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                 ISSUE:  Regional Medical Program Support of Recruitment
                         and Basic Training of Health Personnel as Distinct
                         from Continuing Education and Refresher Tra


                      The Div,.sion staff offers the following background and
                 suggested criteria to permit the Council  to  review  and  reaffirm

                 its position on this issue:



                      While the wording of P.L. 89-239 is quite general, our
                 educational programs have been  limited  to  continuing  education
                 and training activities.   ale National Advi sory  Council  discussed
                 the parameters of support  of educational activities at its June 21,
                 1966 meetin& and accepted  the position outlined in Doctor 14arston's
                 memo to the Council july 8, i966.  Since  that  time  three  major
                 reviews of this position by Division staff have taken p ace:
                 In preparation for June 1967 Coordinators' Conference; in preparation
                 for Joint @aining Comittee  meeting  of  14ational  Heart  Institute,
                 January 9, 1968; and in preparation for the revision of the
                 Guidelines.
                      As a general operational  definition  of  continuing  education
                 and training, the following have been accepted:  "Those educational
                 endeavors which are above and  beyond  those  normally  considered
                 appropriate for qualification or entrance into a health profession
                 or an occupation in the health related fields."

                      Certain criteria have been.adop'ued for  deciding  whether  or
                 not an activity is to be considered  as  continuing  education  and
                 training, e.g. activities must in general  not  be  those  designed
                 principally to qual@ify one for a degree, diploma,  or  Board  certi-
                 fication; therefore, intu@rrshi-,o and. residency program have  been
                 excluded from pr@@ consideration.  The education and/or training
                 activity should lead to the assumption of new responsibility in the
                 already chosen career field, update knowled-e and  skil'L  in  the
                 chosen career field, or update knowledge and sk-J-11 in  a  different
                 but related health field. in o-eneral,  therefore,  interest  is  in
                 task-oriented training.
                      i@in4-ng designed princioa!'Ly as preparation  for  a  research
                 career in the biomedical sciences have been excluded.  It has been
                 stated that Rea-ional Medical Program funding is not to  be  used  to
                                CD
                 replace existi-, sources of  support  for  educational  activities.
                                --Ig
                 In general -Reo-ional Medical Program funding should be used in
                 cowunction with other available sources of funding, whenever possible.






                                                  -2-

                     it has been reco@ized from the beginning that most activities
                funded by Regional Medical Program might theoretically be funded
                by other agencies.  Criteria have been developed by which activities
                are judged with overlapping interest which is the area where
                recruitment and basic training requests usually fall, for example. . .
                         The activity must satisfy a documented need of a
                         Regional 14edical Program, and must be shown to have
                         a relatively high priority for funding.
                         Other a-venues,--of--@ding,.must have-,..been exp  r d and
                            d iTia@at
                         foun          ,e.--either by the Region or by the
                         Continuing Education and Trainin- Branch of the
                         Division of Regional Medical Programs.  In @y cases,
                         funding is requested for projects because of a lack
                         of available funds by other agencies such as the
                         Bureau of Health 14anpower.
                         The Division of Reo,,ional PIedical Programs or the
                         Region itself must also explore the possibility of
                         phasing out the Regional @qedical Program funding as
                         money becomes available from other sources.  Other
                         Federal agencies such as the Office of Education
                         and the Department of Labor are beginning to support
                         parts of recruitment and training activities affecting
                         the health field.
                         The Region or the Continuing Education and Train
                         Branch of the Division of -Regional 14edical Program
                         must have explored the possibility of joint funding
                         with other interested agencies.
                        If the education and training activity has been shown to be
                 necessary to achieving the purposes of a Re@ional Medical Program,
                 and the above criteria have been net, then the proposed project
                 may be approved for funding.











                                                                          February 1969