The Regional Medical Programs Collection
In February 1964, President Lyndon B. Johnson delivered his
health message to Congress in which he announced the
establishment of a Commission on Heart Disease, Cancer and
Stroke. Chaired by the eminent heart surgeon, Dr. Michael E.
DeBakey, the Commission prepared a report, "A National Program
to Conquer Heart Disease, Cancer and Stroke." Published in
December 1964, the report recommended instituting cooperative
arrangements at the regional level, to make the latest advances
from biomedical research available to benefit the health of the
Ten months later, in October 1965, from legislation introduced
by Senator Lister Hill of Alabama and Representative Oren Harris
of Arkansas, the Heart Disease, Cancer and Stroke Amendments
became law (Public Law 89-239). The act authorized the
establishment and maintenance of Regional Medical Programs. Its
purpose was " to encourage and assist in the establishment of
regional cooperative arrangements among medical schools,
research institutions, and hospitals for research and training,
including continuing education, and for related demonstration of
patient care . . . . " (Sec. 900, Public Law 89-239). Fifty-six
regions were established, covering the nation, including Puerto
Rico. In December 1965, the National Advisory Council on
Regional Medical Programs met to initiate the program, and in
February, Dr. Robert Q. Marston was appointed first Director of
the Division of RMP, an NIH office. Dr. Marston served as
Associate Director of NIH, under Director James A. Shannon.
The National Advisory Council awarded the first planning grants
in April 1966, followed by the first operational grants ten
months later, in February 1967. By the end of that year,
sixty-one Regional Medical Programs had been designated and four of
these were operational. Most programs were located at or near
university medical schools.
In 1968, the Regional Medical Programs office was transferred to
a newly created Health Services and Mental Health Administration
(HSMHA), and Dr. Marston became the first HSMHA Administrator.
The original RMP was expanded with additions from the National
Center for Chronic Disease Control to form a Regional Medical
Program Service (RMPS) within HSMHA, with Stanley W. Olson as
Later that year, the RMP was extended for two more years and the
program expanded. By 1969, forty-four Regional Medical Programs
were operational, as Joseph T. English took office as new
Administrator of HSMHA, when Dr. Marston became Director of NIH.
In 1970, the RMP was re-authorized for two more years and again
expanded. New provisions reflected an emphasis on primary care
and regionalization of health care resources; added prevention
and rehabilitation services; added kidney disease treatment
programs; added authority for new construction; required review
of RMP applications by Area-wide Comprehensive Planning
agencies; and emphasized health services delivery and human
resource utilization. New modes of this utilization included
"physician extenders," such as nurse practitioners. Fifty-four
Regional Medical Programs were operational by the end of the
However, in that same year, the RMPS was reduced by the phase-out
of many of the original chronic disease programs, leaving in
place only RMP, the Kidney Disease Program, and the National
Clearinghouse for Smoking and Health.
In 1973 the RMPS enjoyed its peak year of funding, with $140
million appropriated. Emergency medical services were playing an
increasing role and receiving a larger share of funding.
However, in the Nixon administration's proposed health budget,
the RMPS was allotted no funds for FY 1974. Bureaucratic and
local support gained it a one-year extension. The National
Health Planning and Resource Development Act of 1974, Public Law
93-641, consolidated RMPS with the federal Hill-Burton and
Comprehensive Health Planning programs. In 1976, after a
transitional period, independent RMP operations ceased.
One side effect from the Regional Medical Programs was the
creation of the National Network of Libraries of Medicine, which
was recommended by the DeBakey commission and authorized by the
Medical Library Assistance Act. It is in operation to this day.
- February 1964 --President Johnson delivered his "Health Message" to Congress in which he announced the establishment of a Commission on Heart Disease, Cancer and Stroke.
- December 1964 --The Report of the President's Commission on Heart Disease, Cancer and Stroke was issued, presenting 35 recommendations--including the development of regional complexes, medical facilities and resources.
- 7 January 1965 --President Johnson delivers a special message to Congress on "Advancing the Nation's Health."
- 18 January 1965 --Companion bills--S. 596 and H.R. 3140--were introduced in the Senate by Senator Lister Hill (Ala.), and in the House by Rep. Oren Harris (Ark.), giving concrete legislative form to the recommendations of the DeBakey Commission.
- 18 August 1965 --Anthony J. Celebrezze was replaced by John W. Gardner as Secretary of the Department of Health, Education and Welfare.
- October 1965 --P.L. 89-239, the Heart Disease, Cancer and Stroke Amendments of 1965, was signed. The Commission concepts of "regional medical complexes" and "coordinated arrangements" were replaced by "regional medical programs" (RMP) and "cooperative arrangements," thus emphasizing voluntary linkages.
- 2 October 1965 --Luther L. Terry was replaced by William H. Stewart as Surgeon General of the United States Public Health Service.
- 2 November 1965 --Philip R. Lee takes office as Assistant Secretary for Health and Scientific Affairs, DHEW.
- December 1965 --National Advisory Council on RMPs met for the first time to advise on initial plans and policies.
- February 1966 --Dr. Robert Q. Marston appointed first Director of the Division of RMPs under NIH. He also served as Associate Director of NIH. James A. Shannon was NIH Director.
- April 1966 --First planning grants approved by National Advisory Council. Original emphasis of RMPs placed on continuing education, patient-care demonstration projects, and development of new manpower resources.
- February 1967 --First operational grants approved by National Advisory Council.
- June 1967 --The Surgeon General submitted the Report on Regional Medical Programs to the President and the Congress, summarizing progress made and recommending extension of the program.
- December 1967 --61 RMPs designated; only four were operational.
- February 1968 --Wilbur J. Cohen becomes Acting Secretary of HEW.
- March 1968 --Companion bills to extend RMPs were introduced in the House by Harley 0. Staggers (W.Va.) as H.R. 15758 and in the Senate by Senator Lister Hill (Ala.) as S. 3094.
- 13 March 1968 --Reorganization of Public Health Service. All functions of PHS transferred from Surgeon General (William H. Stewart) to Assistant Secretary for Health and Scientific Affairs (Philip R. Lee). Surgeon General was made Deputy Assistant Secretary.
- 9 May 1968 --Wilbur J. Cohen takes office as Secretary of HEW.
- Spring, Summer 1968 --The Health Services and Mental Health Administration (HSMHA) is created, with Robert Q. Marston as first Administrator; RMPs transferred from NIH to HSMHA. RMPs combined with eight programs of the National Center for Chronic Disease Control to form, within HSMHA, the Regional Medical Program Service. Stanley W. Olson made Director of Regional Medical Programs Service.
The chronic disease programs included the Cancer Program; Chronic Respiratory Disease Program; Diabetes and Arthritis Program; Heart Disease and Stroke Program; Kidney Disease Program; Smoking and Health Program; Neurological and Sensory Disease Program; and Nutrition Program.
- September 1968 --Meeting of all RMP program coordinators in Alexandria, VA. Five regional groups established: Northeast, Southeast, Midwest, Southwest and West.
Robert Q. Marston leaves HSMHA to become NIH Director.
- October 1968 --P.L. 90-574, extending RMPs for two years, was signed. Changes included: expansion outside the 50 states; funding interregional activities; permission of dentists to refer patients; permission of Federal hospital participation.
- 1969 --Joseph T. English becomes Administrator of HSMHA.
- 22 January 1969 --Robert H. Finch takes office as Secretary of HEW in the Nixon administration.
- 14 July 1969 --Roger O. Egeberg takes office as Assistant Secretary for Health and Scientific Affairs, DHEW.
- September 1969 --National meeting of coordinators of RMPs and chairmen of Regional Advisory Groups in Warrenton, VA.
- 18 December 1969 --Jesse L. Steinfeld takes office as Surgeon General, USPHS.
- Fiscal Year 1969 --44 RMPs were operational. Membership in various Regional Advisory Groups exceeds 2000. Over 400 operational projects were under way.
- 1970 --Vernon E. Wilson becomes Administrator of HSHMA. Harold Margulies becomes Director of Regional Medical Programs Service.
- January-October 1970 --Bills extending RMPs introduced; hearings held.
- 24 June 1970 --Elliot L. Richardson takes office as Secretary of HEW.
- October 1970 --P.L. 90-515 was signed into law. New provisions: emphasis on primary care and regionalization of health care resources; added prevention and rehabilitation; added kidney disease; added authority for new construction; required review of RMP applications by Areawide Comprehensive Planning agencies; emphasized health services delivery and manpower utilization. New manpower included "physician extenders" such as nurse practitioners.
- Fiscal Year 1970 --Of the nine original chronic disease programs, the following five were phased out: Cancer, Diabetes and Arthritis, Chronic Respiratory Disease, Heart Disease and Stroke, and Neurological and Sensory disease.
The RMP Service consisted now only of RMPs, Kidney Disease Program, and National Clearinghouse for Smoking and Health.
54 RMPs were operational. Membership in various Regional Advisory Groups was 2,400.
- 1 July 1971 --Merlin K. DuVal takes office as Assistant Secretary f or Health and Scientific Affairs, DHEW.
- 1973 --Herbert B. Pahl becomes Director of Regional Medical Programs Service.
- 20 January 1973 --Jesse L. Steinfeld leaves office as Surgeon General, USPHS. Post is vacant until July 13, 1977.
- 12 February 1973 --Caspar Weinberger takes office as Secretary of HEW.
- 18 April 1973 --Charles C. Edwards takes office as Assistant Secretary for Health, DHEW.
- July 1973 --HSMHA is split into the Health Services Administration, the Health Resources Administration (HRA), and the Alcohol, Drug Abuse, and Mental Health Administration. RMPs placed in the HRA. Harold 0. Buzzell was Administrator of HRA.
- Fiscal Year 1973 --Peak year of funding of RMPS, with $140 million appropriated. Emergency medical services were playing an increasing role, receiving larger share of funding. Nixon administration proposes health spending cuts, including zero funding for RMPs in FY 1974. Bureaucratic and local support gains a one-year extension.
- 1974 --The National Health Planning and Resource Development Act of 1974, P.L. 93-641, consolidated RMPs with the Hill-Burton and Comprehensive Health Planning Federal programs. Kenneth M. Endicott becomes HRA Administrator.
- 7 February 1974 --In response to a law suit filed by the National Association of Regional Medical Programs, the court ordered the Secretary of HEW to release the $126 million in impounded fiscal year 1973 and 1974 funds to the nation's RMPS.
- 1975 --Herbert B. Pahl leaves post of Director of Regional Medical Programs Service.
- 1 July 1975 --Theodore Cooper takes office as Assistant Secretary for Health, DHEW.
- 8 August 1975 --David Mathews takes office as Secretary of HEW.
- 1976 --After a transitional period, independent RMP operations ceased.
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National Institutes of Health,
Department of Health & Human Services