" ..-- ^ . .._ --. .-.-`,.' .,_. ."._ . - . _. . ._.--__- --. .---.. --- -.. tO42. PILGT f&EL NEW HLTH LEGISihTION 102,250' 18,675 XZOt925 ( _. . . . -.. co45 DIST LIAISON KAN CITY ." 31,000 0 31tboo __._..._ __ _ -. __ - .- _ _. ._.._ CO,MPONENTS BY REGION ' __- ___._._ ___-_---_. -. ------.-.---.-I_- .__._,- -.-__ __.. .._..-. --_- 06/74 COUNCIL.. _ .___.._I .__ .___ ._ `9,. `XI S!pJRX . ..-~ PROG- YR O?. .- .__ ..~ ID CCNilNiNT coqp ..-- - _ _ _ . _ . _ . _ . COMPONENT TITLE - -- - ._. - -. . DIRECT -`-. .--_. -_--_.-_---_-_ NJ0 --.. -. -..- . .--_ . . . ._- -.. - -.. . _ _.. _ . I ^ - ._ . . REQUEST CO44 CdSi LIAISON NW MO' ~ -, . _ 1. 31,000' .- _._ .._-. _.. .I . . -`DIST LIAISON NE MO . -' _ ._ . . . CO45 31,000 . _-_. .___ -._ -.. ._. . I. .--- -. ._.- .^- .-.-.. . .- - 1- _,. .__--- _. -._.. __ . . .- CO46 DIST LIAISON SE NO . 31r00O .-. _- . c347 DYST LIAlSON SW MO 31rooo ___- ._. ._ - ..__ .--.. DIST LIAISON CENT MO . - _ _ . _ ._ CO48 319000 _--. A-.- .__.-.-- . -- . 026A TRNG COMMUNITY HOSF `NURS FOR- EMERG' - _ _...._ .--,, _.".. . . . ".. - ._ _ ^ .._. 44r200' .---.- ;- 046 - - _ ._ _ - .._ _ , HI BLOOD * 71,ZOf -. ___ _ _ _. _. -_ _ _. 083 GREEN HILLS COGP-HiTH'-CAR;-- .- .... 42rooo _ II_-.,..-- ._._- -._--. - - - .._. ,. _. _ .I.- _..-..I . _ --. - ..- - 086 DOCENT `NUKS OUTREACH" - "`. 501735 092 --- _ _. ._ _ . . _ ._ . -. . ._ -.. " _.. _ EiMS NE & NO CENT `MO 85r623 - ___--._ -._-.-.._ .- _ 093 :- .- RESQU II ..~ _. . _.. . ._ . _ -. _ 141,838 .' -____ .-_- ---.-- .____..._ _ _ __ ___. . .__ - .-.--..-.._ -.. . . .._. - . ,-. 093A S W MO PILOT TRNG' MiMTS 24,003 - INDIRECT TOTAL REQUEST *RECUESS 0 0 . . .- _ 0 a 0 .`i2;450 0 _ `0.. - 19,395 - -_._ _.. 13P403 499026 .: c . 14:, I:28 37600 --. . _. _- _._. .._. _-- ..- EM MED BASIC TRNG _ . . _. ._ _ . _ I _._ . __ . . 0939 . 29~124 * 0 __ _ _ _ - . . ._ 093c KAYSINGER EMT TRNG -.-.- - - .-.. " _ _ _ __ 19,410 .- 0 .I_--- -_- - -- __.. `. - ..__ 094 GREEN HILLS EMS `. _ _.-. - . _. _ . .." - _. .- _ .._. _- .--,- -. .- 18,000 .. .- 0 ._--_. .- ..- _ _.--__- _ 095. CPR' _, 0. ..-_ I 28,000 .- 21092 _ ._ - _ _ _ _ _ . NU4.5 ASSOC NEURO HANDICAPPED .. .. - .-~. _ .._ _ 097 43;294' 15~078 -.____ --._-- ._ -_. --_ _ .._.-..- ..____ . . . . - ..-.-.. .-.- . . ._- . --...._. _ . _ - 102 I?lPf?OV REG TISSUE TYPING SYS . . 48 r462 0 ~--- ---.---._ - -- _ _ - . ..- _ INTER-HUSP KID,NEY TRANSPiANt SiRV .- ..__ ---..-- .-_. - . . . 103 16,250" - --_ 0 - 104A' .. flZARK.FXlTHILLS EMS PLAN IiPLE _ _. _ _ 19,700 -.- 0 --._----..-M.-e- -. -. . _ . _ _ EMT AMSULANCE TRNG .-- -.._. _ ._ . -_,. - I- -- -.- ._.- -.a. -.._ . .- .-.__. _ ..-*.. -~ . . . - . ," -.-, . ._ -- . ..--.. . ..-.- 1046 8,400 0 . I.. ._ ._I _. ld4C 003THEEL EMIXG ,CARE SYS IMPLE ,. . - 17,665 `: 0. _ LISTING . . COJdPONENTS BY REGION 09 I~~SS0UR.l. " PRGG .YR 07 _ _..__ .._ . . __ _ . _ . . ._-.- - .-.. _ . . - _ COMPONENT`iITLE. . - -. " Mid CONTlbkNi- .__ _. CUMP DIRECT - .-_-.-.- - NO ___ I__.- -__-,. - -- .__... - ._..-- . - -I.- _ ._- . .- .-_.-_.., ..-- II, .- REQUEST ,_ _-_- ..- _ __._ _ _ _ -. CCNT EMS EDUC ENERG PERS - .- _ _ __ . ._-. . - ,. . .-~_ ._._ ___ _-_. 1040 ZVOGO .._-_ - . I_ _. .-.-..-. _ _ _ - - - - 105 INTENS &,RE NURSERY CPR ". -.' - 5,642 -- -___I___- --..- _ I .., . . _ . . . . _._,__-- -.._-- _-I_ -es-.. -----I- - -.-..-.-.. -- 106 EMERG AMBULANCE TECMN 19900 CD&R&AL ERS TRNG _. _. _-. .- . . . ..__ - . . _ - - - -- ._____ --._-.. -_-.. --.. 1CbA -- 679825 -.__ -_ . .._ .----.-.- -.. --.- loba EMERG AXP.ULANCE TECHi .-.- 5~200 . _I_-___-___-.II. - . - _ 107 EM+ T&G -' . ._ _ -. . ,. _. . .- .----. ,- . . .._--^.I. _.- . . . ..- _-. . . --.... 58 t718 .__ _.._ -__ _ . _... _. ?Mi?.G MED PERS TRNG AUDRAIN . . .._- ..- ..-- . .i- 107A 129184 __ -2 _____. ._ .._. --. 1078 - EMS TRNG HANN 16AL _ _ _ _ ._ ., _ ._ 6tOOO -_--. ~---- --.-.- 108 GREEti `HILLS IN iERV TRNG 9 t700 - ____ ._ _..-- - ._.._ -.._.- ..- . 110 `DUNXLIN CNTY COMMUNITY bLO$D PRoG ---' - 31550 _ _ _ _ -. 111 INDEPENDENCE PLAN COViRE HLTH SERV - .' -. 34r 842 ____- --.-- --. .-..- ..--_ - 112 MIDDLE .&SK NEVBDRNhFANT .MGMT ____.._ .- . . . ^_-- _._._.. ."._. .-_..-- 67t572 - ___. - .__-_. -.-_- -...- . -. -... LONG TERM CARE PARAPROF CONT ED __- . . _ _ _ . .._. -- . -.- 113 27r700 _- . ___ -... __.- __. _-... - . -. _ ._ __. . . __-. - - ' 114 GF(EEN HILLS ME0 AtJD1-r WDRKSHOPS .2t400 INDIRECT REQUEST ._ ._ 0 0 0 0 _.. ,_' _ _.. ,_' _ - - 0 0 ??676 ??676 0 0 . . 27r910 ~ 27r910 ~ 0 -- 0 -- 0 0 . . 0 .- 0 .- ". ". 0 0 0 . 51200, _ _ . _ _ -. - _ . - - . 0 b-7 t .`Fz .--- - .. _--. _.._ ---. -- -. ..-- _... __ 0 27t7a _.. __ .- __ -.... .^ .- __ _ -... . .._ _ _ 0 21400 HLT; ii- AND-INVOLVE _-- _. __.._I,_.._._-_ _-.~,.-. -..... . ..-.-_..-_ .---- __..... .- ,.-__ _.- -. _._ -._-. -___ll____l _--.-. WESCENMG -. -. -. -. _ ._ _. 115 72,990 0 72 PS'S o -_--._-. .------. - .--- HOSi PERi `-. ???o??????? ?????? ? ????? ??? ???? ?? 20t000- -. ???????? ? ???? ?? 20,00\~ -- - 116 EFFECTIVE UTILIZ 0 _ . _. _. .-- _ _ _ -12ts50 -. .-- . ..__ ._ _ _, __ ____.. ._ ._.. -... ._. _L .-_, . . . .._ ..-- o ..-. 117 LAKES AREA HLTH MNPkfR- SURVEY 12 t 850 .-- _-- - -. -- -- MN&i KiCRUIT- HLTlis-iARi IiiST `, __ .._-_- .-. ._ -.- .- .-.-__.._ .- . _,. ._ -_.____...- -.. - .-.-. * 3 116 13t270 0 13,270 ___ __.. ---- --___ ------ --.. QUAL CRI-TERIA HOSP SifTING . ___ _.,._._- __. .__ __ ._-_ ___-... ..- --... _. ._-_. __.._ - __.. -__ _.-.. 119 23 9000 0 23r300 .._-^_- _ ~__-- _-._ ___ .__ _. _ .-_ __ __ _. -.. _.,... _ . _._. .-- _--.. _.-_. . ..- _. 120 KIDNEY DIS EDUi' ... 409000 0 40tooo ~. ~ ---....-,- -.-.-_. -. i -. . - - -- .- . . _.- -..._- _ ,._._ _ ._~ ,_- ...-l..l--...- ..- . . . . _-a -,.--..." -...m. .-..-_ ,-_- .-.. - -..- ..- ._. 121 COM!WNITi~ hASiD HYii 34r045 0 ?4,0& ---- ,-- _. _. _____ -.. -.._ -__ .- - _. SE HOME HLTH CARE AiD HOMEMAKER SERV .-.- _ -... _ _.... ._-._ .-.._ _ _. . . . 2. _._. _.__ -._ _ ..--_ _- .-.._ - - - 122 12t350 0 121350 REQUESTED F LI STXNG _ _ _:_ COlYPONEN REGION ,_ 06/24 IL - _..-_- -....-.-.., . : -.. . . . -.---._ . ~"`:>~:jii:J.I __ .____ . . PROS YR- -07 `-. _.-. .- ..-.--. ._-.. .- .- . -. - ..-. ._.. _. _ ._.. . . -.: `. 123 START UP P T SHARE0 SERV -., 134 GREEN HILLS C-WC -. .._ . ._ _ _. ._- . -. . _ ._ ._ 38 ,724. .-._ 0 -- 38,724 9rooo .... - 0 _ . 9,000 -. * - .- .-.. . . .._. ". . _. - . . - -. _ ._.. ._ 125 R E t; P,XN CARE TEAN CEVEL AND ED , 34,450' - . . . o 341450 _ _ FiNPk!? SURVEY AND UTILIZ 2'1,359 _ .-_ d . .___ .- ._.-. -_. .._ L2b !-iLTH 21,350 STUDY DETERXINE NURS SUPPLY AND DEMAND -.- - . - .- ._ _ 127 5 r775 0.. 5,775 . ._ ._ . _. _. _- ___... - 120' . ,... -. _ _,. _ HLTI-! ED- LADDERS-`MID MO * - _. . -. .~ I -... -._. 50~000 . -.- .._ _.. _._.- . _. -__ 0 50,000 `. . . - _.. _.: 129 R!$!?iL AXSULATGRY CARE 52t00d. ."- o - 52~000 Ft. CL71:?L:tiZNTj .._._ _ 73:. . ..-. - -. _- .---. _ . ._ ,. .-. _.__ _ .._.._ REGION TOTALS .__._. .~_ 2rbb0,205 _ -.349190a _. 3,010,113 _I * .._ _ __ _ - . . _ ._ _ _ . __- _ _. _ ___ _ - _ _ __ .- - ._. . 1... - .-... . ._ .-. . . . _ .._ __ _ _,_ -. - _. I.. ._ . . . . _ _..I. -... ._ . . . . "..~. .I.. .- . _. ." . _ . _ . ._ _ ., _ ._ _ _.. .__ _ I .- .-.. _ - . ._- .._. _ -`. . ___ .__ _. ._ . ,_ ., . . ..-. -- -. _I^. . ._.,_ I ,. 1. ._- -_ .., ,.. . I ."_, . _ _ . _ . -- . . . :. . . . . . I. _... _ - _ . _ NM1 Mountain States -- PM ooo 32 MSRMP is a well-organized well-managed program with a good review process. The region has experienced, stable staff leadership. The Regional Advisory Council is strong and viable and controls program staff direction in terms of goals and.prior- ities for the region. The application proposes continuation and new activities that are in line with program objectives, which are well-thought out and properly reviewed. The RMP has attempted to reach out and provide good service to the four states and appears to have a good working relationship with the State govern- ment and CHPS. The Review Committee questioned the marked increase from l/6/74 budget allocations to the proposed figures for the Areawide Neo-, natal Intensive Care Program (page 105) and for all of the EMS projects except the Wyoming component (see pages 92, 94, 97 of the application.) Staff requested and has received additional budget information from the region which appears to substantiate the requests. 3ULY/AuGUST REVIEW EstimaCed rcqucst: as of May 1974; $225,000 STAFF SUMMARY FOR MAY 1 REVIEW MOUNTAIN STATES REGIONAL MEDICAL PROGRAM: RMOO032 GRANTEE: Western Interstate Commission for Higher Education - Boulder, Colorado REGIONAL DIRECTOR: John W. Gerdes, Ph.D. On duty since 1,/l/7.2 STAFF: (FTE) Total - 29.6 Proposed: 38.6 Professional 18.1 Professional 22.1 Other 11.5 Other 16.5 FUNDS REQUESTED: Total (D.C. and I.D.C.) $2,409,356 Program staff (Administrative) 255,316 Projects: (New) 16 635,440 (Continuation) 11 1,518,600 TOTAL REQUEST 2,409,356 CHP COMMENTS: Comments were received fran all four of the CHP(a) agencies and four of.the seven CHP(b) agencies. The Idaho CHP(a) Agency did not endorse Project #313 - _New Health Manpower Developmental Activities Phvsical Assessment Skills for Nurses (see page 232 for CHP comments.) It appears that CHP has misinterpreted the purpose: of the project. MSRMP is in the process of clarifying the issues involved. The Clark County CHP(b) Agency commented negatively on four projects; it is difficult to determine the significance of these comments. The MSRMP, however, has responded to all CHP comments. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal programs, such as HMO, PSRO, Kidney and EMS. Mountain States.- Page 2. 1 I a CONTINUATION ACTIVITIES: Of the 27 discrete activities proposed, 11 are continuations. Significant increases in continuation budgets are noted for: PROJECT 6 months 12 months l/74-6/74 7/74-6/75 Page #112 EMS-Idaho 18,500 240,275 92 #l13 EMS-Montana 26,000 144,749 94 #114 EMS-Nevada 17,131 . 195,760 '97 #212 Areawide Neonatal' Intensive Care 10,000 234,611 105 #312 New Health Man- power in Mountain States 15,301 96,030 181 WO/DRMP 5/20/74 .- a yhY 35t1974 COMPONENTS BY REGION 06174 COUNCIL CCIHPONENT TITLE _ -- _. . . . . _ _. - _ _... -.. .- -. - - 32. NCUNThXN PROG YR Od . _. WE STERN COMP ___ NO . _. .~.. coo0 PROGRAM STAFF REG OFbE ._ . coo1 PRDGRAM STAFF IDAHO ____.---. CD02 PROGRAM STAFF HDNTANA 0 co03 PROGRAIl STAFF NEVADA -- `.-.-- .-- :. coo4 PROGRAM STAFF WYOMING _ .__ .__ _-___ _._ __ .- . .- 0004 AREAHIDE NEONATAL I C' ... ."- -_..-. - .- - .n uoo5 , E H s __- .._ - POGb HOYE HLTH CARE.MT STATES _ __ _ _ ._ . _ -- -.. -- . 0056 ACCFSSIEILITY DEVELOPMENTAL ACTIVITIES DOD9 SPECIALIZED SEKV DEVELOPMENTAL ACTIVITIES _ _- DO10 .__I ..___ -_-.-.- I- DOi - -- - --. 0012 __ * ..- _ DO13 CONSUMtR PARTICIPATION DEVELOPMENTAL ACfIVlTIES . . MECHANIhiS DEVELOPMENTAL ACTIVITIES NEw SKILLS DEVELOPMENTAL ACTIVITIES NEW HLTH HNPWR DEVELOPMENTAL ACTIVITIES ^-. __-..- -.- _---- .__ 022 .- NEW HLTH HNPWR MT STATES . . . ^.. . 023 KEG HLTH TRNG NFTWORK q26A .__. .- _ - _.. _..- - _. - --Y 0266 . 031 ENS IUAHO .* Eus MOMTANA REC EREAST CA DETECT REG ME0 AUDIT SYS DEVELCP ME0 i"DIT ?ROG DEVELOP MONTANA - REG NURSG CARE AUOfT PROG DIRECT ENDIRECT TOTAL REQUESr REQUEST REQUEST - 65,802 3bt4ti 38 (096 349094 391863 I 2071969 181 d60 811331 38,116 32,890 20~898 lr955 48~525 6r813 89,074 259r282 222 ~733 131,071 80,676 177 r547 19rlll 68.r236 12,126 6,954 7,345 6r466 71306 26rbri2 141 SOD 21419 .3,78Q : 3,023 ltbb3 244 3rfBO 105 69956 209416 171542 13 r678 13,011 29~8.58 4tOb7 fr835 77,928 43,418 `-. .- 46,241 60,560 ' 47rl69 234rbll - 22,561 2,199 --. .- 52~305 6r918 96,030 ._ _ . 279,b98 240t275 1449749 93,687 207~ 405 23,178 76,071' . MA e 74 REQUESTED a LISTING COMPONENTS BY REGION 06/74 COUNCIL MUUNTAIN _ . PRO6 YR 06 STERN COMP COMPONENT TITLE DIRECT __.. NO .- -. REQUEST ..-^ ._. _.. 034c PHYS OFFICE LAB IMPROVE . 22,529 _^ _ 035 _ EMS SYS DEV SHERIDAN CO 219294 ---- ._- _ --___. 037 - -- - HiPl SCREENING HYDblING - ..- - .- _ . . - . . 36,143 . _-. .- ._ 039 -SHARED iERV PROJ 30,290 - _ ..- - 040 WY0 ACTIVATE0 PT - `31,345 .-. ..-- -___ .__- 041 CV' 01 S CONSIJLT . .._ -. `... , 17~645 .- -.. __._~ 0.42 DlS DETECJ HYOHING 28,741 _ _ 043 ;ILTH CARE IWPROVE RELATE0 PSRO 53r784 ..---. _.- -_.. _ ,^_ .._ 044 -- Cu AND KIDNEY' DIS REGISTRIES _ _. . _ I 39r838 045 OPERATXCN SEARCHLIGHT 50r035 ._ OF CCMPDNENTS...~....32... --__._. __._. ._ _" _ _ REGION TOTALS 2~168,250 --._- -..-....-- ._..._... --_..-- --- -I ."_._. . . ---. -- - - .-.-_ _ -_ :NDIRECT REQUEST 1~814 lr663 2,879 2,722 1,663 Iv361 2,268 9*912 3,176 `3,932 241,106 I TOTAL REQUEST _ 249343 22,957 - 391022 - 37,012 231006 19,006 .--- 31,009 , 63r696 43r014 53t967 2.4099356 .- -. RMP Nassau-Suffolk RM 00066 __ MAY/JUNE 1974 REVIEW Request: $1,096,910 Committee Recommendation: -O- Overall assessment by individual reviewers: Poor Critique: This application requesting support for an expanded staff (from 8 to 15 professionals), six ongoing projects and one new project, was discussed at length by Panel B. The reviwers pointed out that this FU@ had previously been an I?MF'-CHP agency under one director with priorities for the two-county area developed jointly by the RAG and CHP Council. The dichotimous arrangement was terminat.ed last Fall, with the RMP concentrating on the non-planning priorities. In the past year the RMP has had three coordinators, but the program appears to represent a holdover from the original coordinator in the grand design of previous activity and programming, The present staff, it was noted, appears weak; no member has an advanced degree, including the coordinator and the backgrounds of the proposed new staff are in the fields of social sciences. The reviewers were concerned that staff does not have the leadership qualities and experience that are needed to develop health care programs based on the stated priorities. Furthermore, the reviewers questioned the effective functioning of the Regional Advisory Group and the grantee during the hiatus of staff leadership. The RMP has not complied with the RAG-grantee policy although it is understood by staff that this may be finally near resolution, The problem up to now has been a preponderance of corporate board members on the Regional Advisory Group. After considering the history of this RMP together with an analysis of the current application, Panel B recommended that this RMP grant have an early, orderly termination. The Panel reconsidered the recommendation upon reviewing all its actions, but came to the same conclusion. The Committee concurred, While no funds are recommended, Committee urges that Council and DRMP make available funds that may be needed for appropriate phase-out costs. additional JULY/AUGUST REVIEW Estimated request as of May 1974 : $850,000 NASSAU-SUFFOLK Regional Medical Program Coordinator: Rajeshwar Prasad Staff: Full Time Prof. Full Time Other Total 11 Funds Requested: May 1st Rtd 00066 On duty since: April 1974 2-l/2 yrs. 8 Proposed: 15 3 7 22 Total . . . . . . . . . . . . . . . . . . . -1,096,910 Continuation.. 46$.....,.. ( 682,760 ) New,.......,..!;l!........ ( 50,000 ) Period of Time Requested: All projects core staff and activities are within 6175. Activities Proposed: Refer to Management Information Systems @IS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975,) . RM 00066 I * Nassau/Suffolk List any continuation project or staff activity for which substantial increase over annualized current funding is requested. Project 21, Nassau County EMS Project requests $288,750 a substantial increase 'over the 43,015 & 53,308 the project received to date, Also Proj. 22 is requesting 5116,516 a request over its 43,014 & 53,306 (See EMS below). HMO project: NONE EMS project: Projects 21 & 22 represent $405,226 or 55% of the 732,760 dollars N/S RMP is requesting. Of the $405,266 EMS funds, $229,998 or 56% is for equipment. EMS Project 21 requested 208,000 for equipment. The HS consultant in EMS equipment has been asked to look into this request since we received additional information and still cannot make any judgements. The NYS/EMS Department Gee18 the Nassau request is to expand the existing gaps, NCR&D comments have not been received as yet. PSRO: NONE Kidney: The existing kidney projects were reviewed by one outside the region consultant (Arkansas). He indicated both projects were complementary and supplementary but might be brought into a closer working affiliation. CHP comments: Favorable.CHP comments were received. __ ._ ..- ._ _. ._ ___. _ _ MAY m 4~ _`. .._ .-_ .__ . _ REWESTED LISTXNG COHP.ONEN REGION 06174 COUNCIL NASSAU SUF PROG YR 04 TERN COHP . ..-..NO _ ._- COHPONEtiT TITLE ..__.. ._ - . _ . COO0 PROGRAM STAFF .SUFFOLK CO DATA BASE STUDY FOR AMBULATORY CARE ' - coo4 -._---.- --.__--._. - -_.-. CfYHPREHENSIVi HOHi CARE PROGRAM. _ . I _ I . 001 009 REGIONAL DRUG INFORMATION NETWCiRK OF L I 014 NASSAU SUFFOLK REGIONAL ORGAN DONOR PROGRAM ;- -- .- __ --_.-_. _ _. NASSAU COUNTY EMS .PROGRAM' - .. . . 021 . 022 S C `3% TRAINING PROGRAM -.. _ _ _ __- 023 &NAL OISEASE COOROINATION & ED -PROJECT __-- -_ -.._ _-. _._ __._ _. _ --. __I __ _. _.. ._ _ _ -_ _ -. .-.- -. -. _ _ _ IF CDMPONENTS.. 8 . REGION TOTALS ---------.- ---. _. . -- __---.--_*._ _ . . .- _. . ..- - _ - - - _ _ _. ".. _ -_.--.- _..__..._ ._... - -.. _ - ._ _ _ A- .-_ -- - .- -.- _ __ ._,._- .1..-- _._-._ _-__ --. ---.- .-. -.-.--- __.- _~ _.- - .._ - . .-. -. -. .-. -_ _-. _.. __. .- -_-. _._. ._ --. -- _-...--_- - .- _-_._ ..- .-. -..- - -- . _ .- _ ._ .-. ._. - -.-----.-- .- _- --. -- _-_---- .- ----. -. .- -..-.-. . . _ _ . . DIRECT INDIRECT ..I REQUEST f$QlJEST 3641150 50,000 102r312 .-- 78,615 209303 288,750` - :X16,516 76t264 &t096t910 ; -- _. _ 23 TOTAL REQUEST 3641150 50r000 102,3l2 - . -.. - 78?615 --' - 20~303 288~750 - -. - . 1169516 76,264 lr096~910 ..- I ..-. . _ . ---. __. -_._-... _- --.. .- - - ._ RM 000 68 - e May/June 1974 Review Request: $962,937 Committee Recommendation: $912,000* Overall assessment by individual reviewers: Above Average Critique: Review Committee considered the Nebraska RMP continuation grant application request of $962,937. Reviewers felt that the goals and objectives are well described and within reasonable capacity of Nebraska to carry out. There is a close relationship between the goals and project activities included in the proposal. For example, the two major program thrusts involve six health service education activities and ten different home health care proposals. On May 22, 1974, DRMP received a letter from the Nebraska RMP which . contained copies of three out-of-state Renal Technical Review Committee comments pertaining to project #52 - Statewide Renal Disease Support Plan. All three reviewers had negative comments toward this activity. Program leadership and Program staff were considered satisfactory. Estimated request as of May 1974: $150,000 * Review Committee recommended $912,000 which was $50,000 less than requested. This recommendation was reduced by that amount to comply with the AD HOC Technical Review Committee which in essence disapproved Kidney proposal. July/August Review MC0 6/4/74 STAFF SUMMARY FOR MAY REVIEW NEBRASKA REGIONAL MEDICAL PROGRAM: RM 00068 COORDINATOR: Donald Matthews, M.D. 8n Duty Since 4/5/74 STAFF: (FTE) Total - 11.5 Professional: 7 F.1;. fi. 6.5 Other 5 Additional proposed: 0 FUNDS REQUESTED: Total (D.C. & I.D.C.) $962,937 Program Staff 279,780 Staff Components 51,195 Total Program Staff & Components 330,975 Projects (34) total Continuation (9) 631,962 285,030 New (24) 346,932 Target Funding Amount: $840,000 CHP COMMENTS All negative comments from CHP "A" and "B" agencies except for Project #47 e have been addressed by Nebraska RMP Regional Advisory Group. A follow-up letter from CHP and the Nebraska RMP's response is in the process of being submitted to DRMP. ITEMS FOR ATTENTION 1 - Kidney - Project #52, Statewide Renal Disease Support Plan is a new project activity requesting $51 920 Nebraska RMP has complied with Federal Regulations for interim'approval from S.S.A (see page 456 of application); DRMP Staff recommended out of state technical review for proposal; Dr. Matthews, Coordinator, agreed and project is presently being reviewed by three out of state kidney consultants. 2-- Dr. Uatthews provides 50% time and effort. Mr. Buettow, Deputy Coordinator is full-time and has been with the Program since April, 1968. 3 - July 1 expected request - $150,000. `m 1974 _ . - . . 06/74 COUNCIL 5E NEBRASKA PROCl YR 03 !I2 CU?ETINENT CC?!? NC COO0 . _ -- _ _ coo2 . . _^.__ -- _.___ ._ 008 039 _-.- _ 015 020 c23 025 02-s - ^ $25 Li'i _ COMPONENT TITLE .- PRQGKAN SThfF - LEARNING RESOURCE CTR , NW NEBR HLTH ECUC -SERV CTR . CF?i NE9R COMMUNITY HLTH EDUC CORP COWPPE EDUC AND DETECT CIAR TEACHING REHAB NU PLATTE COMMUHITY HLTH EDUC CONSORTIA M E CENT C@!-fMIJNITY tlLTH EDUC CONSORTIA S w ::E5R HLTH EiUC SERV S E NESS tGti!UN:TY HLTH EDUC CONSORTIA ---.... .- .---._- -_ 034 --' H&ME HLTH SATELLITE FRIEND - -. - _. ._ 035 HC)ME HLTH SATELLITE GENEVA 035 HOGyE HLTH SATELLITE %AHGO --.. -~. _._ .- - .__ _ .__.. _ -. - 037 H(C7:4E .HLTH SATELLITE WEEPING WATER 038 DAY RX SERV ELDERLY AND DISASLED - - c39 HDME HLTH SATELLITE CALLAWAY -._ .-.-. _ - -- G40 .---- HONE HLTh SATELLITE DUNNING 3 _ 041 HG?!E HLTH CARE AGY YORK 042 NCME rlLTH SATELLITE CRAWFOR .- -.-_ -... ._. `043 HCYE HLTH SATELLITE HARRI SCN 044 H3ME MLTH CARE DEVELOP DIRECT REQUEST 235,fiO 42t860 33r300 40tooo 27.000 33,000 17,730 47tooo 32tOOO 27,030 20,000 5 too0 5tooo '5tOOO 5tooo 19t150 4 too6 5tooo 7,500 39625 4r7a7 13t200 -. . . .- INDIRECT REQUEST 441650 8,335 . 0 0 0 0 0 0 0 0 0 -_. 0 0 0 0 _ 0 0 _. 0 0 0 0 0 .a OS lo-23 . ; TOTAL REQUEST 2799780 51t195 . 33,300 48tOOO 271000 33tooo l?t 730 47tooo 32tOO0 27t 000 20,coo 5tooo 5tooo 5tooo 5tooo 19t150 5tooo' . 5tooo 7t500 3t625 4t787, 13tZOO 5 NEBRASKA PROG YR 03 Ir, CONTINENT -.-I.. ._.- ._^. ._ -. .- _ _ .._ _. .._ --.. _. __.___-.. ._ CClMP `NC 045 046 047. 04P 0451 050-. 051 052 053 054 0'5 . ..- .._. -_ _ 056 r CF .UPlYCNENTS . . 35 CCMPONENT TITLE EARLY DETECT CLIb!ICS FLGERLY NURS CLINICIAN SPECIALIST. INNER CITY MATERNAL AND CHILD HLTH OMAHA RESERVATION NE,IGHl?ORHOGD OENT SCREENING D=NT HLTii EDL'C . ^ DENT ?T MGMT HANCICAPDED &lMPRE NUTRITJCN EDUC STATEWIDE RENAL DIS SUPPORT SHACtEO HOSP ASSOC RESOURCES AND EDUC CYI LDREN'S HLTH `EVAL CTR CRITICAL CASE ME3 CHRCNIC RESP CIS AN6 ALLERGY - - INiT PHARM- SERV _. _ REGION TOTALS -.. __ .-_ ._ _ _ _ DIRECT INDIRECT REQUEST REQUEST 4,OOb 0 33,045 0 121150 0 11,652 0 5rlOO 0 15,300 0 33,688 0 51,920 0 17,300 0 23,695 0 28,500 0 27~200 0 51120 0 9101552 52t385 US .e O-23 TOTAL REQUEST 4,000 33,045 12~150 11~652 59100 15r300 339688 51r920 17,300 239695 28r500 27r200 St120 962t937 Iti? 000 42 .--.. ~tcr~~~c!:'t: $3,970,024 -_._ -_--. .---we- ----c_ CcmnJ t1.c~ J:ec:ursi1:c17cJ;!l..j cm : $3 190 000 .--l---L ._____- -- (jv(~r;jl]. ~:;s(-~z.;IIIcIIL by :Jud~.viclu;il. rc!vic'wcrs: Superior in all aspects -w- __---__I cri Ci.C~Ul~ : Panel B considered NJRMP to be a superior region in all respects: strong, effective leadership; an excellent, experienced staff in terms of numbers, skills and competencies; and a RAG, not only representative of the Region, but one whose members have remained interested and active in reviewing the accumulated.data to determine needs of the health care delivery system and then charting a programmatic course to meet those needs. Programmatic efforts have been tailored to span the entire set of Goals relating to access, quality assurance, categorical and cost containment as well as a beginning exploration as to how CHP and RMP may prepare for * new legislative developments. The Region was commended by Committee for some of the fascinating areas in which the program has been iuvolved; particularly new issues such as better access, emergency medical service, quality of care assurance, improvement of health care services to the inner-city poor, setting standards for quality for certificate of need / type activities, and for the assistance given to the development of CHP "b" agencies in N.J. (major support given to development of 3 of 4 existing "b" agencies in New Jersey).. Relationships with CHP within the State over-all appear to be good; however, one "b" agency director submitted a #scathing letter recommending disapproval of the entire RMP application. It was later determined that this "b" agency director had held the position for only 4 or 5 months and that after review of the application, the "b" agency board recommended approval. Committee concurred that this was a superior region and would well utilize funds made available to it, . . I JULY/AUGUST REVIRW ,' Estimated request as of May 1974: $600,000 NEW JERSEY Regional Medical Program Coordinator: Alvin A. Florin, M.D. Staff: Full Time Prof. 16 Full Time Other 8 Total 24 Funds Requested: Total . . . . . . . . . . . . . . . . . . . 3,970,024 RM 00@2 On duty since: 1967 Proposed: 16 10 26 , Continuation...........,. ($3,145,024) ( project); $825,000 Program Staff * New.,.,..............,,.. ( 1 Period of Time Requested: July 1, 1974 to Juhe 30, 1975 Activities Proposed: Refer to Management Information Systems (iUS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) . * ." mnnnL3 New Jersey List any continuation project or staff activity for which substantial increase over annualized current funding is,requested. HMO project: NONE EMS project: #28 - Continuation of pre'viously approved activity PSRO: Quality of Care Assurance Project f34 proposes to establish 8 PSRO organizations in the federally designated areas for N.J. by assisting in organization, incorporation, staffing, and enrollment of participating M.D.s. Kidney: Project #33, Renal Dialysis and Transplant Program - Continuation and expansion of previously approved activity. Produced a statewide plan for ESRD for certificate of need. CHP comments: Comments from the CHP agencies are attached. It should be noted the the NJRMP played a major role in establishing three of the four "b" agencies in the state, m/5/20/74 HAY 4 . . . 0 _-. .-:. ..:. NEW JERSEY _ PRQG YR 05 &RN .. COHP ------_- - _._. - __-_ NO 1- COMPONENT TITLE - coo0 PROGRAW STAFF 010 CDHMUNITY HLTH XMPR PRIM ~HEUHATK HT 01s . .- ._ 025 -.. 028 -- EMS . 033 REHAL DIAL AND TRANSPLANT -: ._ -__ _ 034A EUAL CASE ASSUR - PSRO -034f( QUAL CARE ASSUB - SPECIALIZED SERV` .. Q35A CD&T COHTAINMENT - HOSP SERV - - -- ..___._ 0358 - CDST CONTAINMENT - HOME CARE 036 CO!6MUNXTY RASEG HYPT CONTROL DIRECT _ REQUEST 825,000 lr048,400 .- -. ..I . ._ . . . _ 254,680 72 9920 226,080 2251000 * 184,944 482~200 --- -l%o,ooo 5101800 INDIRECT REQUEST _. 0 0 -_ 0 0 0 . 0 0 0 0 0 ; I TOTAL REQUEST 825 9000 1.048r400 254,680 `-- - "- 72,920 * 226 F 080 225rOOO 1841944 482r200 140?000 510,000 COuPCNENTS -...._ 10 . . . . ._ . _ _ _ _. __ REGION TOTALS __ 3r970r024 0 ..-- 3t970r024 - ---* ---.. -_-._-._. -_-_- _-- ._ - ___ ._ _ _ _ _._ -. _. - _ _. _. _ `- .`. -._ -_- . .-.. . I.._ _ ..- .- --. - - -. ..-- -- --- -..- -____ --. .-- _. _ . . o ?? ??? o .---_ -_ -..- . . . . . .- ---_.- -_.. .- - _... -.. RM OOOA l~ec,ucst: $2,774,838 ' i Committee Rccommc~~c~atio~~: $1,644,754 * Overall assessment by individual reviewers: A'ERAGE o Critique: Review Committee considered the NMRMP continuation grant application request of $2,774,8'38 to be extremely ambitious. Tne reviewers noted tnat tne seleci;ion or' a staff pnysician as new Program Coordinator will provide a continuity of program leadership. ' . The present program staff seems to be adequate and capable. In reviewing the criteria of program leadership, the reviewers felt the ,@ Programs' Executive Standing Board was too dominant over the Regional Advisory Group in the decision-making process. The RAG Budget Committee needs to be reactivated and more involved in the budget decisions. Reviewers were confused about the relationships between NMRMP Program Staff I and individual project directors. Although several project directors are located in the same quarters as program staff, they operateLiindependently but complement'program staff activities. .The requests for oroiect ~~ #18 Health ~Educat - EMS in Rural Areas and project. #25 - .-ion for the Public were too ambitious:.-'-The reviewers felt that the project ot jjectives could not be accomplished within one year, Both project; did not adhere to DRMP Principle of Decremental Funding. Estimated request as of May 1974: 0 * Also, project #25 - Health Education for the Public should have a technical * review site visit by out-of-state consultants who are familiar with the RMP process. 4 . I MC0 6/4/74 rJ 4 STAFF SUMMARY FOR MAY REVIEW NEW MEXICO REGIONAL MEDICAL PROGRAM: RM 00034 COORDINATOR: Richard A. Walsh, M.D. (Acting) On Duty: 5/l/74 STAFF:FTE) Total - 24.5 Additional proposed: 5 Professional: 15.5 Other: 9 Professional: 5 Full-time 3 Part-time 2 FUNDS REQUESTED: Total (D.C. & I.D.C.) $2,774,838 Program Staff 653,664 Projects (11) total 2,121,174 Continuation (8) 1,917,366 New (3) 203,808 CHP COMMENTS: CHP "A" and the two official CHP "B" agencies met on April 11, 1974 for a joint CHP Review Connnittee meeting. Comments are included on pages 62- 72. Dr. James R. Gay's May 1, 1974 cover letter to Dr. Herbert Pahl contains a response from New Mexico RMP RAG which is included as attachment #l. ITEMS FOR ATTENTION: , I. 2. 3. Project #18 - EMS in Rural Areas; $911,106 request for substantial increase from previous two years of support. Project #25 - Health Education for Public; $302,955 request for substantial increase from previous two years of support. Richard A. Walsh, M.D. is AEting Coordinator of NMRMP for 5/l/74 to 6/30/74. James R, Gay, M.D. expects to resign 6/30/74 but will &main as consultant to Dr. Walsh. The NMRMP RAG will forward its recommendation for the permanent appointment of a Coordinator after the May meeting of the NMRMP Executive Board. `0 5r1974 REQUEST COMPO OS LISTING BY REGION _ ..^_ -. _ - . ._ 06174 CWNCXL 34 NEW MEXICO PROG YR 06 MID ~~NTINENT COMP COMPONENT TXTLE ..-- --._- --.. --...--.NO-- ._ ._ _ ___ _. . _ I .- _- _-. --.. _ - _ coo0 - . PROGRAM STAFF .- _ ~_ _ _-. _ __ 018 ----.-..-- .-- .---. -__. 020 - _. .__-. -. _____.._ .._ _ 025 OZR 029 I 030 031 -- ._- -..--- ..-._ ._ _. 032 033 034 ---. -.- -- . ..---_-_.__ - 035 UO OF COHPONENTS 12 -- -- - --.. -.-. -- . . .._ _ _ ~. . - - -_--.- .- . ..__. _ - .._. EMERG HLTH -SERV - - . --Sk' &ES - .._ . .- HLTH EGUC STATEWIDE HLTH NEEDS ASSES .- HVPT 940NATAL INFANT TRANSP - STATEWIGE GENtTIC CTR C@MMUNIM HLTH RESiXJKCE DEVELOP - .. `HLTW RESOURCES REGISTRY REG HLTH RES PLAN AND DEVEL POiS!3N CONTROL/DRUG .-INFO CT.9 `. - -' _ . _ _ _ _ . REGION TOTALS - .- - - - ^ _ ._. . .- -. - - _ . _ _..- _ .-------- .---.--. __... . . DIRECT REQUEST 565,38? 8429932 . 43~563 215,012 699360 ._ 99,060 29,833 5OIOOO 16X*257 909550 4br115 192;608 2~465~677 INDIRECT REQUEST 88e277 68r174 4,587 27~943 59737 12r729 lr713 10,473 27,891 16,862 7r349 37,426.. 3099161 # TOTAL REWEST - 653r664 911,106 * 489150 3021955 75,097 111t789 319546 60~473 189rl48 107,412 53r464 2309034 2r774r838 . a ~orrJ;iittcc m!cornnc!lx.latioll: $2,500,000 . &era11 assessment by individual reviewers: Average ._ - . . Critique: This application requesting $6.4 million for two years, was reviewed in depth by two reviewers, one of whom had only the written word ~to study and the other who had been on the site visit two years ago. Both xeviewexs were impressed with the proposed projects that address a real laeqd in New York--namely, a better network among the clinics and the public md private hospitals. But.the reviewer who was a former site visitor w&s also impressed with the improvements that had accrued in this program despite pha,se:out and other uncertainties--the change in grantee, the quality of staff leadership and the increased functioning of the Regional Advisory Group. : l&e Committee was concerned about the advisability of initiating projects that 9 : weded at least two years funding which was requested; but they concluded that a number of the projects represented the culmination of several years planning and development, that the projects were needed, and that other sources of funds 1 cay be forthcoming if the initial efforts prove effective. The Committee felt @bat additional staff were needed. In consideration of the population served 3 I c i by this RMP and their health needs, the quality of the proposed projects and ehe improvement in the management and grantee-RAG relationships, the Committee mecommends that this application be approved at.$2.5 million level and that l?his region be given a high priority for distribution of funds in the July- I 1 August review. i i i -i i .( JB;ZY/AUGUST REVII% Estimated request as of.May 1974:' $2,000,000 ': a" . Rt4 00058 NEW Yw Regional Medical Program Coordinator: Jesse B. Aronson, M.D. On duty since: 13177 Staff: Full Time Prof. 7 Proposed: 7 0 2 Part Time Prof. 5 Full Time Other Part Time Other 3 0 Funds Requested: 7/l/74-6/30/75 Total . . . . . . . . . . . . . . . . . . . 4,330,808 0 7/l/75-6/30/76 3,033,819 Continuation.,......,.... ( 859,430 ) New ,*,*.,.*.....*.....*.. (2,436,289 ) Staff-Central Core Activ. (1,035,089 > Period of Time Requested: . Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) m 00058 List any continuation project or staff activity for which substantial increase over annualized current funding is requested, HMO project: Project 837 - Comprehensive Medical and Health Care Service at Maimonides Medical Center - This may or may hot be an HMO, depending on the payment mechanism, EMS project: Project #62 - Treatment in Municipal Hospital Emergency Rooms - This may or may not be an EMSS start up. It certainly is not comprehensive; i.e., it does not purport to establish a system. On the other hand, it does not appear to "tie in" to an overall EMSS activity in the city or the state. Perhaps, it is an excellent, highly needed project; however, it still seems to sit in isolation and is not even (apparently) coordinated with the New York State EMSS effort. PSRO: Kidney: . CHP comments: The CHP review;, although cursory, was acquired and was favorable. Conclusion: This program is on the move and needs encouragement. It is more structured, better managed, and appears capable of making an impact on the complex workings of the New York City health care system in the near future. There is little doubt.that money spent in this geographic area would be reasonably well managed and would find itself in areas of critical need; however, it is difficult. to visualize the current stafE and organization effectively administering nearly 5 million dollars in the next fiscal year. A reduced funding level might encourage a consolidation (streamlining) of the multiple hypertension, kedney, manpower and 0 primary care activities. To bripg these clusters under some sort of an umbrella would seem to strengthen the overall program and make it more effective with fewer dollars. E0/5/20/74 8 NYC HETRO. ._~ *. PROG YR 04 * ASTERN C0MP - -w---w - _._. NO. -._ _ .._ _. _ COMPONENT _ __ I TITLE -. - . _ coo0 PROGRAH STAFF .-.. --. .--. ._ - __.__ . coo1 --- HYPT PRCC DEVELOP ---..---- -.--- -_ -.- --.- . ..- _ _ coot IMPACT: NATL HLfH INS ON HLTH PROG 034 nwwR ~NFO CLEARING HOUSE -. - .-.- _ _ ._ 037 COMi MED & HLTH CARE SERV 03R" - AMi HLTH CARE ELDERLY 041 \ PEEKSKILL AHRULATORY HLTH 04L- HOSP SATELLITE AMI~ULAT~RY --. ---..-_ _-__-* .-.. _ _.. .-_. __ 045 PLAi Rfi AFFILIATION EDUC 04R NY NJ REG TRANSPLANT , ' - _ _ CARE CTR CA-RE -- ._ - -_ -. . .- - - -.-_-_-.- - --.. ._ _ 052 EL BARRIO YOUYG PEOPLES CLINIC'-. -. ..' -_ .-' 053 HLTH MNPWR COUN~ELLING ~ERV .- .- -- --. --- ..-- -. - _ .,_ __. . 054 I.NS;.EH.ERG HED -~ ..- - ._. I__-.---- ..-. .- - .._._. .- - - -- -.. _. _ _ oss DEMO DEL COMP HOME HLTH iERV - _. . .._ -- - - - . . . _ ._ _ .- -_ 056 `NURS PRACT --- 057 -- ,- HYPT REFERENCE LAB -' -.-------.----_ _ _. - .--.. - 05P USE UNION'MEMBER COMPLIANCE MECH HYPT CNTRL .-. -_ . ._ -.. .-_ - . .___ 059.- _ DIAG WED SOtJCGRAPHY TRNG - 060 `XGAN ACQUXSTTION --- ..I --.- ____-- - .--.. EVAL HYPT OX-RX b HOSPi .- 061 . - - 062 IMP CARE PTS SEEK EPISODIC T RX MUNIGIP HOSP EH RH DIRECT REQUEST INDIRECT REQUEST 371,779 88t514 66,300 15,978 397,500 95,798 2941624 -0 itl22.603 0 70.26i)' 0 214~926 0 4751562 0 190,804 --' . __ _ _ 0 120t693 .- 0 20t241 -- -'o 192t044 0 183t500 0 . . 513,257 0 173t725 0 354481 0 - OS lo-23 TOTAL * REQUEST _ 460,293 82t278 .- 493t298 - . . .._-. 2949624 c ltl22t603 c -?O.t260 - -- 214t926 C 475,562 c 190t804 -' . 120,693 ~- C .' 2ot241 --- ..- 1921046 183tSOO 513t257 173.725 3541481 120,637 0 120 t637 182t332 0 182t332 107t160 0 LO7t X60 96,653 '.'- .Q` 96,653 947 t632 0 947t632 c C c C c -.--.-.- -- - .- -. - ~_ . . _ _. _ _ NYC UETRO _ PROG YR 04 STERN COW .- -. _-__ --.-NO. .._. . . -. OF ChblPONENTS 22 - I _. ._ - -.- _ - _ -. ~. _ _ _ .__- __ _ _ _ -... - --.- - _-...- _- -. -- -----. _ - -. . ._ LISTING .* OS?4 -23 _ _. _ -. _ 1 COMPONENT TITLE OIRECT INOIRECT TOTAL . . . _. REQUEST REQUEST - REQUEST - - . REGION TOTALS 6,216,715 200,290 6,417,005 ._. .__ :-. . . . __ _. __ _ . -_ --_ _. _. -.- - --.. - . ^._. _._ - ^. - .._ .__.. _. .-. _. ._ -_ _ _.-. - ._ .-. -._ .- ._ ..__._ ._. .."RIsA --"II-"- l&l 00006 Iommi.ttcc lCcconvllcrltlnt:ion: $2,375,522 -- --- Overall. ksessment by Individual. Revi cwers : Superior -- Grit i quc : -_.- The reviewers regardc.1 Lhe EK.XW as a supcri.or progyam, whose past performance has been outstandi.ng in terms of designing programs to meet the needs and providing servj ccs to arcas that are deprived of health care. Al.though there has been a change in leadership, the IEW Exccuti.ve Director having been with the program as Deputy' Director for five years, was thought to be quik adcqtinte in providing leadership and direction to the program. The: Regional. fldvisory Group's performance j.s consj.dcred good, CUP relationships are good and the program staff though small. appears to p0:;z;CSs the necessary skills and competence to manage alrd monitor program activities. The present application, although over-ambitious and some of the activities inappropriate, is believed to be congruent with obj ecti.ves and priorities . the region's Reduction in reconm~ended level based on the fact that some were considered over-ambitious and some were consid.ered to for DRMP funding , 3ULY/AlJGIJST REVIEW Estimated Request as of May 1974: $400,000 -- DWJ'/IKID SCOB/G-6-74 proposals be inappropriate f"' - MAY REVIEW STAFF SUMMARY Prepared by: ,SgqE W&L P T CKAVEN C;YTY HOBL HLTi CARE AREA HLTH EDUC SYS REG C D & E ST?OKE REHAF! CHILDWOCD CA PSRCI HYPT EDUC REFER DURHAM HIGH 6 P EOUC MCGEL CLINIC AND COMPLIANCE INDUSTRIAL HYPT .- HYPT PHYS EDUC 3771097 50,000 _'- --_ 48,403 21~424 83,117 34r308 35,000 539103 809404 54,481 631725 47,742 39r397 63i381 179998 .20,000 125,215 309240 52,008 33,440 43,840 `31,325 INDIRECT REQUEST 79.247 0 0 3t720 15,656 0 0 0 0 .O 16t123 0 0 0 tt181 0 0 31665 6r303 4,053 5 r313 3t797 034 .Y o-23 . - -b TOTAL REQUEST 456~344 50,000 489403 259 144 981773 34,308 35,000 539103 80~404 54,481 79,846 47,742 39,397 63,381 20,179 20t000 12?r215 33r905 58r311 37*493 49,153 , 35* 122 MAY 15,1974 - _ __ .-- _ _ . a - .. ---..--- ..- .. - .__ I CAROLINA _. PROG YR 06 I CENTRAL - COMP _ _.. .___ NO ___ _ -. __ _ ._ ._ COMPONENT TITLE _ . __ _. . _. _ . , .- ._.. . . -. . 066F HIGH b-P pU8 EDUC _ ----_ 066C -- NUQS TRNG -"-.- -. _. .- - . _. HI~-I SCHOOL- HYPT EDUC 6. CNTRL 066H - -~-_ -_ ._ . 0661 -. EDGEGOMSE CNTY HYPT CNTRL a._ -. ._. -- ~_. .- Q66J SHELBY HYPT CNTRL .__- -- ---_ _... ._ D66K HEG .R HYPT CNTRL - 066L 067A - ._.__-_ -----... _ 0673 067C .~ .-.... Ob7D 067; - _.. __-_-.--_~ __._.- 067F Oh7G . _ . _ 06x+ 067I ~- db7J 069 ) 069 070 DIRECT INDIRECT - TOTAL REQUEST _. REQUEST. REQUEST _.-_. . . ---- 34,750 4~211 5tooo 0 ..- .- . ._. _ _ 649100 11709 31~985 0 30,000 0 .-. 144rooo .. " -0 NCl?MP HYP PG;LI 1?4PA$T MEASURE AND DESCRIPT ST&T DATA DASE RURAL PRIM CARE DEVELOP OEVELDP GUIDEBOUK i. MATERIALS RURAL`CLINIC DEVELOP DOCUWENTARY FILI4 WI3 LEVEL PRACT RURAL AREAS PH~S RECRUIT DEt?O pHYs. STAFFED RURAL HLTH CTR DEMO .- .- ." -. CDNT EDUC PHYS EXTEIvDERS RURAL PRIH CARE N C RURAL SATELLITE CLINIi WORKSHOP 38,975 -.. .- 31,875 58,000 -. 16,400 38,961 5*000 -..--.- .- -. 65,809 30to00 --. 144rooo 30*000 41*500 , 90,000 319155 38~975 _ _ __ - 31,875 58,000 16,400 RURAL'HLTH CLINIC OPERATIONAL & E&P A-SSIST _ _. .-_ .._ . 243r100 '. -- o' - 243t100 .- --. - RURAL.H;T)? SERV EVAL QESIDENT INCENTIVE ~CCMSiJf~tR / PRGVIDER CHNC .- . .- STATEUIDE NETYORK UNXV LINKED HOSP LIBRARIES . PERXNATAL NURS SPECIALIST TRNG _. _ 20,000 0 2orooo ._ 10*000 0 10t000 54,646 29tD21 -. 839667 354~ 572 8,421 -~ 362~ 993 839626 `7,081 909707 _ . _ . ._. .-.._- _ 071 - ELEM SChOOL HLTH CUERIC 36,540 3b.540 071 PFiGBLEb! ORIENT XED RECORD WqRKSHOPS 32,123 8,872 4or 995 __- . .- . .-._ ..- - -. ._-._ .--. __ _ ..-.. __. MAY 74 -0 * _ - .: - -.-- -- - -.`. -: .-(. -. -- `- * N CAROLINA PROG YR 06 1l-H CENTRAL CDt4P .' CDMPONENT TITLE _. ._._._ - ______ _-_. NO __ . . 073 CdNSULT & TECH ASSIST DEVELOP HLTH SERV DEL MODELS 60,98L 6r212 -. .- . 074 HOME ~~Tfll ~ERV CRAVEN NORTHA~~PTON ONSLOW ROUAN co - _._-_.. ._ _- _._. - _.._ -- ,___ - --~__-_ _ I _ .___ . _ -- .- .C!F COMPONENTS 46 REGION TOTALS I . --T---.- -.__ .- .__._ - _ ._ _ _ _ _. . ._ _ . - _-__ --. ..- .- _. . . _ _. " .._ . . . DIRECT INDIRECT TOTAL T REGUEST REQUEST ..~ REQUEST 103 9694 0 679193 103t694 .- 3.052~670 205,585 3r258t255 @Y/JUM`: 1974 REVII'W &?qucst: $774,057 ' (&mittcc Rccommcndation: $582,517 *: Averaqe and Below Average :i r ', Overal. assessment: by tndividual revia\rers: .: 1 I! i 1, . :11 ; 1, i ;:I i 'I. Critique: ;f' ;s I. ;e Continuity ,of program is achieved through a small but well oriented central program staff. A full-time deputy director is being requested to strengthen program direction. Reviewers considered as unrealistic the request of $400,000 (Z/3 of project i dollars) for Biomedical Communications System, at each of 4 AHECs (Area Health '( Education Centers, supported by previous grant from Health Manpower Bureau), 1 with huge investment jn hardware, computer linkages and other new equipment. The RMP subsequently advised it could reduce the request to about $3001000, ,i. and slow down linking facilities with the base centers. Reviewers believed i the project overly ambitious, and recommended considerable scaling down 1 in view of other priorities. ,i t 'Concerns were expressed with regard to data projects (2 later withdrawn) and , !.. a contract for guidance on implementing Certificate of Need Legislation. ii Reviewers reconanended more emphasis on improving capability of allled 11 : ) professional health personnel in delivery of services. The need for a 3-bed unit for kidney dialysis outpatients whi.ch was 'questioned was approved by CHP A and B agencies, as well as Social Security Admini The request has been given high priority by RAG and CHP. JUI.,Y/AUGUST REVIEl? Ii . i O L Estimated request ES OE May 1974: I/ : I/ MC0 6/4/74 STAFF SUMMARY FOR MAY REVIEW 1) NORTH DAKOTA REGIONAL MEDICAL PROGRAM: RM 00060 EXECUTIVE DIRECTOR: Charles Arneson, M.D. - since September 1972 STAFF:FTE) Total - 5.6 Additional Proposed: 1 Professional: 4 Full-time 2"- + Part-time 2 Professional: 1 Other: Full-time 2 2 * Executive Director and Computer Programmer FUNDS REQUESTED: Total (D.C. & I.D.C.) $774,057 (exceeds target figure of 582,517 by 191,000) Program Staff (total) Projects: (10) total Continuation New (10) ** CHP COMMENTS: $145,940 628,117 (see note) 62:,117 "A" Agency Executive Conunittee to meet 5/15 but favorable comments from staff on general review, especially projects related to medical school expansion and further development.** Three active "B" agencies reviewed and commented; approved manpower development projects. Concerns about data collection and forms. RAG considered all comments on review; disapproved some data activities. Identified priorities. (!j/20/74 - A agency comments received.) ISSUES: #95 #97 Note: ** 8 July 1 Biomedical Communications System - establish at each of 4 AHECs and given high priority by all reviewers at all levels. Requesttotals $400,000 (about 3/4 for communication equipment and stations). Upon questioning Region , reported that it could consider some modification and reduction of portion of equipment (#95); est. reduction of $104,000. Kidney: Establish satellite hemodialysis unit (3 beds for outpatients) at United Hospital (under supervision of Minn. Regional Kidney Disease Program) and seeking exception from SSA of freeze. High priority and under study during past grant period (equipment $18,131). RMP advised 5/20/74 that 1 data project and a study proposal (#lOO and #lOl) were withdrawn (approx. $28,000) reducing projects to 8 and total project $ to $600,000. - 0 Request expected. 1. Resnick - MC0 Revised 5/28/74 -. m ,I974 ._ _ .._ -. _ . _ __ _ . - _ DS LISTING BY REGION UNCIL 60 N DAKOTA PROG YR 04 ?liD CONiINENT COW COMPONENT TITLE .-- -.-. .._..- -_.-. -.I_. _ NC ._ ._ coo0 PROGRAM STAFF 093 FEAS STUDY DEVELOP OF RESIeDENCY INT MED _____- -I ---.. -. -.-- -. STUDY.REi GRAd PROG -t3EHAVI&Af SC1 _ , - I 094 , _ 095 &IOHED CMNC SYS 096. - ._ EVAL APPLICATION COMPUTER IN HLTH CARE --A---.---- 097 -.-- _-- _. -... _. -. 096 . ..- -.. -. _ _ .- ..-. 099.. - ---- --. _- --.- _ tiithhrawn 4++- Es? SATELLITE HEMODIAL UNIT PRO3 REVIEWJEF N 0 CERTIFICATE OF PLAN HUUAN SERV CTR DATA ANAL AREA HLTH PROBLEMS . NEED .- -_ Uithdvak -- ks-~- GROUP STUDY IDENiIFY COMMUNITY HLTH PROBLEMS -. ._ ._ _ 102 .- D&LOP HLTH DATA COLLECT FClRklS _-.- .__._ -- -__. .- -... __- __ _. _ / _ `10 GF COMPCNENTS 11 REGION TOTALS . _- ..-._._ -.- -_ --__.- _- .-- - . _ _ . .- . .-. .._ _ _ - _. _ _-._ .-. _-_. _ _ . .._ DIRECT INDIRECT TOTAL REOUEST REQUEST REQUEST 145;940' - 13,775 _.. _ 9r620 400,000 369617 48,191' __ .____. 25.006 41,700 20,072 - v. - St142 251000 ._ ._- - 774*057 . 0 0 _._. 0 - 0 0 . 0 0 0 0 0 0 0 _ -. _ 145r940 13,775 91620 400r000 369617 489191 25~000 42,700 20,072 St142 25,000 _ .-. . RMJ? I-?M MAY/JUNE 1974 REVIEW Request: $1,039,670 Committee Iieconmlendation: $7i10,000 Overall assessment by individual reviewers: Above average - superior Northern New England _ -__u 00003 JULY/AUGUST REVIEW Estimated request as of May 1974: $800,000 Critique : This application requesting support for staff and seven ongoing projects presents a coheJ rive program with staff activities and projects clustered around well-defi.ned objectives . The 1W.P continues to be involved in the evalua.ti.on and improvement of the medical care system through the mechanism of disease management committees. The Regional Advisory Group has been actively involved in the development and support of established program prlorl.ties. It is a major strength in the program. The relationship with other state agencies also appears strong. The staff is now directed. by a new coordinator who has se-rved on the staff for some time. The Committee was concerned about the budget, however, which seemed high, particularly the program staff portion. The Committee recom- mended that this application So approved at a reduced level of $700,000, but believes the RMP should be in-a high priority for. an increase level, pending satisfactory review of the July application. Northern New England Regional Medical Program Coordinator: Edward Francisco, Ph.D. On duty since: 6/30/73 Staff: Full Time Prof. Part Time Prof. Full Time Other Part Time Other Total Funds Requested: Total . . . . . . . . . . . . . . . . . . . 1,039,670 . Continuation............. (608,870 ( None Period of Time Requested: RM 00003 > - 7 Projects* 1 Proposed: 14 Activities Proposed: Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) *Although all projects in their request are continuations, most are only in their second year of funding, Two projects -- numbers 37 & 38 appear as new projects, but are actually continuations as the first 12 months were funded via the contract mechanism from the "core" budget, RM 00003 (NNE) e List any continuation project or staff activi.ty for which substantial increase over annualized current funding is requested. HMO project: NONE EMS project: This request is for the third and final year .of RMP support. The amount requested is higher in the third year as the program can now increase its training capacities and devote greater attention to the development of local ambulance districts; This next year activities build on a long-range EMS plan that Vermont has effectively developed. PSRO: Vermont has long been active with issues surrounding "quality of care," The state has pioneered with the "Problem-Oriented Medical Record" and ways to relate it to measuring quality of care. The NNERMP since its e inception has devoted considerable attention to quality of care with heart disease, cancer, respiratory disease, etc., as well as extensive data collection. In addition, the Coordinator is active in the development of a statewide PSRO. Kidney: This application requests an increased level of support, but it is stated that this will be the last year of RMP support, The increase is primarily to support the kidney program staff and training of personnel to render end-stage renal disease patient care, After this year, the major financial bunden associated with meeting initial training needs should be substantiately diminished and the program in a position to function on other funding sources, CHP comments: This application requestB continuation only, of activities previously reviewed and approved by CHP. The "continuation" application was submitted to CHP and CHP has verbally endorsed it. CHP has chosen to devote its attention to new RMP proposals developed for submission on July 1. E0/5/20/74 NO NEW ENG ' - . _ . _ _ PROG YR 05 ' `ERN _ .._ .____ -_ COYP _. NO _ __ COMPONENT TITLE _ .__ ___ _ ._. ._ coo0 ._- -.. QOb _.______- --_---- -. 007 ___. .-. _~ - 009 - 011 .-__. _ -. --.. - 012 -_ 037 \ PROGRAM STAFF REG END-STAGE KIDNEY RX -INCREASE CAPABILITY RURAL AHEWLANCE s ER PERS - REG HZGH RZSK INFANT & MOTHER PROG - I . REG RESP DISEASE PROG AMBULATORY PEDIATRIC CARE ST JOHNSBURY -- VCJL PROBLEM-ORIENT HLTH CARE INFO SyS 038 TRNG SERV CTR DISORDERS OF CMNC _-. ._. _. ._. -_ -- _.._.. ..- .._ -..- _-. .^ _._ _ - - _ . ._ . . -- . IF CUHPONtNlS s REGION TOTALS _-_- .__.__.. -... -_-__ ~- -----. -. .-. -- . ..- _ _. .- .,-. . . I_ -. .._ .---. _ _ _ _ _ -`..- .._- .- _ . _. . _____._-___ -__ ._. __ -_.--_. -_-- _ -. - -.- --._-- -._. _._. _, ___ _ _ -- ._ -. . .- _ f - .____.____ -. -._- ___. - ___ -. - .-_ __ _ _. _-._ . .._ _- _. . . - ._ . _.. . 1- _. ____ __ _ .-. _ - _.. ..^ -.. -- __ _ _ . -.- -. -. ._. ._ _' DIRECT REQUEST 430,800 62,700 89,740 145,954 53,425 46,000' 76,200 79,068 - 983r887 55,783 .lsO39,670 __ -- INDIRECT REOUEST 0 99854 21335 15,808 4,670 0 0 239116 TOTAL REQUEST 430r800 72,554 92,075 .. - .. -- 1619762 58,095 46*.000 769200 -- 102,184 __ __ _. _ _ _ - .^ ._.__ - .---. . . _ -. -. m NUKlHLA?Ib l'&blUAfU MIAJILAL YlWW.Aivl RM 00021 . MAY/JUNE 1974 REVIEW -. Request: $1,889,395 _ Committee Recommendation: $1,700,000 Overall Assessment by Individual Reviewers: Below Average/Average Critique : The past performance for this region has been excellent, with internal management considered to be one of their greatest strengths. Historically Northlands RMP has been using a contract mechanism to increase extramural participation. The region is continuing this approach via the active involvement of the various committees of RAG. These funds have been used for the most part as seed monies of short duration to study and develop new approaches to the delivery of health care for the constituents of NRMP. The region has been successful in the past in finding other sources of funding after termination of DRi@ support. As of June 30, 1973, the Program Coordinator left and the Deputy Director was appointed to his position. The past Coordinator has remained active on a voluntary basis in terms of providing advice and counsel. Prior to the phase-out this program had an adequately experienced program staff. Following the rescinding of the phase-out order, the Board decided to retain a small nucleus of program staff personnel and purchase by contract the various consultants that would be needed. This created concern with the reviewers as to the adequacy of staff in terms of fiscal and program monitoring of the various activities proposed. In spite of the past record on local support, concern was expressed by the reviewers relative to the generation of local support for the proposed AHEC's. The reviewers felt that good work had been done in terms of the development of a program call the Foundation for Health Care Evaluation, but expressed concern as to whether existing staff could properly guide and monitor such a program, and (expressed concern) as to the need for further information on this program. The reviewers generally expressed a concern for the lack of specificity in the programs presented. To reiterate, the reviewers expressed concern relative to staffing, lack of activity in primary care, possible funding in the PSRO+ area. *The above concerns were considered in arriving at a recommendation by the Committee. In this application the region has requested funds to support the initial staffing of two CUP "b" agencies. JULY/AUGUST REVIEW Estimated Request as of 3la.y 1974: $600,GOO SCOB/DRMP 6/h/74 NORTHLANDS REGIONAL MEDICAL PROGRAM, INC. 375 Jackson Street St. Paul, Minnesota 55101 Prepared By: Joe Jewel1 Grant # : RM 00021 Robert Wilkins, Coordinator Current Staff: Proposed Staff: 3 Full-time Professionals 3 Full-time Other On Duty As Coordinator Since: 7/73 Deputy Director Since: l/68 5 Full-time Professionals 4 Full-time Other FUNDS REQUESTED: Total Cost - $1,889,395 Program Staff - 200,223 Continuation -(1,463,022) New -( 226,150) Target Figure: $2,116,240 (7/l/74-6/30/75) Estimated July Request: $600,000 Period of Time Requested: All activities to terminate as of 6/30/75 ITEMS FOR REVIEWERS ATTENTION: Excludingthe amount requested for Program Staff (CORE) support, the region is requesting $1,689,172 for operational activities via contracts. The percentage of the proposed program to be beamed at the following health care areas or systems are: Percentage of Activity Community-based Health Education and Manpower Training Total Request 39 Quality Assurance $326,676 20 Hypertension $191,985 11 Emergency Medical Services $281,506 17 Kidney Disease $149,777 CHP Regional Agency Support $ 64,610 4 The plans for these activities are described in the program report section (orange) portion of the application. The requests for EMS and Kidney proposal e are for the continuation and expansion of currently funded activities. (. Page 2 Northlands RMP Summary e Last year the region allocated $25,000 to develop a State EMS Plan. The requests in this application are to begin to implement the plan. The Quality Assurance Requests are for the development of standards to complement the Professional Service Review Organization(s) when this is settled in Minnesota. CHP: The region outlines its procedures and expectations for the involvement and support of health planning agencies in the May 1st cover letter to Dr. Pahl as well as throughout the application. An April 25, 1974 letter from the Executive Director of the Southeastern Minnesota Health Planning Council (Rochester) is included in the application. This was not received in time for consideration when the RAG reviewed this submission. The (b) agency recommended "disapproval, approval with conditions and denial" on three of the five requests it reviewed. The region has assured DRMP Staff that the concerns expressed by the planning agency will be solved or satisfied before the proposals are presented to RAG for funding considerations. The region is requesting funds ($64,610) to support two unstaffed CHP (b) agencies in South-Central and Southwestern Minnesota. DRMP/DOD SCOB/5-16-74 URTHLANDS PROG YR 05 CENTRAL CDMP ND - . -- . .._ COO0 _.__ - _ .- -_ _ LO3 -.__ -..-.. --.. loss - . .._ 106 _.. COMPONENTS COMPONENT TITLE . -. Pl?OG STAFF 200,223 0 2009223 KIDNEY DONOR RECOV t TRANSPL -`A V TECWIIQUES &AL .ASSUR OUTCOME -- - WAL ASSUR OUTCOME ASSIST CURL CARE EVAL . - hSS>ST CUAL ASSUR 7?ECHANISM SWERV MGHT TRNG -HLTH CARE S k MINN . CLINICAL PASTORAL MINISTRY ED,UC CRITICAL C4RE NURSING C E & TFNG N M N1N.N _._ -.. - S E MIp;N PRUdRAh I#PLEWATIDN CDNTI:WING EDUC HLTH `PERS S C MINN Ir'tST CENTRAL MINN CHEC PROGRAM NL'RSE AID CURRICULM . DIRECT INDIRECT ,- REQUEST REQUEST 279500 . . . 47,480 2O?OOO 73,135 I 30,000 158~926 129,628 25rooo 10,000 24,339 . 25,000 25,000 25,000 ,25,953 0 2f800 ..*_ 0 -' 0 0 0 --. 10,199 CURRICULUY OFFERINGS IN HLTH DCCUPATIONS MAY3-CiXF!UNITY-EASED HLTH EOUC HLTH SC1 CO!!MUNXTY HLTH ECUC MANAGEMENT TRAINING REG LEARNIIIG CTRS AGASSIZ HLTti PLAN E%ERGENCY CEVELC?? PUeLIC INFORMATION PPOGRAMS 25.600 0 .._ I 10,000 0 10,000 0 79,396 18,419 10,OOG 0 17,294 0 0 11,410 -. 0 24~615 0 0 0 0 "b TOTAL REQUEST 27t500 58,890 ' `-. 20rOOO 97,750 30,000 1589926 129~628 25~000 lO*OOO 27,239 25,000 - 25,000 25,000 25,000 36,152 25,000 10,000 10,000 97,815 10,000 17.294 ,1974 Q. . . 21 NORTHLANDS . PROG YR 05 SOUTH CENTRAL CCIMP . . Nil _. -. .-. -_ _.. _ .- ._ -. 1255 126 127 127s 128 129s' 131s 135s 138 13" 140 141 142 143 144 - 1'45 14tr 147 - -.. 0 3F COMPONENTS 42 COMPONENT TITLE RIN-DAK CHP EMS METRO AREA EMZRG SERV STUDY ?1ETRO AREA EMERG SERV STUDY - INTERSTATE EMS PLAN FOR COHPRE EMS PLANNING CDMPRE EMS STRENGTHEN LIiCAL DUAL ASSURANCE MCDiL HYPT DETECTICN MGMT COMPRE ORGAN RECOVERY PROG IMPROVE COKNUHITY SASED MNPWR DEV SE ?!Ii\!N EMS PLAN & HOSP GESIGNATXON REG Ix CHP SD CENTRAL CONPRE HLTH PLAN SW . * METRO AREA CHEC RESOURCE CTR REHAS ILL PLAN EMS PERS AUDIO VISUAL PT EDUC ON HYPT !?INN `o'?T OF hLTH HYPT SEUTH CENTRAL EMS S W EMS DIRECT INDIRECT REQUEST REQUEST lOtOOO 0. 10 9000 0 15,000 0 10t000 0 lOtOOO 0 . 118,428 17~823 20rooo 0 119,135 14r080 122,277 0 95*1&S ; 0 lO*OOO 0 349842 1 0 29,768 0 25,000 0 19,254 59555 28,650 4t311 7,035 1,735 ~- 50,000 0 10,000 0 10t000 0 _ . REGION TOTALS 1~7789448 110,947 !eJ US IO-23 1 TOTAL REQUEST 10?000 lO,OOO 15,000 10,000 10,000 X36+251 20tooo 133,215 1221277 95,185 10*000 . 34r842 29,768 25,000 24,809 32,961 8,770 5OTOOO LOI 000 10*000 1~889,395 WnLU vluA.lcI1 nLu.lu1Y.t#.L l"uiU.LLaud lTIL"Luuu', . RM 00048 MAY/JUNE 1974 REVIEW $2,820,536 Request: Committee Recommendation: $2,205,636 plus 100,000 for Project 27(d) to fund Toledo, Lima, Dayton, Ohio activity. Overall Assessment by Individual Reviewers: Below Average/Average Critique : This region was reviewed in depth by two reviewers neither of which had ever site visited the region. This region has had a change in Coordinators, as of July 1973. The new Coordinator has been a member of program staff since 1969. Program staff is considered to be adequate. Regional Advisory Council relationships are excellent, and all program activities are congruent with the goals, objectives and priorities established by the Regional Advisory Council. This RAC has a long history of being one of the better ones in terms of decision-making. This region historically covers parts of Indiana, West Virginia, Ohio and Kentuclky, with input from the medical schools in Kentucky, Lotiisville and Cincinnati. The region is entering its third triennial year and has been considered to be in the upper quartile of regions within the country. The Ohio Valley Regional Medical Program at the request of Division of Regional Medical Programs had agreed to accept applications from the three phased-out Ohio regions. This meant accepting fiscal responsibilities as the Grantee and staff responsibilities for monitoring and evaluating any activities submitted. Assurances were made by DRNP that should such activities fit within the region's program priorities and objectives this would not effect their funding level. This region's past performance and accomplishments and their relationships with CHP, -Appalachia and other agencies, including surrounding RMP's are considered to be excellent. In arriving at a reduced funding recommendation, criticism was leveled relative to the tripartite nature of certain projects as it relates to the three medical schools. Concerns were expressed relative to the length of funding of certain demonstration projects that had been receiving RMP support beyond a three year period. Another concern was expressed relative to financial stimulation of the Home Care Programs under third party payees. Such coverage has not yet been too successful. (CONTINUED ON PAGE 2) PAGE 2 - OHIO VALLEY REGIONAL IMEDIC.& PROGRAM RM 00048 JULY/AUGUST REVIEW Estimited'Rec@eSt'as of'May'1974: None DRMI? SCOB,'IX)D 6/6/74 r d MAY REVIEw STAFF SD&MARY e 0 OHIO VALLEY REGIONAL MEDICAL PROCJ?AM 1733 Harrodsbury Road P.0, Box 4098 Lexington, Kentucky 40504 Prepared by: ,Jea.nne L. J'arks E.L. Angie Hebbeler, Director On Duty Since: 7/l/73 CURRENT STAFF Full-time Professional staff: 9 Total 15 Part- time Professional proposed: staff: 1 0 Full-time Other : 4 Total proposed: 16 Part-time Other : 0 6 Former member of Program Ikvelopmcnt staff since 1969 REQUESTED: (Target figure: $2,294,728) Total Costs : $2,820,536 Program Staff : 503,710 Continuation : 2,150,303 NW . . 166,523 This region does not anticipate submitting July 1, 1974. Period of time requested: All projects are scheduled to terminate 6/30/75 a request for funds for CHP c-s: No problems noted. All proposals were reviewed by the CHP(a) and (b) agencies prior to the RAC review. Page 87 of the application lists each project and the CHP(a) and (b) agency reviewing the project. ITEM5 FOR REVIEWERS A'l-TENTION : E%lS - No new EMS activities are requested. Project #36 - Advanced EM.J is a continuation activity and currently funded through 6/30/75 for a total of $14,585. The region is now requesting $44,239 for the period 7/l/74-6/30/75. Project #37C - Area EM5 Development - Kentuckiana is a continuation activity and is currently funded through 6/30/75 for a total of $16,769. The region is now requesting $26,159 to complete the development of coordinated emergency medical services plans for a 17-county area of Kentucky and Indiana. Page 2 - OHIO VALLEY REGIONAL MEDICAL PROGRAM Kidney: Project #44 - Computerized Time-Oriented Data Base Implementation Renal Failure This is a new activity directed at the creation and computerization of a time-oriented data base for end-stage renal failure. HAY OHlO VAL PROG YR 05 H CENTRAL COMP _-._. _ .- NO _ coo0 . COO4 -.--_ ----_.. coo5 -_ COO6 005A ._.- --. . ..-_ -.. ..--. 0058 -' \ .005c . 005Q .- _._.. - -I - OllA -- 0118 ._ 311D _ SlfF -. OflH ..- OllI - -._ _ OlIJ - OLlK PROGRAM STAFF - REQUESTED F COMPONENT TITLE HLTH MNPWR SURVEY DEMO E;FCT uF HARRIERS IMP NUR~ COORO~`~IS PLAN HLTH DEL SYS NEEDS & EVAL STUDY. UN14 CONT EDUC RESOURCES _-. UNIV CONT EDUC RESOURCES UNIV CONT. EDUC RESOURCES UNIV CONT. EDUC RES - MULTI-SPONSOR _. _ - .- HOME CARE HDME CARE - DANVILLE KY . HO'IE Cb.2.E - GEORGETOWN @iI0 --. . - HOE CARE - DEVELCPHENTAL AWAROS HOWE CARE - MAYSVILLE KY HUME cisaE - LEXINGTON KY - tfi),t!E; CARE _ ASn`AND KY ._ -- -.- ELDERLY HLTH SUPERVISOR - LOUISVTLLE KY-- -. 015 `CLINICAL ASSDC _.-_.. _ ..__ I_. 020 `- pIALYSlS TECHNCLXIST - - - G2lA '.R;G PEDXATkIC HT CLINICS 0215 SfG PEDIATRIC HT CLINIC -021c- REG PEDIATRIC HT CLXNICS . 022: RURAt PRIM CARE DIRECT REQUEST 417r550 15,000 6rUOO -`- lr500 44,55? 29,976 129695 15,000 38,253 25,000 35,512 200,000 339210 105 r69f 559880 45,405 62,691 36,865 20,283 22,965 20,547 15tOTI INDIRECT TOTAL REQUEST REQUEST `-.- 86,160 0 .O 0 18,861 14,798 .44,774 _- 6r347 19 r.042 0 89217 - 0 119133 28 9971 _ 15r650 6,220 101175 . 8,749 0 0sn-w -. a? 3 F 503r710 15TOOO 6rOOO 19500 63,418 15,000 46,470 25rODO 467 645 2007000 33,210 - 105,697 55,880 45,405 919662 52,515 26r503 33r140 29,296 151077 MAY 1 m--- __ .___ _...., -.--- - REQUESTED FU STING GXON Iii10 YAL PRDG YR 05 4 CENTRAL - CWiP L ___ ___._____ -. NO ---- ..- COMPONENT TITLE 024 STUDY CLINICAL RESOURCES NURSG STUDENTS 02&A iNIV . _--_--I-__- --- - ----- 026B UNIV UNIV ARE4 AREA AREd AMbULATORY CARE - . 4HfiULATORY CARE .. _ 027A - _. 0278 027c G27tl 027E SDHHET - PENFiyRI L' L 027F SOHMET - SE KY SOHt+ET - LAKE CW8ERLAND 5 0 r; ?4 E T - sn OHIO PHYS ASSIST UfILIZATION PRtXLEM-ORIENTFD MED RECORDS h?;CUL.~TL?EY CAKE .- DEVELOPMENTAL CC.MPONENT , A~VANCFfJ EMT C27G 027H - 029 03; 03b 037c .___ _ _. _. -_-. C42A 042t C42C . _ AM%!LATDRY CARE HLTH EDuC SYS . HLTH EDUC SYS HtTH EDUC SYS Sl-!H?.?fT - DfVELDPMENTAL COHPCNENT AREA EMS DEVELOP - KENTUCKIANA REG DOSXbtETRY STANGAKOS OEVELDP * KEG tX?S IfiETiiY STAt:DAirDS DEVELO REG COSii'lETRY STANDARDS DEVELOP -__-. _.__ -._ 043.' - -CHILDREMS H&P EVENING HED CLINIC C44 CCMPUTERIZED THE ORIFNT DATA BASE RENTAL FAILURE DIRECT REQUEST 3. INDIRECT - TOTAL REQUEST REQUEST 29r900 34,251 '44,241 411750 27,005 82,657 78,963 150,000 529426 371456 22,650 31,975 14rooo 105~000 '150,000 44t239 26,159 4?150 9,662 8,850 21,778 72,575 16.134 50r385 . . ._ ___ ^ 209224 64r4bS 20,125 -. 61~875 12,211 39~216 37r343 -120,000 .. 3??357 116~320 0 150r000 i4.045 66,471 14~293 46*268 0 - 150,000 `. 39491 47,730 0 299900 0 37~456 2*50C 25,150 0 1*-r OOQ 0 105t000 0 26,159 `1,800 5,950 3,162 12~824 11050 9,900 0 21.778 22,170 94,745 - MAY 1 REQUESTEC FU a STING COnPCNENTS GION 06174 COUNCIL It?10 VAL PROG YR 05 3 CENTRAL cow COHPC!NENT TITLE NO._-- .- . . 045 CONT EOUC EXPANDED FUNCTIONS--DENT _.. _- ?COMPONENTS __ 45 .I_ _._ __._ _ _ . _. . .- - _ __ _ . . - - -. .- . .._. - ,____- - . ..- _.- .' _ _.. --_.- . ..-__ -- -_.. _ ,- _ I ._ _ _ . - _. _ _... - _ __ - AUXIL REGION TOTALS OSH-PW * t ._ . DIRECT INDIRECT TOTAL REQUEST REQUEST . REQUEST 5otooo 0 - 5otooo 2t399t350 .42lt186 - 2t820.536. _ _ _ _ ..____._ __. ..- _ _ _. _ -. _ - - - ._ _ .._...-_._. . .-. - :-. -.- , a a RM 00023 - MAY/JUNE 1974 REVIEW Request: $1,382,243 Committee Recommendation: $1,062,237 Overall assessment by individual reviewers: Average and below average; the before theeopportunity to study concept and objectives. latter was based on review of the application, a comprehensive statement regarding the RHDAP Critique: Reviewers noted that the program had turned around from a heavily oriented continuing professional medical education emphasis to health care delivery, promotion of areawide institutional participation and regionalization, with primary emphasis on quality of care improvement, sharing of services, and cost containment. Concerns were expressed regarding the additional staff requested (7 new positions) and the vagueness of staff component activities. Questions were raised as to consumer and community involvement. Staff pointed out that the RHDAP concept stems from the Health Services Education activities, initiated through community-wide institutional consortia, beginning with the coronary care monitoring program and the telelecture conferences, with emphasis on manpower development. These activities involve community hospitals, local health institutions and organizations. Reviewers observed the strengths which result from the furthering of community hospital and educational institution consortia, with outreach to rural areas with limited resources. JULY/AUGUST REVIEW Estimated request as of May 1974: $448,000 MC0 6/4/74 STAFF SUMMARY FOR MAY REVIEW OKLAHOMA REGIONAL MEDICAL PROGRAM: RM 00023 PROGRAM DIRECTOR: Mr. A. Donnell (Hospital Admin.) - since January 1973 STAFF: (FTE) Total -*lo (formerly Pl. CHP) Addt tional Proposed: 7 Professional: 7 Full-time 6 Part-time 1 (50%) * to be full-time July 1 Professional: 4 Full-time 4 Other: 3 Full-time 3 Other: Full-time 3" FUNDS REQUESTED: Total (D.C. & I.D.C.) $1,382,243 (IDC = $96,635) (exceeds estimated target of $1,062,237 by 320,000 ) Program Staff $400,372 Staff Components (3) 83,315 Total Program Staff & Components 483,681: Projects: (9) total 898,556 Continuation (6) 727,356 New (3) 171,200 CHP COMMENTS: Oklahoma Planning Corrrnission ("A" Agency) commented on each project separately; generally concurred, but noted concern about possible duplication in pending EMS application to new EMS Division , under PL 94-153. (Similarly questioned EMS aspects of RHDA, area program proposals, but so far no approvals from D/EMS). An overall statement from "A" agency will be furnished DRMP.k Four "B' agencies confirmed approval of individual proposals and also noted approval of total program proposal. * hfas furnished 5/23/74 Activities: EMS - training expanded; communications expansion through RHDA programs; requesting l/3 more than 12 month base and reaching other locations. RHDA - Regional Health Development Area Programs - 4 locations; area-wide multiple county programs of cost containment activities, sharing services, joint personnel utilization, in rural areas; (non-profit hospital organi- zations - manpower development, education activities). #34 - Strengthen regionalization through expansion of areawide planning support for 4 locations in Western Oklahoma. (Two had been initiated by Core with unexpended funds.) ., #43,45 & 46 - These three new activities involve primary care and referral services; also education and training to improve manpower resources, and focus on rural area needs. July 7 - expect to request $448,030 L. Resnick -MC0 - Revised 5/28/74 n 1974 . ~_ * -- - `- .- . _-._ _ - 3. OKLAWOffA PROG YR Oi ID CONTINENT con6 -- COMPONENT TITLE DIRECT NO _ _ ._ _ _- - ._ ..^ _ REQUEST ._. .-...-. _ . . . ._- -. _._. : coo0 - PROGRAM STAFF 387~062 - _ .~ __. - 025 EMS TRNG & SYS DEVELOP . 101',622 _~ -._.. __-.----- " - 032A- - R& HLTH DEVELOP ADA -- 86,035 0320 REG HLTH DEVELOP ARDMORE 95*419 033 REG HLTH DEVELOP BARTLESVILLE 861913 ---._.^.__---. ^- - _ ^ .- _. 034A CONT AREAWIDE HLTH PLAN`NW OKLA 62,130' 0348 CflNT ARiA!JIDE HLTH PLAN SW OKLA 62,136 039 RCG HLT.H DEVELOP ENID 126 9352 _ .- _..-_.-. -_-. .-..--. - 041 REG HLTH DEVELOP LAW&N 106r755 -043. UPDATING KNOHLEDdE & SKILLS.RN'S & LPN'S- 91,000 045 MflBL EYE UIS SCREENING SEKV ___ .__-.- _... - _ _- . __ 046 PT. F.EFER'-& TRANSp' S;;.- .- - 3 OF .COMPGN"NTS 12 -. .__ -. -. 47*500 0 32 e700 0 REGION TOTALS 1.2859618 - 96,625. 1.382~243 INDIRECT TOTAL REQUEST ^ REQUEST 969625 0 0 0 0 0 0 0 0 0 4839687 lOlt622 86to35 95,419 86t913 _ . _ 62t130 62 t 230 126t 352 106.755 91?000 4?*500 321700. --..- -._ - ._ . _. . . _ _ . . . ..--.i . , Oregon RMJ' --- --CI IZM 000 12 *I_ -- Crf. ci.C] IIC? : As in the past, Oregon has continued to be an exemplary, well- managed program with strong leadership. The Region has a viable Regional Advisory Board with a good review process. The relationships with CHPs are good. These agencies are apparently involved in program planning. New staff has and is being recruited to fill existing vacancies. The ongoing and proposed activities are well-developed and in line with program objectives. The Committee recommends that this application be approved at the requested level. , WOB 6/6/74 . . . e STAFF SUMRY FOR MAY 1 REVIEW OREGON REGIONAL MEDICAL PROGRAM: RM00012 University of Oregon Medical School, Portland, Oregon COORDINATOR: Julian S. Reinschmidt, M.D. Since- 12/l/70 STAFF: (FTE) Total - 15.35 Proposed: 15.35 Professional 10.35 Professional 10.35 Other 5.00 Other 5.00 FUNDS REQUESTED: Total (D.C. & i.d.c.) $1,201,357 Program Staff (Administration) Staff Components (9) - 3 new activities Total Program Staff & Componenta Projects (8) total 633,330 356,995 990,325 211,032 $ 1,201,357 CHP COMMENTS: As a mstter of procedure, all project applications are reviewed by the ORMP-CHP Subcommittee composed of representatives from each of the CHP 8genCies in the state. Further, applications were sent to 14 area-wide CHP groups, of these nine did not respond formally. Of the five CHP Agencies which did not respond only one critized one activity, the Fami.ly snd Self Yelp Education Program (COOK). This criticism was addressed and reflected in the conditions on which ORMP approved the activity. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal grant: programs--such as, HMO, PSRO, KIDNEY, and EMS. CONTINUATION ACTIVITIES: Of the 17 discrete activities proposed 12 are continuations. Only significant increase in continuation budget is noted for EMS Consultation (CO06) which goes from $48,593 for six months to $158,910 for 12 months. (See p. 66). NEW ACTIVITIES: CHP Agency Priorities (CMJ), Family and Self Help Education Program (COOK), Chicano Health Task Force (COOM), Oregon Cryopreservation Eve Bank (#31) and Management Training Program for Hospital Personnel. e .f DRMP/DOD WOB-S/17/74 111 15.1974 _- - -- il) _. -__ ~ _._ ^_ _ _. . __.- - . . - _.. - - 12 OREGON- PRDG YR 06 .._ WESTERN COHP `- - -COMPONENT TITLE _ _- .-- _ _ _. - _.~ NO - ._ _ . _ _ _ _ coo0 PROGRAH STAFF ..-- .- -_ .-.~ _ -_ COlA PT ORIGIN STUD+ .- -.-___-___ --_ - --. _ -.._ ._ -.- ..-, a _.. -... - _.. COlE RENAL 015 COlF OREGON COMPRE CA - COlG STATE EMERG HED CONSULT SERV "___. ._ _ ._._. --. . -coikl -. QUAI. ASSUR 3 - ---- - COlJ , STATEWIDE CHP AGY PRIORITIES __ _ _ -_ _ COlK FAMILY AN0 SELF HELP EDUC ---_---_._- _~_-_--__. -_- _ . . COIL -- -' __ _ .._. .- corn-. Olti PEER f?EVIEW CJUAL ASSUR NH CHICANO HLTH TASK FORCE OPER SERV REMOTE C C MONITORING I__-._ . . . .- _ _ . 022--.- .._, - .-___ _ - _ _.. 025. , 02; EMERG YED TECHN TRNG RURAL Ct-MHUNITY STROKE REHAB GROlJP PURCHASING .- ._-_ ____ ._ -- __.-. 029 AREAHIDE COURD HLTH DATA `INFO . `-. 031- iREGOt CRYOPRESERVATION EYE `BhNK 033 E M S OIST ORGAN12 035 HGMT- TRNG iiOSP' PERS -`- .- -.. ..`. DIRECT INDIRECT TOTAL REQUEST _ REQUEST REQUEST 469,390 163,940 633,330 33~988 0 33~988 _ _ , .- _ .~_ 21800 119780 158r910 - 21,358 0 2.8Od 0 llt780 0 1589910 _.._. -. _.. -. -. 0 21r358 100*000 9,650 ._. 13r509 -, 5rooo 23~409 359169 22,796 . 7,500 18,620 - 16,523 23 r6 10 -... - _ 24~334 -" NO DF.COMPONENTS 18 . REGION TOTALS 998,346 203tOll 1.201.3~7 .,+ ._ _ -.. -..-- .__.. - _.._. -- _. . . .._ ..__ ._-. .._- ..- _- _ .-. -. - - ..- - . -- 0 100,000 0 9rb50 _ _. 0 13,509 0 51000 4,299 279708 - 12~907 48,076 br900 291696 0 7,500 ..- _ .- 0 189620 69300 22r623 8,665 329275 --. . 0 .24* 334 ;" - Crl.tique: Previous concerns of reviewers had brought future funding of this program into serious question. A site visit was conducted in January 1974 to deal with the previous concerns in anticipation of thils application. The primary reviewer, having participated in the January site visit, expressed complete satisfaction with the findings and . indicated that previous concerns stemmed more from problems of communication than from programmatic inadequacies. On the strength of the site visit experfence plus his review of this application, he recommended funding in the full amount requested,' This recommendation was concurred in by the secondary reviewer and unanimously adopted &y Panel B. JWX/AUGUST REVIEW . . c. PUERTO RICO Regional Medical Program Coordinator: Rafael A. Rivera-Castano, M.D. Staff: Full Time Prof. 4 Full Time Other 8 Total 12 On duty (Previously Assoc.., Proposed: 11.25 9 1 I I 20.24 Funds Requested: Total .s#,*......****I..* 695,862 Continuation .***....*..m. (570,491 ) 390,137 Prof. 180,354 Program'Staff (125,371 ) Period of Time Requested:None later than June 1975 Activities Proposed: Refer to Management Information . . . Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) c ist over any continuation project or staff activity for annualized current funding is requested. which substantial increase HMO project: EMS project: 13 - Health Planning Assistance - This is a program staff activity. It will be devoted this year to planning for EMS thoughout the island. l/20 - Cardiac Pulmonary Center (new> - has long range implications relative to planning transportation needs for trauma patients. PSRO: 1118 - Promote and Strengthen Integration of Health Services in Humacao - (staff planning assistance for establishment of a PSRO was given last year). The development of integrated services on a community wide basis is the long range goal, but PSRO concerns will almost surely arise as those services are planned and developed. Kidney: Staff assistance was given to the Board of Health last year to plan a program for the island . Further assistance plans are not indicated . CHP comments: A letter of general approval is contained in the application E0/5/20/74 N&Y 15.1974 .-.. -.... * ..-. - .- _ - PUERTO RIG. _._... PROG YR 04 . iTERN COUP COMPONENT TITLE .-.. _. _-_ -._. _ NO.- -. _. - . coo0 PROGRAM STAFF SUPPORT _.~ ..-. ..-. -. _- coo1 ACTIVITY NO 1 I-..---.--. .-- coo2 ---- . ..- .__ - ACTIVIr'Y ii0 2 ._ _._ _ coo3 ACTIVITY NO 3 _' _ ._ : _ 018 PROiOTE AND STRENGTHEN THE INTEG OF HLTH SERV IN H : --- .----.. _ L .020 .-ESTAE -CARDIAC PULMONARY RESUCITATION TRNG CTR _- 021 TRIG PROG TREAT CHILD LANGUAGE AND HEARING DISABIL 43,366. OF..COMPONENTS __ _ _. 7-s ___- . _ _ REGION TOTALS . 621r129 DIRECT REQUEST 153,355. 77r907 . 33r755 133r224 108r136 71,38k. : . _ . -. - - INOfRECf REQUEST 261999 13,716 101779 6,677 61203 - 4~416 t TOTAL REQUEST 1801354 91t623 .. 39t698 *- ^' "-. 144tm3 114t813 779589 47,782 695,862 ..- . . _- _ ._ __. _ _ _ _ . _ _ _ m Cr:i.ti.qui! : The reviewers were very impressed with this application which requests continued support for staff and two on-going projects. (Two year funding is requested for one project,) The display of goals, activities, priorities and funding was especially noted as reflecting a well-ordered program based on identified areas of need. The staff, Regional Advisory. Group and review process appear outstanding. The CHP(b) is supportive.. . In recommending approval as requested of this application, the Committee expressed anticipation at. seeing the nel CT proposals in the July application. K13V:I El? ,~1IIx/hw.KT __-I__L Estimated request as of llay 1374: $1,080,000 1 , (.' 1 e ,ROCHESTER Regional Medical Program Coordinator: Peter D. Mott. M.D. On duty since: h?r. 19a Staff: Full Time Prof. Other Total Funds Requested: Total ................... $ 361,437 . Continuation ............. ( 88,652 Period of Time Requested: July 1, 1974 Activities Proposed: 5.75 3 a.75 > (projects); 1 KM ooqq Proposed: 6.75 .- 8.75 to June 30, 1975 272,785 program staff Refer to ?!enagement Information Systems (?XS> printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) 4 RN 00025 f Rochester List any continuation project or staff activity for which substantial increase over annualized current funding is requested. I HMO project: EMS project: t43~ - Continuation of a pieviously approved project. PSRO: Kidney: CHP comments: The Genesee Region Heal& Planning Council recommended approval of this application. m/5/20/74 - _ _--. . - _ _ _ . .- - RCCHESTER .- PROG. YR 06 _-. ..~. -_ __ _. `ERN COMP COMPONEkT `TITLE -- - ----."- - -- NO _ _.._. _-__. _. _. ..__ _ . _ .,. F COMPONENTS- 3 ~PROiR&U STAFF RURAL PRIM CARE EVAL STUDY ---._. .- ___. *- EMS PLAN AND' DEVELOP - _.__ __- _ _. _ _ REGION TOTALS . DIRECT INDIRECT TOTAL REQUEST REQUEST _ _ REQUEST -__ - 224,324 48,461 272r785 - 25,000 5r425 30,425 . c- .- - 47,845 10,382 S&227-- .k- . . 297rl69 64.268 Ml*437 _ I `.. - _. .._ _. _. __. ._ .- . ----.-`----- _-.-. _..,_ _--_-- ._-. --. -_ ..- . - _-.-.- _ _ _. . _ -...--.-. - ---- ._._- . _ - - .-.. _... - -. -.. - .- .----_ -- .- .- . ..- - . - , -..-. ..-. _.."_ .._-..-_- -...-_I_ .__-__ _ -...__ ___ ..__ . - ..^... ,. __ _ _ .- ._. __ _. ._--- ._ _ __- _ . . --_-.--- - . .._. -. -~ .-- _.____ -_-_ . ..- _._ _-_.. _._. -.-. ._ __- ._._ - -- ._. -. _ -. . ., - ---..- -- _- -----_ `_ - -. _ - ..-.- -__ -_ ._ _ .._ _.. ._ _ --.---_. -___ _- . . .__._ - _.-.. _.. ._ _ - _ . .- _ . _ ._ ._ _ . . $3,000,000 Request: Committee Recommendation: $2,200,000 1: Average/Above-Average : Critique Members of the Review Committee agreed that this was one of the better applications from an obviously matured program. The region has established goa.ls and objectives with priorities carefully spelled outr They are making a real attempt, in their cooperation with the CHP and other agencies, to solve the health authority problem, During the last 18 months the region has made good progress in restructuring its RAC by disciplines of members as well as geographic representation. South Carolina RN? is consider&i to have an excellent local review process. They were considered to have an experienced program staff under strong leadership. There are many divergent political forces at work in the region at the present time, both medical. a.@ administrative, that affects the- future of the health care agencies in this area.. The Regional Medical Program may emerge as the agency to provide a platform to the resolution of the health care problems in the delivery system. In arriving at the reduced funding level, members of the Committee were not convinced that the rather large amounts requested for activities had not had time to be completely reviewed under the local review process. For example, escrowed funds were requested for: regionalization of services, - for health manpower development and improvement; for strengthening of quality assurance efforts and several other activities which the region was interested in to accomplish its objectives. In arriving at the reduced funding level, the reviewers also did not believe that these particular activities were sufficiently developed at this time to allow for proper review by this Committee. JULY/AUGUST REVIEW * Estimated Request as of May 1974: $500,000 SCXIB~IXID 6/6/74 F MAY REVIEW STAFF SUMMARY SOUTH UROLINA REGIONAL MEDICAL PROGRAM 80 Barre Street Charleston, South Carolina 29401 Prepared by : Lorraine Kyttle RM# : 00035 Vince Moseley, M.D., Coordinator On duty since: 1969 Current Staff: Proposed Staff: 6 Full-time Professionals 9 Full-time Professionals 0 Part-time Professionals 0 Part-time Professionals 11 Full-time Other 11 Full-time Other 0 Part-time Other 0 Part-time Other Funds Requested : (Target Figure - $2,444,287) Total : $3,000,000 Program Staff - $ 497,380 Continuation - $ 983,512 (23 activities) New - $1,519,108 ( 2 activities plus 6 targeted thrusts) Activities Proposed: Continuations 5, -fntinuations" 8 are components initiated with October 1973, awards and the remaining 15 were started with January 1974 6-month awards. The law country RMS activity (#88) is a CHP "b" sponsored assessment of needs and resources study. Component #71 continues an activity which designed curriculum and procedures for advanced training for EMT's and which has ongoing enrolled students. Component #75 does not propose to increase renal services but rather to share consultant back-up. EMarch 1, 1974, SCRMP issued an invitation for contract proposals to its constituency. It outlined five areas of activity in which SCRMP was interested in extending its objectives: , Regional development of Planning and Services . Regional Health Manpower Development . Strengthening Quality Assurance * Regional programs in Categorical Diseases . Improvements in Primary Care These areas all directly reflect SCRMP goals and objectives set by JUG in April 1972 to guide the program in its triennium. One hundred sovcn letters of intent were received. Pages 79-8'2 list the 48 formal applica- tions which have been developed through this response and which have entered the formal review system. They were discussed at the Annual ,South Carolina Regional Eedical Program 0 Conference with CHP on April 15 and will emerge from the comnlete local review in late May. Final CHP comments are Gticipated in mid-June. In late June, final RAG discussions, priority ranking and contract award will be made and the activities will begin July 1. These activities are grouped on the printout under the heading 032A through 032F. The specific activity addressed in 032F, Advanced Health Resources Planning, is an advanced planning group to develop realistic responses to emerging legislation in health resources planning. It proposes the establishment of a body of participants with a balanced and objective structure to logically build upon what South Carolina already has learned and done in health resources planning rather than to discard it and start over again. CHP Comments: Components #89 and #90 seek initial funding in this application. The proposer of #89 is a CHP "b" agency. Number 90 is an activity that was submitted for local "b" comment in the last review cycle and the comment was favorable. With respect to the initiative 032F, Advanced Health Resources Planning, it was submitted to all "b's" and the replies ranged from "premature" to "characteristic foresight" and "timely proposal ." e Items for Reviewers Attention: The responses of the "b'i" to SCRMP's proposal for an advanced planning body, mirror the divergent currents prevailing in South Carolina in matters medical. It is difficult at this point to forecast whether the existing divergencies are healthy disagreements that are good checks and balances or if they are forces that may prove to be counterproductive. DRMP/DoD 5/20/74 REQllESTED COMPONEN Gb/74 LISTING REGION IL S CAROLINA PROG YR 06 TH CENTRAL- - -COMP -. _ .._ _ _ _ .__ NO CGOG G32A --..- - .._.-._ - -.._._ _- G32i . G32C .- 032D .- - . _ _ -032E 032; . . 0608 _ . ._ GbC 067 __ 065 _ . 069 070 071 _ .~___... _ 072 . 073 `COMPONENT TITLE ' DIRECT. INDIRECT _- REQUEST REQUEST PROGRAH STAFF RECiONAL'IZATION OF SER HLTH MJiPWR OEVEL ;HPROV `_. -. STRENGTHEN QUAL ASSUR EFFORTS * SPECIAL CATEGORICAL INTERESTS PRIM HLTH CARE ADVANCED HLTH RESOURCE PLAN SCREENING HYPT CHILOREN CI'UAL ASSUR OIAfZTICS PERINATAL WA1 ASSUR RURAL MC'BL HLTH SHARED MNPWR CEVELOP 353 t398 . 539,499 . 89t916 104,903 404t624. .- - 1949819 164t847 43t75G . 551500 48,750 125tGG0 229700 PEE DtE, H'JSP BASED HNPWR DEVEL AGVANCEO TRNG ERTS 13t412 18,450 CRITERIA IMPUCVE H?SP AND A!+BULATORY SERV 20,000 074 ' UPPER SAVANNAH QUAL ASSUR 19,950 _ .__. -. ---_- .._ _ 075 -- _ &MPUTEhZZELI CARE RENAL 01s _ _ 14,250 . .~ Of6 . . CWVtJCXTY l+YPT CNTRL 55tOGG @7& SCREthlSNG UROPATHIES AN0 HYPT CHILDREN 37,000 -()io _ HOSP ME0 CARE EVAL SYS 55 rOGO GBG INTENSIVE COURSE NEDNATAL CARE NURSG 33tl54 143,982 0 . .o - 0 G 0 - 0 16t250 19t5GO 16t25G 0 0- 0 0 0 13tOOG G 0 G 13tGOG G 16t846 SOtOO 5 TOTAL REQUEST 49rt 380 539t499 89t916 - -- 104t903 - 4G4t 624 194;819 164;847 6Gr GO0 7StGOO 65tOOG 12StGOO 22tfOO 13t412 189450 .- 20rooo 4StGGO 19t950 14s 250 55tGGO 5GtGOO 55tGOG - 5 S CAROLINA PROG YR 06 S LISTING Y REGION NCIL OUTH `CENTR-AL COMP -_ COMPONENT TITLE . . .-----...__ _- - -.... NO.-.-. _.. . _ _. _ _ _ __. .._ _ 081 CATAWBA AREAWIDE HLTH DATA BASE 082 -- -iiYPT SiUDY BLACK MALEi CHARLESTON CNTY -..__ --_ -- _ .___.. - 083 DEMO HYPT CNTRL -- -_.-~_..-..--_.- 084 QlJE.IkC METHODS IMPROV `AMBULATORY CARE 085 --.. - _._... _- ______.__ - 086. .--- - 087 OCONOLOGY RADIATION DOSInETRY UUAL ASSIJR LAB PERS ' -^- WktAHAH BIS HLTH PLAN OR8 wi--- 090 LOW t@UNTRY E M S_.STUM UPPER SAVkN'ib.tl rLTH PLAN &RSE HIDHIFERY _ _ - -_. _ _. _ - . .I . REGION TOTALS 20710~1l9 _... -- -.._ .- - ____ - . - . _. _ -. - . _ . . DIRECT ,. REQUEST 32,000' 65~452 53,495 32rOOO 25~250 17,000' 15,000' 39500 51500 15,000 INDIRECT REQUEST 0 21~798 6r505 13rooo 9r750 .O 0 0 0 0 .289r881 O-23 _- * TOTAL REQUEST 32,000 87~250 60*000 45rooo -- 35tooo 17tooo 15~000 3r500 5t500 15,000 3T000~000 _ ~ ._ NA.y/JW!E 1974 REVIEW Request: $729,417 Committee Recommendation: $729.417 Overall assessment by individual reviewers: SUeEBLQ&_ . Its goals and objectives appear to be achievable. Critique: The joint RAG and CHP Advisory Council provide primary strength in leadership and in support of a small, capable staff. Program proposals are considered well defined and priorities well meshed. With regard to Indian involvement, several staff activities conducted on Indian Reservations, were proposed by Indian RAG members. Cooperation is commendable, as is the participation of the Grantee institution in program implementation. Quality assurance activities are continuations of two program staff initiatives directed at developing guidelines for use in establishing PSRO criteria and the identification of continuing medical education needs of MDs. These are proposed to be assumed by the 6D Med. Care Foundation which will be the State PSRO when funds are available. The Medical Genetics service began as a developmental activity under program staff funding, and will be the only one in the State. Its focus is on identification of birth defects, , to improve diagnoses and establish referral systems. It would be managed in conjunction with training in chromosome analysis, while other sources of support are being sought. JULY/AUGUST REVIEW -- Estimated request as of May 1974: $15Q,OOO MC0 . 6/4/74 , STAFF SUMMARY FOR MAY REVIEW SOUTH DAKOTA REGIONAL MEDICAL PROGRAM: RM 00067 PROGRAM DIRECTOR: Mr. Donald Brekke (full-time) on Duty since Nov. 1972 (Prior to appt. had been deputy director) STAFF: (FTE) Total - 6 Additional-Proposed: None Professional: 4 Other: 2 Expect to use increasing number of consultants and University technical advisors, without reimbursement. FUNDS REQUESTED: Total (D.C. & I.D.C.) $729,417 (exceeds est. target of 571,095 by 158,009) * Program Staff 210,921 - - Staff Components (8) 76,252 Total Program Staff & Components 287,173 Projects: (11) total 442,244 Continuation (6) 252,568 New (5) 189,676 * Funding base reflected program in planning status. Program approved for operational status January 1974 by NAC. e f CHP COMMENTS: RAG and CHP Council one and same; members of various technical and review committees, represented on Executive Committee and actively participate. Goals and priorities coordinated and integrated in a dual matrix - care levels and functional objectives. Priorities are manpower development resources to improve quality care. and ACTIVITIES: #3 - EMS - continuing at only slightly high level for expansion of training and for advance program in development of a total system (EMS) CATTAC. #6 - PSRO - Quality assurance activities; emphasis on improved data base, medical record quality, base for continuing education of MDs and other health professionals in preparation of a PSRO; assist SD Medical Research Foundation . Most activities requesting the same, less or only small increases above current program (annualized). Exceptions are the PSRO activity and the development of the Sioux Falls CHES (presently a core component until project director appointed - site selection has been made and will be converted to project. This activity will complete the Statewide CHES program and enhance the total manpower resources development activity. July 1 s- expected to request $150,000 L. Resnick - MC0 -Revised 5/28/74 a n _______ .*. 1974. __._ _. __ _ ___ - - __. __ .__ ._ . 7 S DAKOTA _. _ PROG YR 03 `__ . S LISTING ID~CDNTINENT CDMP . . . . .-- - _.__ . . NO - - - - . _ - ---- - __ __ _. _ _ COO4 - -.--- .-.---- ---_.-_. COO6 - --. - -- __ -- . . coo7 .-_ _. ___ ._ ___ &8 ---*.-es -... ---.-- _ ..___ __ COO9 ---. _-z __.... ---. __ co10 I ----~ -.- - __- :_ _ -. co11 -.------.. -_l_l_ _ _ co12 -- . - _ __ ___ 002. - --- -..- ---.-- -- -- --. . .._.-_ -_._ -_ _._ Cl03 _ _.-. 004 005 -. obd COMPONENT TITLE OIRECT -.. _. REQUEST PROGRAM STAFF 149r568 ' SANA INDIAN RESERVATION PRECEPTORSHIP 21250 NURSE RESOURCE LIBRARY . `. _.. .,_ . 3rooo ACUTELY POISONED PTS 3rSOO MGT HYPT PHARM PIME RIDGE RESERVATION 6,400 PT iJRI;NTEG HED RECORDS ' . . 17,262 ' RDhUD INDIAN HLTH HLTH OCCUPATIONS 39200 * COUNCIL AFFILIATED HOSP - 1,140 S1OUX FALLS AREA CHES --- -- I -. 39*500 L&IS ANG CLARK HLTH ED AND SERV CTR 60,350 EMERG HLTH SERV 471301 OAHE- -C&nUNITY HLTH. EOUC SYS --. ._ _. - - . . . .-- - - L._ . . . 45r200 - HYPT EDUC PR`!ZV OFT REFER .- .. 3or800 PSRO 43;ooo 006 -.- CMNC D1SDRDFRS GERIATR1C PTS `.. - ; ~ ..- - -. ^ _ 329956 Ol@ ME0 GENETICS 46,354 011 EST CDhT ED RECOCNITIUN 10,300 Oli - ORGAN12 AWARENESS DEVELOP IN SiRV TRNG --. 221000 013 ST -LUKE'S RESP OUTREACH 30rooo 014 &TERN ~LTH SYSTEM CHES -- 48 ~066 ..--.--we . - -.-.. .- --_- - - ._-____ _ -. - --.. . . CF CDMPCNENTS 20 REGION TOTALS 642~147 -. IN01 RECf REQUEST 611353 0 -. 0 ._ -0 0 0 0 0 0 .14r 407 4,730 6,780 0 0 0 0 ' 0 0. 0 0 879 270 osn -0 O-23 , _-. TOTAL REQUEST 21&921 2,250 _ _. ..- _ 39000 3rSOO 6r400 17,262 .- 39200 X*143 39,500 f4*757 - 52 to31 .- _- 51,980 .' 3or400 43rCcl 32,956 46 ~354 JO, 300 22,000 .- - 48 t 066 7299417 ---- -.-.. . _. 1 - a , cr3 t: .i ct\K? : The Committee expressed concern over the lack of planning for present and future activities. The application appeared to be essentially a rebuilding of their budget. The request was primarily for staff support-and a request to fill.10 . vacant positions, plus support for 2 projects, Committee recommended $250,000 in program staff support, $60,000.for grantee costs and $95,000 for ongoing projects.' This would in effect give,SVRMP some room for expansion as well as keep the remaining 14 positions. Further hiring should cease until a definite program can be identified. Committee recommended a site visit to this region prior to Council meeting or if this could not be arranged, to have key representation of the program visit DRMP to provide additional information regarding future plans for the program. i JULY/AUGUST REVIEW Estimated request as of May 1974: $705,.860 \ 'Y , e : , ? o SUSQUERANNA VALLEY Regional Medical Program Coordinator: Chad Combs, T.hm Staff: Full Time Prof.: 9 , Part Time Prof.: 3 Full Time Other: 2 Dart Time Other: 0 Total 14 RM 00059 On duty since: 5174 As Coordinator with RMP 2 yrs* 16 Proposed : 4 3 0 -. 23 Funds Requested: 1st May Total ..*.*.,.*......*... 721,606 . Continuation., .C2), . . . . . . . ( 32,634 ) . ..*...***.. ???? ? ? ? ? o ? ? ( 63,000 ) Period of Time Requested: . Request is for program staff 6/75 continuation of three previously funded activities for July and August 1974, and 6/75. Activities Proposed: Refer to Management will be placed next Information Systems (MIS) printout. (Also, note symbol C to activities which extend beyond June 30, 1975.) one new health planning initiative e List over any continuation project or staff activity annualized current funding is requested. RM 00059 .(Susuuehanna Valley) for which substantial increase The FY 73 annualized level+for program staff was $599,435 d.c. HMO project: NONE EMS project: PIONE - PSRO: NONE Kidney: NONE CHP comments: One CHP will forward comments to Associate Director, Health Resource Planning since they -fo)md it impossible to complete their review by 5/l/74. . . SUSQUE VAL _ ~_ PROG YR 05 . . . LISTING REGION ERN CUHP COMPONENT TITLE DIRECT NO .__ _ R EQUE ST - _- ----. _ . _ .- coo0 PROGPAPI STAFF 498,124 _. _-_ . . _ coo1 &HBULANT PATIENT DATA ANALYSXS 5,000 -.-_ -I___..._A._- . -- .- CO15 FACILiTiTINC; DEV REG HLTH PiiN ..' - -. `. 50*000 040 - SO CENTRAL PENNSYLVANIA HLTH ED CONSORTIUM 8,472 041 NORTiCENTRAL PENN HLTH ED SYSTEM 13,530 . ,,---.- - .- _ - ._ _-... __. ._. ._ ._- _. F COMPONENTS _ 5 --. ~_ ._ -. -- .._ I REGION TOTALS 575rl26 .- .-.. _.- . _ -- - _ . .--I..___ .-_-._-- _...-. - . --_ . -. .-.. - .- . _ . - .- .._ -. __ ._ . . - INDIRECT `. TOTAL REQUEST __ REQUEST 127,848 '625,972 11300 be300 _ _ 13rooo -- -- -i3,000 * _ _ _. _ _ 3t195 llt667 lrl37 14t667 _ . . 146,480 -721~606 -. `I'I~NNESSl.~E NJ)-SOUI'I I REGIONN, l\lEDI CAL, PROCRAM Iv4 00018 MAY/,JINl: 1.9'74 lEViI% $2,283,972 Request: Committee Recommendation : $2,133,972 .~---- Overall. Assessnm~ t by Indiv.klual Reviewers : Average Cri. t iquc : This proposal was reviewed in depth by two reviewers and the consensus was that this regi.on al.though it h.as a new coordina.tor, does have adequate leadership ;uld staffing . The new RAG is good and assuming a proper role as dcc.i.sion-maker. Past pcrforxinnce and accomplishments were considered good, with activities properly addressing their priorities, The proposed appl ication had 49% budgeted for continuation activities, 37% for new activities and 14% for staff and. staff acti.vities. W-II' rcl.ationships have been good w.ith proper coordination and participation. One of the reviewers, who had formerly sit.e visited this region, complimented the region for beginning to move into outreach programs where the needs are so great. In arriving at the recommendation, tlnro lxojects were considered to be of low priority and the region may want to consider purchasing films on dialysis rather than producing new ones, It was felt that the cancer activity proposed, in view of time-frame, should be funded from other funds. JULY/AUGUST REVIEW Estimated Request as of May 1974: $850,000 Dnr/ir'/l~D SCOB/G-6-74 TENNESSEE MID-SOUTH REGIONAL MEDICAL PROGRAM 1110 Baker Building 110 21st Avenue, South Nashville, Tennessee 37203 MAY REVIEW STAFF SUMMARY Prepared by: Lorraine Eyttla RM 00018 Richard 0. Cannon, M.D., Coordinator Current Staff: 6 Full-time Professionals (1 of whom is located as full-time professional outside RMP office) 1 Part-time Professional ( at 50% effort of a consultant located outside RMP office) 3 Full-time Support Staff 2 Part-time Support Staff 12 Total Staff FUNDS REQUESTED: On Duty Since: 9173 Proposed Staff: 8 Full-time Professionals 1 Part-time Professional 7 Full-time Support Staff (1 hired since application was prepared) 2 Part-time Support Staff (1 hired since application was prepared) 18 Total Staff Target Figure: $3,118,179 Total Costs - $2,283,972 Program Staff - $370,866 Continuation - $1,094,490 (18 activities) New - $818,616 (19 activities) PERIOD OF TIME REQUESTED: 7/l/74-6/30/75 ACTIVITIES PROPOSED: Continuation - Although these activities are classified "continuation" most were activated as an operational component approximately November 1973, and some were activated within the past four months. Component #72, is the logical extension of a pilot project seeking to develop a telemetry link from patients in the field to coronary units for emergency purposes. Component t82 concerns the treatment of renal e disease. However, the proposal does not seek to fund the expansion of existing chronic dialysis units. The equipment purchases are not dialysis machines. Page 2 a TMS/RMP Summary e New Activities: #98, Upper East Tennessee Dialysis Project, represents an expansion of chronic renal dialysis services. CHP need certification has been received; interim approval from SSA has been applied for but not yet received. CHP Comments: All projects were submitted to appropriate "b" agencies. Written comments submitted on 10 of the 19 new activities (all favorable). Verbal approval has been received on all new activities from appropriate "b's" with promise of written follow-up. Mr. Boris Georgiff, Director of the "a" agency is a member of the Regional Advisory Group and attended the meeting at which this application was discussed. Items for Reviewers' Attention: .During the last year this region has faced some provocative issues and has emerged with the following strengths and weaknesses: - A revitalized RAG (operating with new by-laws) which in very short order assumed the proper role of decision-maker. - A small (one-third its former size) central staff that is spread a little too thin but mobilizes itself totally and without friction. - Improving relationships with a grantee which has assumed a more proper role in the tripartite aspects of RMP structure (RAG - Coordinator - Grantee) DRMP/WD 0 scOB/5-16/74 MAY 1 _. _. . _-. `ENN HID S. .PROG YR 06 I CENTRAL-. COHP _ _ .-.--- _ NO CC00 - . _ _ _ coo7 _-_,. _ __ -._--. _ CO25 _. 057 .~ 061 ._ .-.---. ._ 062. ._. ._ ..- 064 065 .- -. 067 COMPONENT TITLE PROGRAH STAFF RURAL STUDENT HLTH COALITION E TENN _ .- STUDENT APPRENTICESHIP FAMILY COI'iMUNITv HLTH . HYPERTENSIVE FOLLOW UP SE HLTH SERV EDUC nro EAST HLTH SEKV EDUC COORO PEDIATRIC EDUC SERV SYS - RE&JNALIZATION HIGH RISK NEWBORN CARE CAYiE MIHES CDM+lU!JI JY cLINlc 068 NiJRSE CLINICIAN PRCVID PRIM HLTH CARE DO? - _- 072 HIGH RISK OS; _.. . UPPER E TENN EHS 074 078 ..- _..- 079 0.50 082 -.._ - 084 065 . OPP - 069 090 -_ WYNN HP~ERSHAH CLIKIC . APPALACHIAN NURSE HIOUIFERY CHILD PROJ -ORGAN DON02 EDUC UJILI.? REG TEACH PERS STRENGTHEN PUB HLTH ED CHRLiNIC KIWEY DIS PT CARE SYS ' HYPERTENSIOY SCREENING .. . -. -- - COORD SYS APPRCACH COST REDUCTION . -FIRST TENN REG LENT P'(@J &GS CNTY PRIM CARE __. . _ PRIM CARE STONEY FORK TENN - REQUESTED FU COMPONENTS STING GION 06/?4 COUNCIL . _. OIRECT - ._ REQUEST 309rlTf __ 5atooo .-. -_. ..-. _.-..1 . ._ ._ . 15,400 ._ 82,119 122,082 \5r158 'iOlt737 .125,131 . 90,042 149442 339132 24t900 34,764 19,420 55r915 469620 125t056 12rooo 24,923 52,000 76,544 12.820 _. -- INOIRECT REQUEST 61~689 2rllO lr232 139302 -. 0 6~484 '30,189 29t927 0 -. l&242 6r218 . 0 0 3~923 0. 7,022 0 0. 0 0 5t602 - 0 TOTAL- REQUEST .370t866 52tllO _.- lb632 -- 95.421 1229082 219642 131r926 155~058 909042 15r684 39,350 24~900 34~764 23*343 559915 53~642 125rG56 12tooo 24,923 52,000 82~146 12*820 TENN flro S... * PR9G YR C6 REQUESTED FU 0 STING COMYONENTS EGION 06f-74 COUNCIL --- H CENTRAL -. CDMP COHPONENT TITLE ___~ _____.._._ - __.___. NO ___ _ -.- -. 091 P. H HURL CLINIC'SERV -- -. _ _ ..__ ,- 092 '--LIFE ADJUSTMENT SERV CA PTS __ . --' - -_-.-. I_ _ -.. ..-. _. _ 093 PLAN ;UNG CA DETECT . -.-~ 054 HYPERTENSION HGMT CTR I * _ _ __ _ 095 PNEUMOCONIOSIS SURVEIL AND !4GMT __.__.___ - ---. 096 '-- V tj INFO CTR - ." - \ .O97 SE REG REHXB THFRdPY . * . 098 UPPER E DIALYSIS -. -_ .-. - 053 TENN HOSP EidGINEERING & SAFETY- - 100 CCJORD Mb!DWR DEVELOP 101 R&P HGiJSE CDMXJYITY CLINIC _ - lC2 - HLTd STATUS C !?ZD `%`WR `. lC3 ARCHA HLTH SERV PLAN .- . 104 iRNG NURS PRACT CHRONIC CAdE 105 CkRFER LADDERS ALLIEC HLTH PERS CF.-CCMPCNENTS . _ _ __ _ - -. ^.._._. -- 106 Di%T AUXILIARY %OGULAR EDUC I 38 _. . _. ..- ---. .-- - -- . _ ._ _ .- _ -. . . ._ __. .__.. -_ . . -- REGIm TOTALS - 2t072t122 OSW-PU * 3 _- _--. DIRECT REQUEST 5,006 24t620 43t900 71t856 42t498 20t610 48t714 25tfOO 37ra00 52t004 699928 - ._ 12,770 .24t453 74t225 24t656 5otooo INDIRECT TOTAL `. REQUEST _. . . REQUEST - - .- 0 - -59006 it510 29t130 . _.- . 8.856 - - 52t756 0 7lt856 - 0. 42t498 .-- 0 20t610 - 6t674 55t388 0 25t700 _ 0 37*800 - __ _ I - _ St&' -.- 18t695 0 24t453 .-. I_ 0 52t004 0 69,928 1 . -- . 16t945 91t170 - o- .. 24t656 -- 0 50,000 21lt850 21283t972 RM 000 07 . . . . .. . Request: $3,333,557 Committee Rccommendntion: m 0veral.l. assessment by individual reviewers: m _ ww&+$age . Critique: Committee recommended that the RMPT submit the RAG-CHP reviewed contract proposals in July for a detailed review by the Review Committee. Permission would be extended to the next scheduled Review Committee by the June National Advisory Council allowing the Committee to review and extend final approval of the contracts with their accompanying funding requests. The procedure would allow the contracts to initiate in July, rather than September, and would preclude the necessity of a Council review in August. This expediency measure has been considered important from a management standpoint. The RMPT has been most effectively managed by an able Director, Mr. David Ferguson, and a talented staff of very limited size. Reviewers did express concern regarding the capability of the staff to effectively manage and monitor the very ambitious program set forth in the application. Mr. Ferguson,.through the select contract mechanism, is expected to follow through most competently by-DRMP staff. Concern was expressed regarding the Requests for Proposals, the contract language employed and the Sameness- in the language used to describe the activities. The submission on July 1 of the form 15 s (narrative) and 16 s (budget) should further alleviate the concerns raised. The relation- ship between the new activities, the expected outcomes and the prospect of future funding for the new activities should be clearly discernible from W.the--:J~ly submissjon. Estimated request as of May 1974: -$1,298,599 for contraqts not approved for funding in yay application. I STAFF SUMMARY FOR MAY REVIEW Prepared by: M.E. Murphy REGIONAL MEDICAL PROGRAM OF TEXAS: RMP #07 COORDINATOR: David K. Ferguson - since 8/73 Deputy Director - since 6/71. STAFF: (FTE) Total - 12 Professional: 8 l/2 Clerical: 3 l/2 Requested Positions: 5 (3 Prof.; ,2 clerical) FUNDS REQUESTED: Total (D.C. & I.D.C.): $2,;;;,::; Prosram Staff: Staff Developmental: 210:ooo Staff TOTAL: 529,111 Projects: 1,804,440 r.-Continuatfofi (6): 348,000 .*SJew (5) 1,456,440 CHP comments: Received from all funded and appropriate '5' agencies and the 'A' agency. Comments good and responded to by RAG. Included application. Reference on page 21. CONCERNS: (5) in 1) Project #glA: EMS Manual Implementation is a continuation activity. p) Project #106: Renal Program of Texas. Expansion of ongoing project. Activities consistent with the statewide coordinated comprehensive Renal Program of'Texas. RMPT application request is equal to target figure (140% annualized amt.)- $2,333,551. Provided application is funded, AS REQUESTED, no July 1 application request will be made. * Will include approximately 35 contracts in 5 areas of emphasis: 1) Health Education; 2) Health Economics and Systems Demonstration; 3) Health Manpower; 4) Health Care Quality; and 5) Management of Major Diseases. Status as of 5/15/74: 25 requests for proposals (RFP) distributed to 500 bidders (select universit$es, organizations, individuals, etc.) Received 130 proposals and anticipate 70-80 proposals will receive full review., Expansion and Continuation Activities 091A EMS Manual Implementation 30,000 094A Community Health Nursing 32,000 1OOA APACHE 50,000 1028 Hospital Patient Education Program 35,000 1048 Planning a Community Hypertension Control Program 60,000 106 Renal Program Support Project 141,000 Mew Activities 108 Health Education Project 286,400 109 Health Economics and Systems Demonstration Project 636,340 160,000 308,700 65,000 $2,333,551 - 110 Health Manpower 111 Health Care Quality Program 112 Regional Disease Management Program e Total Application Request Application Philosophy Mid-Continent Operations Staff Analysis: Mary E. Murphy Texas RMP: #07 The application requests funding for the period of July 1, 1974 through June 30, 1975 for the following activities: Program Staff Staff Developmental Projects/Contracts $319,111 210,000 The new activities, to be funded as contracts, are in the developmental stage within each area of emphasis, 1) health education, and Systems demonstration, 3) health manpower, 4) health 2)health economics care quality, and 5) management of major diseases, 25 requests for proposa 1s have been developed and widely circulated (See Appendix). Letters of intent are now being received by RMPT and the full proposal is due May 15. The designated Program Committee consisting of Regional Advisory Group member(s) and related specialists will give the proposals an in-depth technical review. At the next scheduled RAG meeting on June 28, 1974. Action will be taken on the proposals selected for funding by the six Program Committees. Form 15 & 16s will be prepared immediatelJr,and submitted to DRMP. By requesting funding for the new activities at this time, rather than in the July 1 application, it -- will allow the contracts to operate for a full 12 month period. Mr. Ferguson strongly feels that an operational period of less than 12 months hinders the activity. If reviewers have marked reservations regarding funding of activities which do not present Form 15 and 16s, a consideration could be given to hold the award until the forms are received after June 28, 1974. Funds could then be released to cover Program Staff, continuation and new activities, covered by 15 and 16s. Therefore, the new activity operational period of 12 months would remain unaffected. If reviewers find funding at this time totally unacceptable, then the approved contracts will be submitted in a July 1 application which would give the contracts less than the desired 12 months operational period. -2- The RMPT submitted an Arthritis Proposal for funding in the amount of $356,559. Performance sites included Dallas, San Antonio, Houston, Galveston,. Lubboch and Austin, Texas, The proposal was to be critiqued by an assigned body of reviewers. Summary of the Regional Medical Program of Texas The RMPT is in the second year of its triennium. Present funding (l/1/74 - 6/30/74) is in the amount of $775,832. Project Activities number 14 at a cost of $340,127. Program staff numbers 12 full time, consisting of 8 l/2 professional and 3 l/2 clerical members. Pre-phaseout staff numbered 35. The Program Director is Mr. David Ferguson who succeeded Dr. Charles McCall. Mr. Ferguson served as Deputy Director from June, 1971 until August, 1973 when he became Acting Director. The Regional Advisory Group recommended the appointment of Mr. Ferguson as Director which became effective November 1, 1973. As a manager of the Regional Medical Program of Texas, Mr. Ferguson has exhibited strong leadership capabilities. No major organizational changes have taken place since the last NAC review in November 1973. The grantee for the Program is a non-profit corporation, Texas Regional Medical Program, Inc. The Board of Trustees numbers six members. The Grantee/RAG relationship is most satisfactory. The 1974 - 75 program is designed to utilize the contract award mechanism. Experience in 1972 and 1973, as well as during the 1973-74 period attest to the value of the contract as a management tool especially for activities of short duration. Experience with the contract mechanism is most positive in Texas and it is the intention of the Regional Advisory Group that it be continued. In order for a project activity to develop community involvement, carry out its specific objectives, evaluate its effectiveness, and present usable results for general distribution is at least a one-year tabk. The application appears acceptable for funding in its present form. a M ,1974 * -- . . . . . . 37 TEXLS P.RGG YR 06 4IC CONTINENT CDXP .- .._.. _ .._ NC! ._ Cii~O -.- ~. . COO3 091A _-- .- ---. 094A 1OOA - -_--. _..-- .__._ -._ - _ 1028 104A 106 ' 103 139 .llO ._.__ -. ._- 111 112 lrifX.CDMPfJN"NTS _ 13 -.- COMPONENT TITLE PROGRAH STAFF PROGRAM STAFF CEVELOPHENT -- EMS MANUAL IMPLE' ---- ___ _~,.. ._ - .- * CI-JWWNITY HLTH NURSG APACtiE HOSP PT EOUC --. - -- ' PLiN Cw?MUNITY*t!YPT CNTRL RENAL SUPPORT HLTH EGUC .- HLTd ECONOMICS AND SYS DEMD HLTti MNPWR HLTd CARE @JALe- . _.. ._.. .- ..- _ _. _ _ . REG DIS-.HGHT __ _ _ _ . _ . . _ -_ - - . REGION TOTALS .- _ _ __ _ . _ _ _ . - _. _ .__. ---._ I -.- ------.. .-. _- _ .- DIRECT INDIRECT REQUEST REQUEST 319,111 210T000 23,000 `- 259960 33r250 35 too0 51 too0 131,337 286 1400 636,340 : 160 9000 308,700 ._ 65r000 0 0 7,000 67040 16r-f50 0 9,000 9~663 0 0 0 0 0. 2~2859098 48t453 2,333t551 OS IO-23 F TOTAL . REQUEST 319*11x 210,000 30tooo - 32rOOO 50,000 35rooo --- 60rOOO 14L,OOO 286 ~400 636,340 160,000 308r700 -- 65,000 -- -. _-_ .-. . - i::.!:' ,.TR.I+TA?E ____-..._ ,.._ I,,.! ! ,;),`I (j2 ._.. -.. Crj. tiq1w : The Tri-State PPP request for $1,886,907 which was for the Massachusetts and Rhode Island portions only, g enerated considerable concern for the Review Committee especially with regard to certain projects which appeared to be over-budgeted. The reviewers in general were concerned with the Rhode Island portion.since there appeared to be.a lack of linkages of projects to an overall program. k minimal interim funding level of $850,500 was recommended. In addition, a site visit prior to June Council was felt necessary in order to obtain additional facts not found in the application. It was hoped that the site visit findings would aid Council in their deliberations. Estimated request as of Nay 1974: --; .I \ F. - 0 RM 000 62 TRI-STATE Regicnal Medical. Program 1-"-~-1-I- Coordinator: Mr. Roberi- Murrh.y, M,P,H. 2--~-"~~~&-&. On duty since: June 1972 Staff: Full Time Prof, 6 Proposed: 7 --1 .-I~~ .- - Part Time Prof, 5 4 I-.-"--._I"~. Y.I.--.-.l- Full Time Otli~~ h' 3 4 -_-- ~- .--. --III--IIIL-y- Part Time Other 2 3 .-".. "--"- "- 1"1- 'd'0t:d 15 18 Funds Requested:ga:-t Continuatl.on,GLk, a *. u I G. ( 324,779 ) Period of Time Reque: :ed: The program md all b I. one project requests support until June '75. Project 19 requests support u.: i.l June '76, a fourth year of support. Also, the Region requests 2110,O'r: in its core budget to contract out fiscal monitoring of its proi:am after June 1975. Activities Proposed: Refer to Iknagement Ir i zrmation Systems (XIS) printout. (Also, note symbol C will be placed next tc activities which extend beyond June 30, 1975.) @i QQ062 (Ia ( _.. _ 3 > t any continuation pr:,j ect 413" :2 taff acti.v:lty for which substantial increase r annualized current Fi~r:-1' 1 .,ig ia requested. Although Project 19 does noi. i.djl."tl:.c '--nr a substantial increase over the 1972 supplemental appropriat%on; thcire iT3 no evidence of declining funding for the fourth year, HMO project: jq:i:;E E8S project: Project 5ci Oi-gai:iizat:ion 6 Standardization of a Cardiopulmonary Resusitation from the EMS of confusion Program P..I. 'This pro:ject requests $40,160 and appears separate Project IE: 1;~:i;,:,.-!:I.zatl.un, which has been found to be in a state (See Clii' i:o:rl:i!t.r!r.s a:t.so) PSRCY: Kidney: CWP comments: The CHP A ct 8 comments only refer to Mass. and R.I. since N.H. will send in their activities July lst, R., I. Pro&Xt 50 m CPR '- --* T---- .-.-."I 'i'his project was felt to be highly ambitious and has a "dubious organization arrangement. TMG executive board, however, approved this with pressure from the R.I. members with the condition that the EMS Advisory Board of Project 18 approved this request, Mass, Project_29 Re.~ionalization of Maternitv & Newborn Care, was denied by one %S" agency, However, -."-lp the "A" agency g%Fzllthe highest priority. commended this p~:ojeci: not be funded, More information as to why the Tri-State ecutlve Board CommJ.ttee approved this is forthcoming. However, we were told the New Bedford por,tion of this project woti.ld he deleted, All other "B'" agency colnmm~nts a3xar favorab:!r and constructive. khC advice hefore funding. 'NAG will incorporate 13 comments and the STERN CIXIP .__-. __ - _ _ - _ NO coo0 018 019 ._ _. 043 044 .-.L...- _I- .-.. ___ ---~. 045 046 _ COMPCNENT TITLE _. -. ^. _ -PROGRAW STAFF EHSS - .-_. R I tiLTi SCL EDUC COUNCIL - - `- _ _ _ ' STUDY tiLTI-! POLICY IN MASS STUDY AMRULATGRY SERV GREATER BOSTON --TMPKDV CUAL CARE iURSXNG HOMES . . . I. - HYPT -SCREENING L@# INCOHE CDMMUNITIES INC ACCESS CARE MODEL CITIES RES meCDOi .FA:IILY HLTH CTR DATA SYS . -. I_ _ _ REGIONALIZATION MATERNITY AND NEWBORN CARE ORG AND STAND CP R I -"_ .- - _ ..--___ ..-- __ - _ 051 PREV Ek.`IRO'+tENTAL dIS . _ _ 052 HLTH SERV TIME OF ECONOMIC TRANSITION 053 FAMILY-PRACTICE RESIDENCY TRNG PROG STUDY II `.-II-._-~----_-"-.. .- .- .--- _ _ .--- _.- - -. .-_ -- ,-.. _ -. - -. CIF ~~~~~N~NTS 14 ~- --- - -- -- .- -- - REGION TOTALS .~ ..-- -__-.. ..-_ -_ __ ..____. _. _-- __ .--- --._ -.. - _.- ._._ __ _ _ .-_ _._._ .-- _ _. ._ L _ . _ _ ..- - -_ DIRECT 654.560 123r474 201r305 $86,300 35 0486 43r34j 82r990 31,500 * 131960 819057 4OtlbO . 349322 250rooo 17r500 1.795.959 . . REQUEST INDIRECT REQUEST 16,000 0 =3r743 0 ._. 0 0 0 90 r948 TOTAL REQUEST 670,560 123,474 201,305 23% ,000 35,486 `bf p 850 3Z~WcJ 31 * 5.00 P3*9eiO 84 9 800 40,160 34,322 250,000 17,500 l,0%b ,907 c -. . . .._....- .-. __ . . ..- . . -._ - ._ . . MAY/JUNE 1974 REVIEW Request: $1,290,482 Committee Recommendation:, $1,000,000 Overall assessment by individual reviewers: Average Critique: Reviewed by Panel R, this application was considered "average" and reflective of an "average" program by two assigned reviewers. Concern was expressed about the proporti.on of vacant staff positions, the proportion of hypertension related projects and a tendency by the region to "parrot" national initiatives as a funding strategy. Objectives and priorities were considered consistent with national guide- lines and leadership was considered adequate. Notice was taken that planning is closely coordinated with a "Governor's Committee" but in reality that applies to EMS planning rather than total program planning. A problem with one CUP(b) agency was discussed but not considered to be of critical importance. A motion to fund at $l,OOO,OOO was unanimously carried, JULY/AUGUST REVIEW Estimated request as of May 1974: $1,362,894 RM 000 49 e VIRGINIA Regional Medical Program Coordinator: Eupene P. Percz,.!E?..D, Staff: Full Time Prof. 9 Full Time Oither 5 -__..- - Funds Requested: Total ,,.I,..,*...*.*.... 1,290,482 On duty since: 7167 -- Proposed: S Continuation,........~~.. ( 1,290,482 > 581,602 projects; 708,880 program staff Period of Time Requested: None later than .June 1978 Activities Proposed: Refer to ?!anagement Information Systems WETS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) EN 00049 e List any continuation project or staff ac:ti.vity for which substantial increase over annualized current funding i.s requested, HMO project : ENS project: The region has a contract with Tidewater EMS to employ a training supervisor and a clerk; using previously unexpended contract funds. Project COL'L proposes regi.onalization of the state to tie into rescue squad patterns "for transport of newborns with emergency problems." Project CO28 will contract for instruction of qualified EMTs and certify them as lay instructors. All EMS planning has been closely correlated with the Governor's Advisory Commit tee. PSRO : Project COO4 has 10 physicians (others being invited) involved in an outcome audit of ambulatory care rendered relative to present criteria; and e to develop new criteria for at least 18 diseases and problems as a result. Project CO31 will1 make servi.ces of a Quality of Care Assurance Committee xnd a Utilization Review Committee available to all EVIMEC as well as any others interested i-n joining. Project CO33 wPl1 support workshops aimed at effective self analysis of quality of dental care rendered. Kidney : s CHP comments : Not sol.i.cited because all projects are continuations which have previously been reviewed by CUP MAY 15r 4 Q _~._. _ --. . _ - , -_ _ _ - -_ IREINIA PROG YR 05 RN - CCHP -..-._ .._ .-._ _ NO ..- caoo COO4 __- I_. ---- -.._- .-.-- . - -.- coo9 COII. to12 - _ .- "- _-_ --__ -. co13 COY4 CR2R - ._._._- -. .- ca2.s ccsc CO.?? CFZB co29 cc!30 .-.. .._ ..--_. _-- CO31 _. CO32 te33 -_ COMPONENT TITLE PROGRAM STAFF OuAL ME3 CASE REV - PRIM CARE PHYS DIETItIAN TiG PROG 2 RENAL DXS 6 HYPT` EHERG PERINATAL MED FA?IILY CIuf?S PRACT TNG ._ BP SCSEFNING - VA HT ASSN PRIM CARE NUXS PRACT HYPT tCiiM?RE COMWNITY RASFD HVPT CONTROL SCREENING HYPT DENT OFFICE PHA9f-l DRUG MGYT ED HYPT PT BY PHARN PUB SCu CuRRIC HYPT - CIRCULATORV SVS Euls TRNG- TRAINERS. COST CCNTAINMENT RATE REV ADLlLESCENT HYPT SCREENING. ~IJAL MEO CARE ASSUR - NOR FOLK -CONiORTIUM HOSPS EDuC PRCIG CHILD ABUSE PREV PUAL DENT HLTH CARE ASSESS - C&A , NURS-IN-RESIDENCE ..-- .- - .-__ - COB% -- PHYS-IN-RESIDENCE ' . COPC PHARH-IN-RESIDENCE _. DXRECT INDIRECT TOTAL REQUEST REQUEST REQUEST 7084880 0 30,ooa 0 539969 ; 32,000 _.. 10 ,OUO 40,000 12,850 441930 28rOOO 0 0 0 0 0 0 _ 0 0 0 0 0 0 0 0 0 0 50,000 .- 10,000 - 12,000 . 0 llr200 0 COHPDNENTS 20. REGION TOTALS 1.290.482 0 1 r290t482 ""I. *"I--- -- ,. ,o I 708~880 30~000 -12v000 39v400 - --. 54v 000 20rOOO - .. 25~000 739645 22r608 - 53*969 32vOoQ 10,000 -' .. - 40,000 12,850 44,930 I' . 28~000 50tooo 10~000 -- - 12,000 ~. llr200 .I. -- _ - m RI41 Washington/Alaska __----..--.-- -"-.-- M,`iY/.JU;;E 1974 i!l:V1 IN .-___ ---..----- e-_--e CrJ t4 quc : Washington/Alaska is a superior, well-managed program. The RkG is forceful and active in determining program policy and direction based on'the needs of the area. The technical review committee structure appears well-designed and active. Staff was reduced from 52 to 35 during phase-out. Howeverr recruitment of new staff is in process. Staff direction is superior. There appears to be close collaboration with the CHP agenciesin the.area. The proposed program, as well as current activities, represent a good balance both programmati- tally and geographically. The Committee recommends that this application be approved the requested level. JW..S!/AlJGUST REVXI!W Estimated 'request as of Hay 1974: $500,000 \ WOB 6/6/74 . at ' FUNDS REQUESTED: Total. (D.C.- 1.d.c.) Program Staff 7 continuation Projects 12 New Project84 Since - 1966 Proposed: 38.85 Professional 24.60 14.25 $2,077,3LL L,053,131 521,948 502,232 $2,077,311 ~o~~~ts were received from the two CHP (a) agenci.es and five of the eight CHP (b) agencies, The Alaska CRP (a) agency questioned the need for Alaska Health mupower Corporation's project, Physician Extender Placement Program (R7Q - page 89). The Spokane County CHP (b) agency In commenting on the projects, noted that "i.t was apparent that none 0 of them wouLd directly impact our area. If at all, their impact would be P'.ndbrect". (See page 45) The Spokane group also expressed concern about the Gynecorps Training Program and a Clinical Laboratory Services pr0jtXt. Roth of these projeCtE, however, were not approved by W/ARMP. The Puget Sound Health PLanning CounciL's Special Regional Project Review Committee did not complete its review of the W/ARMY application. The staff of the Puget Sound HeaLth Planning Council commented on 19 projec t8. Between the council and its staff concerns were (see p. 55-63) expressed as follows: #47 Stroke Nurses Training --"difficult to assess need for additianal practioners'"; #?7 Patient Care Appraisal--"program an wmaceaaary duplication of effort, especially in light of the up- comitrg PSRO prograd!; #81 EducatLon of Nurses to treat Hypertension-- gpecialized training in hypertension should be included in the nursing continuation education processtP. Other projects for which the Council had concerns were not approved by WILtDiP. y 22 aLI CHY comments wiL.L be further reviewed by the W/ARMP Executive ttee end each significant negative comment will be addressed. W/ARMP will submit wfrnutes af this meeting to DRMp. ITEMS FOR REVIEWERS ATTENTION: ,I- None of the activities proposed appear to conflict with other Federal programs -- such as Lipao, PSRO, Kidney and EMS. WASHINGTON/ALASKA REGIONAL MEDICAL PROGRAM: RMOO038 University of Washington, Seattle I COORDINATOR: Donal R, Sparkman, M.D. ,+' " Since - 1966 STAFF: (FTE) 30.85 Proposed : 38.85 Professional 20.60 Profes8ional 24.60 Other 10.25 : 14.25 FUNDS REQUESTED: Total (D.C,- i.d.c.) $2,077,311 Program Staff 7 Continuation Projects 12 New Project8 1,053,131 521,948 502,232 $2,077,311 CHP COMMENTS: Coarnents were received from the two CHP (a) agencies end five of the eight CHP (b) agencies, The Alaska CHP (a) agency questioned the need for Alaska Health Manpower Corporation's psojrct, Phyeician Extender Placement Program (#70 - page 89). The Spokane County CHP (b) agency in commenting on the projects, noted that "it wa8 apparent that none of them would directly impact our area. If at all, their impact would be indirect". (See page 45) The Spokane group also expressed concern about the Gynecorpe Training Program and a Clinical Laboratory Services project. Both of these projects, however, were not approved by W/ARMP. The Puget Sound Health Planning Council'8 Special Regional Project Review Cormnittee did not complete its review of the W/ARMP application. The staff of the Puget Sound Health Planning Council commented on 19 projecta. Between the Council and its staff concern8 were (see p. 55-63) expreaeed as follows: f47 Stroke Nurse8 Training --"difficult to 888888 need for additional practioners"; 1177 Patient Care Appraisal--"program an unaacessary duplication of effort, especially in light of the up- coming PSRO program'!; P81 Education of Nurses to treat Hypertension-- $pecialized training in hypertension should be included in the nursing continuation education process". Other project8 for which the Council had concerns were not approved by W/ARMP. On May 22 all CHP comments will be further reviewed by the W/ARMP Executive Catmaittee and each significant negative comment will be addressed. W/ARMP will submit minute8 of this meeting to DRMP. ITEMS FOR REVIEWERS ATTENTION: None of the activities proposed appear to conflict with other Federal program8 -- such as HMO, PSRO, Kidney and EMS. *WASHINGTON/ALASKA Summary Page 2 0 CONTINUATION ACTIVITIES : Of the 19 projects, seven are continuations, six of these continuation8 are projects which were initially funded a8 Functional Program Activities (FPA) . The FPA is an application to utilize fund8 for an "immediate purpos etr and for which specific evaluation questions have been developed t0 888888 it8 Value. There does not appear to be any significant budget increase8 in any of the continuation activities. DRMP/DOD WOB 5/21/74 n ' ,1974 .`- .-.Q. ----.-- --.-:I - -- .- -- - _._ 38 WASH ALASK . PRCG YR 06 WESTERN -. _. _. COMP -C&PONENT TITLE-' ---_ -..- --. .___-_ _.- WI - _.._. - . .._ - ._ _ - . .-. . coo0 PROGRAH STAFF 047 -- STROKE NURS CLINICIAi ---.----- _-.._ L. . ..- -._ Of0 PHys EXTENOER `PLACEMENT -. . .`- - .--._I ____. .-_ ._~._ 071 INUIAN MID-LEVEL HLTH PRACT 072 TRNG HLTH CURRIC -- --- -_.. ._._ ..__ . _ . . _ . 073 SE ALAiKA CONT FDUC .. 074 N\IP,S- PRAcT PREPARATION ~LACEHENT AND EVAL' 075 `COtJT NURS EDUC COORD -l---l..-- _-_. -.-- .~ _ ___ . ~_._ _.. - 076 PROFICIFNCY ASSESS H&P LABS --. .- ..-_.... - ._- 077 -. PT CARF APPRAISAL 078 -- ~_. NURSlNG AUDIT .-- ..-. -- .--____--. 079 --WELL-ADULT CLINIC SENIOR CITIZENS' - ' .-' 080 PACIFIC NW REG CA COUNCJL 081 EDUC NURS TREAT HYPT -I--------.-. `- _ _ 082 SHDRTENfO TIME HOME DIAL .- --. ..-~ ._.. - _.._ -. OK - REG FARMHbRKERS HLTH- ADVISORY GROUP 084 HLTH MNPWR CLEARINGHOUSE - - . .._ - -.- ._-_. _ _-._-. 085' MIPJORITY HLTH SfRV EXPERIENCE' : -- .-_ 066 o ANAL REG NEEDS CARE NEWPORN 083 HLTH POLICY PLAN - . _.._ _ ._.. ._ ._. _. _ __. _ ___ _ _. DIRECT _ REQUEST INDIRECT REQUEST 9309255 122t8?6 699171 0 36 9793 72,173 _.. 0 6rOOl 0 . I 110,810 1649136 -- 13,327 0 -. 0 42r645 37~844 39 (994 21r700 . . 219319 ; 0 0 0 39789 3rOlO 42,290 68 9998 48,650 23,412 67,710 7r780 0 8~222 3~096 5,880 ft740 3 OF COHPONENTS 20 REGION TOTALS . lr901*591 175,720 2rQr?*311 -_ _- o TOTAL REQUEST ._ _._. 1*053* 131 -. 72,173 69001 110,810- -- 177,463 , 62.D64 27~046 42tb45 37, a44 8r580 43,783 24,710 29~099 42,290 77,220 51,746 299292 75,450 . . -. m . . _ (,. 1.. , . >, i i I _- 3, ; .i: , i `# ; .I . , i'T:`J; i,' ' / __. ,...___ - - ._.. _ _ _ _. . . Critique: The application submitted by West Virginia RMP was a request for continuation of staff and on-going activities only. The request for support of new activities will be submitted on July 1, 1974. The Reviewers and Panel B members agreed that WVaRMP was a superior . region, not unlike Maine in that it is a state with few health resources, many problems, poverty, etc., and that the WVaRMP has quite success- fully been addressing these problems. * The Region was characterized as having strong leadership, an active and dominant RAG (which is well represented by the sparce health resources in the area), and a competent, experienced staff, It was noted that the program enjoys support from not only the University (the grantee) but also the State Medic&l. Society and State Government as well, The region was commended for its ability to attract "outside" funds to support and expand activities planned and initiated by the RMP. There were no dissenting votes on the motion to approve the application in the amount requested. : . JUJ.X/AUGUST REVIEW Estimated request as of May 1974: $1,200,000 \ I' . WEST VIRGINIA Regional Medical Program RM 00095 Coordinator: Charles Holland Staff: Full Time Prof. Full Time Other Funds Requested: Total I.*.*.,...,.*.,.*.. $ 663,132 Continuation..,.,........ ( 42,457 13 4 17 > (projects); ) On duty since: 1967 (Coord. since 1967 Proposed: 15 7 LZ Period of Time Requested: Juty 1, 1974 to June 30, 1975 Activities Proposed: 620,675 Program Staff Refer to Management Information Systems (MIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) moo045 W. Va. List any continuation project or staff activity for which substantial increase over annualized current funding is requested. HMO project: EMS project: PSRO: Kidney: CHP comments: State Director of Comprehksive Health Planning recommends approval of this application. Both projects are continuations and have been previously approved by the "b" agency, KAY 74 - . a _ ._ _ ..-. _- _ _ - REQUESTED COMPONEN 06#74 0SM-P -23 e c H VIRGINIA _ PROG YR G5 t COMP - COMPONENT TITLE - TERN DIRECT INDIRECT TOTAL ._. ._ ._- .-I-. _ ._ ..-._.. NO. -_. . - _ _ . . .REQUEST _ REQUEST REQUEST -_- COO0 PROGRAM STAFF - _ _ _ 011 - SCHOOL HLTH PROG RURAL- COMMUNITIES _.-___-.---- - - -__ . . . LEGAL P.RiJ - " -_ . 015 __-- .~ - .~ 491,590 13t829 219274 129t085 b20t675 0 13t829 ?t354 -- - 28tb28 _ OF COMPONENTS. ~ 3 - .__ # . REGION TOTALS 526,693 136t439 bb3t 132 .--. --.- -- -._..- .-.- I___ - __-. --- _-._ . _ __ -.. _ ._ ._-..-._. ___ ._ -... .,_- ._. . _ -- I *- _. _ I ._ .._. _.. _ _- _ .._ _ \ --- --.. -.-. -_ .:~~---.--. _.,_- __ ___ .__ __- _____ __ _..._- __ _ _.. ____.. . ..__^_._ - _.._ __ ._... ." _. ._-- -.. .- --. . . , _ _ _ .,. _ ._ . _ __. ----.- -.-. . -- _... -._. _. - .- -_-_.- _ _ _ _ _. _ _-.._ _. __..__. I ._ _. _ ._. _ . _ _____ _-. ._ __- _ ._ _. . - - - _ _ . - ---- -__ ---I_- --.- -_ ---- .___ -_-- _ _- _ . . _- _-_ -_ __ - . . -.-.- - . - . .- ._ I . _ _.-- _ - _--_ - - RMP Western Pennsylvania RM 00041 MAY/JUNE 1974 REVIEW Rapes t : $1,985,273 Ohio Project: $170,285 Committee recommendation: $1,370,285 includes Ohio Projtct: $170,285 Overall assessment by individual reviewers: Average Critique: This application includes continuation funding for staff and 16 ongoing projects in Western Pennsylvania area and one ongoing project in Ohio which had been developed under the former Northeast Ohio RMP. Two-year funding is requested for two of the Western Pennsylvania pro j ects . The objectives of the program appear well throughout and the projects well designed. The community involvement throughout the areas was noteworthy but the review process*with area committees appeared somewhat cumbersome. Three issues concerned the Committee: the fact that the coordinator is still the University Vice-President for Health Affairs, the kidney project and the request for two years support for the kidney project, and a nursing education project. Staff was asked to clarify several, questions about the kidney projects, The Committee was informed that the coordinator-director issue would probably be resolved this summer with the retirement of the coordinator, The RMP has always had a full-time director and the coordinator has not received support from the grant. The Committee did not believe the two-year funding was warranted. The Committee recommends that this application be approved at a reduced level of $l,ZOO,OOO pending clarification of the kidney project issues. In addition, the Committee recommends continuation funding at the requested level of the Mahoning-Shenango Area Health Education Center in Ohio. The latter project will be monitored by Western Pennsylvania staff: . JULY/AUGUST REVIEW Estimated request as of May 1974: $650,000 WESTERN PENNSYLVANIA Regional Medical Program Coordinator: David E, Reed, M.D. Staff: Full Time Prof. 16 Part Time Prof. 2 Full Time Other 5 Part Time Other Total ---&-- RM 00041 On duty since: 5 years Proposed: 5 vacant positions listed and asked for Funds Requested: Total ,..,....,.....,.... 1,985,873 , Continuation............. ( 1,814,588 > New e ,,,..I*..*.,....*..... ( 170,285 )Mahoning Shenangq Area Health Education Network Inc. (044)* - Period of Time Requested: July 1, 1974 to June 30, 1975 *044 - WP/RMP has included in the consultant category of this budget funds to allow for WP/RMP administrative, monitoring and evaluation activities. Activities Proposed: Refer to Management Information Systems (PIIS) printout. (Also, note symbol C will be placed next to activities which extend beyond June 30, 1975.) Project #25 Adult Nurse Proc. Educ. Nurse Adult Ambulatory Care is requesting support through 6/76. $419,305 Project 826 Regional Renal is requesting support through 6176. $312, 348. . .# d RMooo41 W. Pa. List any continuation project or staff activity for which substantial increase over annualized current funding is requested, HMO project: NONE HMS project: , COO3 Emergency Medical Services - This activity was initiated 7173, The overall objective of this activity is to develop a pool of competent instructors for training the three areas of life support: cardiopulmonary resuscitation and basic and advanced medical care. 1 PSRO: NONE Kidney: Project i/26 Regional Renal is requesting support through 6/76. $312,348. Increase the following activities on a regional basis: to increase dialysis capability in Region; to expand the transplantation capabilities of the H.C.; to train the required manpower for dialysis and transplantation; to develop a communications and unfform record system. CHP comments: It is my understanding that the two CHP "b" agencies have recommended approval of this application. The Southwest Pa. CHP "b" agency did provide a representative to be present at the RAG meeting. Comments from both "b" agencies will be forwarded upon receipt. E0/5/20/74 1 YPA PRDG YR 05 .- - &STERN COMP --- ..- .--.. -_ ._ __ _ NO COMPONENT TITLE _. coo0 coo1 MT--..-..- ---- .___ co& .-. .._ - ~. t003 _. coo4 017A 017R - .- .-.-. 019 .-- - .--. ._ ._ 023 025 - _ 026 -... -.- --.- _. _ _. 036 - 031 037 ----. - -. _^ .- . _ 035 040 041 -- -.--.___- .._ 044 IF cG!4POFJENTs l@ PROGRAM STAFF EvAiJRES ACTIV AREA LIAISON ACTIV EHS TRNG REG QUAt ASSUR ACTXV REAVER CNTY LIPID SCdEENINi - BEAVER CNTY LIPID SCREENING BUCKTAIL RHEUMATIC FEVER . H PENN REG NEONATAL _ ,. _ DIRECT REQUEST 265t583 551075 : 63,891 60 rb54 90,023 35t079 21,643 29,189 67,512 ADULT NURSE PRAC iDUC NURS ADULT AHBULATORY CARE 293 r362 REG RENAL 253t038 EiUAL ASSUR SELECT ALLEGHENY CNTY HOSP 53,320 WESTMORELAND. CNTY .QUAL ASSUR _ 27,630 LAUREL MT PUAL ASSUR `b T AUDIT EUCKTAIL NuRS AUDIT 16,856 _.. 18~090 '19,160 BEAVER VALLEY HOME HLTH NURSG AUDIT 12,853 MAH~NING SHENANGO ARES HLTH EDUC NETWORK INC . 170,285 REGION TOTALS 1?553t248 INDIRECT TOTAL REQUEST REQUEST 741599 24,990 28t990 27t522 4lt387 9t138 9,469 7,648 23rb29 12519'43 59r310 .-_ 0 0 0 0 0 0 0 340tl82 80rOb5 . 92t881 - - 881176 131r415 44t217 311112 3bt837 . 91,i41- - - 419t305 c 312,348 c _-. _. 53.320 .'- - . _ 27,630 16,856 -- .- ,- 18,090 19,160 12.853 170,285 432tb25 1,985t873 lo-23 I . --.-' - `~- -- * * !44Y/JmE 1974 RJXEW Request: $4,577,325 Committee Recommendation: WISCOXSIN REGIONAL MEDICAL PROGRAM RM 00037 $2,000,000 Overall Assessment by Individual Reviewers: Critique: Average The reviewers noted that this region having had a very illustrious past history, is now in a crisis of leadership. With the exception of the Program Coordinator, most of the present program staff members are new. The reviewers found little evidence that the RAG has accomplished much during the past year, although past performance had been quite good. CHP relationships as in the past are still good overall objectives and priorities are vague. The proposal represents a series of poorly conceived, fragmented project activities, some research in nature, others (such as mental health, etc.) not in keeping with the usual DRMP goals and may be inappropriate for funding. Except for the evidence of past performance,there is little evaluation of what is currently going on in the region. JULY/AUGUST REVIEW Estimated Request as of May 1974: $2,500,000 DRMP/DoD SCOB/6-6-74 rt . MAY REVIEW STAFF SUMMARY WISCONSIN REGIONAL MEDICAL PROGRAM, INC. 5721 Odana Road Madision, Wisconsin 53719 Prepared by: Jeanne Parks RM# : 00037 Mr. Charles W. Lemke, Coordinator On duty since: Z/74 Current Staff: 8 Full-time Professionals 17 Part-time Professionals 5 Full-time Other 9 Part-time Other Proposed Staff: 23 Full-time Professionals 3 Part-time Professionals 6 Full-time Other 1 Part-time Other Staff - Contractural services not included in Program Staff Budget: 1 Full- time Professional 2 Part-time Professionals 1 Full-time Other 3 Part-time Other Funds Requested : Total - $4,577,325 Continuation - 0 1,517,322 Target Figure - $2,490,701 New 2,239,203 Estimated July Request - $2,500,000 Program Staff - 820,800 Budget Period: 7/74 - 6/75 Period of time Requested: All activities will terminate 6/30/75. Activities Proposed: See MIS printout. Items for the Reviewers Attention: The region is requesting a total of $156,413 for the following proposals which are in the Mental Health area: Project # 84 - Project #112 - Self Administered Sex Therapy Program $ 1.8,263 Evaluation of Mental Health Outcome 59,513 Developing Program Project #113 - Reducing Suicides in Wisconsin Project #120 - 39,862 De-Institutuionalization Implementation 38,775 Methodology TOTAL $156,413 Page 2 Wisconsin Regional Medical Program While there may be a need for work in this area, it raises several questions: (1) the appropriateness of DRMP funds to support these activities; and(2) how do the proposals tie in with the goals and objectives of WRMP. The following activities are flagged because they are either research oriented, continuing education activities or activities which are believed not to be'in line with DRMP initiatives: Project 847 - Health Line $100,147 Project #56 - Comparative Evaluation of Diabetics 128,590 Project #53 - Crisis Intervention in an Emergency 22,196 Room Project #70 - Development of Seriodiagnostic 59,548 Procedures for Gonorrhea in Wise. Project #77 - Reprod. Info. 6 Data Collection System 51,360 Project#lll - Quantitation of the Cytotoxic Assay 35,750 Project #95 - Hodgkin's Disease in Wisconsin 41,625 EMS: The region received approval for a three year period for the establishment of a Statewide EMS Program. Funds were provided in the amount of $1,265,816 for two years only, beginning June 1972. In addition, the region was awarded $118,850 additional funds for the period January 1, 1974-June 30, 1974 for two components of the INS program, The region is now requesting $938,198 for the third and final year of the EMS activity. CHP Comments: Copies of the WRMP application were forwarded to each of the eight CHP "b" agencies for review and comment. Letters from two of the (b) agencies (pages 66 and 69) indicated that the application was not received in time for consideration when the WRAG reviewed the application to submission to DRMP. One negative comment which dealt with the technical aspects of a project. .a. H 91974 REQUEST a OS LISTING CONPON BY REGION 06/?4 COUNCIL 37 WISCONSIN PRCG YR G7 _ SOUTH CENTRAL COW .-: - .._ _- -- - NC - . COO0 . . CC01 _.-.. -. .-.- ._- -. CGOi 026 G32 ___ .I __ ._-. - - rj34T 036A 03ie ,.. - __ 040 044 0444 .- -- -... - 04fd . 046' ,337 _ _ 051 052 c53 .- C56 _ 058 -001 _-, __ - C62 063 ._ . COHPONENT TITLE DIRECT INDIRECT - TOTAL REQUEST .RECXJEST . REQUEST PROGRAM STAFF 820r8UO DEVELOP PLAN STANDARDS 52,800 -&AL ASSUR FEAS STUDY ~ 5O*OOO . NURSE ASSOC PHYS TEAM 28,368 STUDY UTILIZ FINANCE & CUAL HE0 CARE 53,268 VC'L FCR STROKE 11,665 ?iT CROIX VAL SHARED SERV INC 16,000 SHARED HLTH SERV INC EMS CWT HYPT SCREEt!ING 569538 837,314 2br035 t4YD-f SCREENING RX 145,040 .SCH HYPT SCREENiWG .--. -- - . . 149 160 PT HLTH DljTCC!ME CRITERIA NURS PEERS 74,557 HLTH LINE ,84,189 .,. ALLIED'HLTH EDUC COORD COUNCIL 409041 * IMPRtjV UTZLTZ NURS AMRULATOKY CARE 78,141 CPISIS INTiiiVEN EMERG RM 22,196 DKAB TEACH APPROACH EVAL 89,910 HYPT COMPUTER ASSIST SCREEN AND HGNT 24~295 DFVFLOP YURS hCME CARE APPRAIS COCRD DENT CARE QUAL ASSUR WISC FACIL ST/WIDE HYPT SCREEN RX 149,300 35,050 55,700 lo-23 0 820,800 0 - --52,800 50.000 * 0 12,320 17~942 0 0 0 '100,884 49632 13~618. 29495. 301016 151958 0 299454 0 38,680 9t128 0 0 7,126 409088 71,210 llr665 16~000 569538 938t198 30~667 158r658 .- -' 16r655 104,573 100,147 .. -- 40,041 107r595 229196 128r590 339423 149r300 3510.50 629826 -. PlAY a 4 _-.. ..". .I .~ -. . __. . . ..__ . . ._ REQUESTED F 06/?4 COUNCIL WISCONSIN _ -. PROG.YR 07.. 'H CENTRAL cob+-. .. .. CCHPONENT TITLE I-..- -- ---_-.-.- Nff I..__ _ ._ .-_ __ _ _ _ ._ _ -_ _- -._-~. 064 EDUC P&S RIO EFFECTS RADI.ATION. _ . .._ .-. .__-_. _- 065 EDUC DENT WISC .--...._- __ ..- .___ _ 067 MOTIVAT CONSUMERS-MEET HLTH RESPONSIBiL - .- - 069-- - REVEL ALT CARE w wxs ._ -. 070 DE&b SERIO DX PRO,CEDURES GONORRHEA WIS - .- ---. --- . 071 -CGMJ ET)UC c;% FA.MILY PKACT `.- .~. .--. 073 -. - . `. PtiYSIEAL ACTSV PROi; AGEC ..-. .-. - 074 -PR;V MAiNT CVA DIS 376--. - ,- COM'IUNX'TY NURSG SERV ELDERLY ._ 077 R&P%05 INFO E RAT& CCLLECJ Si.S OEV XHPLE 075 CCMP HLTH SYST INNOV MTHDS PRIM HLTH CARE DEL -.. -- ._----_- I __.- .._ _ SELF ~&~NI&'~Ex THRPY-' -..' - . __. -.. .I 084 ._ .-- .._. -.. 087 DEVELGP TRANSITIONAL NURSG COURSE RN'S Gtcc? HOME CARE DEVELOP' St WISC .-._I.. -_ -__ _ 094-. Pi&I CClR HT`DIS SC; CiILDREN -.. - ..-, ._-- ..- --HDbGKIN'S DiS -WISC 095 c97 FOX VAL SHAREG SERV EDUC hSSdC -- ._. - .^._^. -_-. --.. . . . . 098 OUAL CNTRL DX RADIO,LOGY ,- -' _- ._-_ _ 104 -' PJ EDUC 105 ASSESS EXPECT OUJCOtiES & PT SAJISFACT 136 '-- .RURAL CLASSKOOM PAACT - 111 IMHUNOLGG HICRO-CYTOTOXIC AiSAY _ . .-. _ _. _. ". - osn-P a 23 * DIRECT INDIRECT TOTAL REQUEST ..- REQUEST .REGUEST 91380 39,500 73,927 - 31rfloo 50,560 `21,777 ..' 15,861 - 14~200 45~842 -- 51,360 49,730 750 . 101130 316 39,816 - _-.. .' 23 t 186 97,113 0 -8,988 79420 5 9640 0 -- 0 ; 0 0 31,800 59,548 29,197 229501 14* 200 45 vi?42 519360 499730 18r263 -. -._. . - 13,783 ---' _. 4~480. - .- 20 ~204 19616 21,820 44,400 0 44r400 ..,. .' - .. 539698 169361 .70,059 33,365 81260 41tt25 -- 92r500 0 929500 50r550 15,382 651932 51,380 23,435 74,815 155,181 67,536 222,717 ?5,500 0 35*500 - .-. _ --. - I .-.. -- - ._ _ .__ _ ._ _ _. ^.. .- _- - O&/74 COUNCIL _ ' .u~SCONSIN. ' PROG YR .07 IUTH CENTRAL - CCINP NO 112 -113 - .-_-__-_ .- __.__- 115 116 118 .- -, _ _ _-^ _. _ ___ _ 120 -.- , OF CO!!POMENTS . 50 -- - COMPONENT TITLE DIRECT INDIRECT _.. .__ REQUEST REQUEST DEVELOP MENTAL HLTH OUTCOME MEASUREMENTS 429692, 16~821 REDUCiNG `SUICIDES WISC _ 32~491 71371 iifPi6; .MEAStiREMENT .PHYS PERFORH'HOSP _ _ ._ . _. _ 52,748 6,765 STATEWIDE HOSP DISCHARGE SURVEY ._ 141,069 1r433 NURS EDUC HIGH RISK PERINATAL 01s 12tooo . 0 DE-IlkTITUTIONALIi IHPLE METHUDOL __ 387775 ' 0 _ _ - REGION TOTALS 4r068,4?6 508,849 . - - _-_-. .-_--. .._ -_. _ _ . _ -. .._ _ ., --. _-_ ___. ._ _-_-._ -. .--- - _. - ._ -., . -. " . ..__ _. . _ _ _._ _ .-.. ._ ._ ,_. __- .-. _. - - - - . ..--. - -_ _ . _ __ _ _ -- - -. __.. _ .-I ..____-.- ---- --.- - _. . _ _ _. . ._._. -_ .- . . .- , ..- .-.- . .-- _ I.. , - - _ -- _. .- . _. .- - . -a 010~23* TOTAL REQUEST 599 513 399 862 .. 59,513 142r502 12,000 38 ,i?S 4r5YTt325