COI@ITY BASED EDUCATIONAL PROG@ 1. Review Committee; 2. Guides for Review; 3. General Counsells Opinion of April 14, 1972. COMMITY BASED EDUCATIOX PROGRAMS Special Review Committee: Dr. Perry, Chaiman Dr. Hess Mrs. Wyckoff Mr. Hilton Miss Anderson Dr. Popma, Consultant Miss Kerr Headed by Dr. Veronica Conleyi RMPS Staff ik 11,@GIONAL IVIDICAL PROGf,'-i@is SERVICE GUIDES TOP, rEVII"@,l OF CO@',-U'@,'IT'i' BASED PROGI',AM PROPOSALS I. APPLICATION ESSENTTIALS A. Proposal is requesting funding in excess of $50,000. B. Proposal has approval of the Regional Advisory Group. C. Proposal includes review and comment of the appropriate CHP agency, if not, explanation is given. D. The area to be served is clearly defined and comprises a medical trade area. E. Names of all institutions and agencies involved. II. DOCIWNTATION OF NEED A. What,sources of data have been used for planning to determine needs for health services? Do these include: 1. Number and characteristics of the population to be served. 2. Numbers, distribution, and utilization of health manpower providing services. 3. Numbers and kinds of institutions, agencies, both private and public, providing health manpower,education and training opportunities; numbers and nature of their training programs. III. OBJECTIVES A. Objectives are stated in clear and measurable terms. B. Objectives relatd to the RMPS concept of the community based manpower programs. IV. PJANNING A. The proposal is not in competition with similar efforts within the same geographical area. B. Identification of the accredited education institutions, health care provider institutions and community health care and planning interests committed to the advancement of the program. 2 IV. PLANNING (conti.niied) C. Identification of the potential membership of a Coordinating/ L Governing Body group. D.- -There is a plan for evaluating the developmental process. E. An implementation scheme has bc.,.c,,n developed and appropriate sources of funding to support each phase has been identified. .V. ORGANIZATIO-,\' A@'D DEVELOP@pl@'@T A. The Coordinating/Governing Body has been formed,'its function formalized, and an administrative structure planned for management purposes. 1. For established Bodies, by-lax,7s are attached. B. Such a Coordinating/Governing Body is proposed. 1. braft by-laws are attached if availab e. C. The Coordinating/Governing Body represents a consortium of: 1. At '.cast one fully accredited institution of higher learning. 2. Principal-health care provider groups or institutions, including appropriate clinical resources. 3. Consumer interests. 4. Health professional societies. D. Evidence is provided of the degree of commitment of participating educational institutions, health service institutions, and other appropriate groups. VI. OPERATIOI;AL A. The operational phase of the proposal describes which of the following activities are to be undertaken in the current period. 1. Setting of priorities based upon continuous appraisal of the relationship between community health service needs and production of health manpower. 2. Designing education for both traditional and new health occupations to meet the particular health service needs of the area. 3 VI. OPEI?Ji'FIO@4-AL (conti-i-iuecl) 3. Provision of basic and continuing education with appropriate clinical experience, and in-service training for health -manpower. 4. Providing educational experiences that will- develop strong interest and commitment to an interdisciplinary health care del.ivery approach. 5. Recruitraerit, training, and placement of local residents in health careers related to manpower needs. 6. Provision for health education and information services for patients and the general public. 7. Studies of current licensure and related manpower issues. S. Other. 4/7/72 7 TO 7,L-. @ymoiid D. Cotton Office of the Ceneril Counsel )@@?.ecutive ))-,.--CC-6or OA'fice of A--sistant Socr6tary Date: for YLealtli and Scientific @airs APR I I PRO',Q Sidney @l !=n As34-stant General Counsel for Public IAealth simnCT: Arei Ilealth Dlucation Contcrs--Support under section 910, Azt You in'Lortinlly reques ted our vie@;s t,.,Jth re,,ard to t'sle ivtil- ability of section 910, t,.ct, I_q ti -.0u,--ce of I,,itliority for ftnidi@@ r>o-called Are,- linaltli 1-:dtic--tion Centers (A:IEC's). 'v@'a -,nclcrqtmd that such fundi-@il- i7ould in general be on a contract rather. than grant, basis. Tile purpose of such centr-@rs, fl@ de3cril,)ecl in the attached undated-excerpt from an unidentified dociLraent, i@,,oul.d be to "provide educational opportunities for students to enter healt'q careers in co-.:!:Iunities iiii@xe students do not ',-mve ready access to such Opport:u@'itic-S. 'L@i-ley will tiie@4e stuflentf3 to provide health services in communities and regions that are Ltndorsc,-ved so that services appropriate to the health need5 of the corr.,l-,inity or re,@,,io,,i will be available to tho3c fire need them. j'he centers 1,7ill recruit students, ofL@er educational and trainin- pro- ams for initial entry into liealt'Li occi-,pation3, for retrainin.- of health personnel and for continttin,-, education so that those in the health occupations and professions ruiy -etain and prove t'@,,eir cot.@-tetenco to provide safe and effective health services needed in the area," The pri-,iiry -oal of AIIEC's is described as beinr,, "to provide educational opporti-,nity for individuals ratio x7ould othe-,i;ira tend to be e;-.cluded fr= training or education in the health field." I-L-, naymoild D. Cottoa 2 no thin!-. t"ciat section 910 cort@iiii restrictions i,7hich l@, ill full trainino may limit its utility c.@- avehicle 'or --uPPOrti A. J. t3 .4 activities o-l" the scope of those described above. Section 910(a)(t@) authorizes Llie Secretary to ma@ E;rariL-a and contracts for "clovelo,.p,iient of traininc.- specifically related to i@l I)ra-icritio-., C t, -non@r, o,-' Of tl'C-! (linea5eo cancer, or other related dineascs], or to the ronabilitation of persons au-r-,--'erin- fro-in any of such and for coritir,"ia,@ probes of sucli sliorta3e of trained personnel would o?."liet-;Lse - l@iit application of and skills iin-,,)ortant to the control of @-iy of (lipea@ie.-Il (1@,-lpliasic; added). Tha scope of section 910(a)(4) is thus liriited in the r@iost- specific ter.-.,is to the Title l'"' di,-etres. l@'tiilc t,ie scope and tura of the trairia-3 for 't,io stated puz-,,)oses @s essentially 22r del@-arriii-uition by t'@io Sonrice in tlio erercise of sound pto,'ession,-il @nt, the operation of tae I)ro-@)osed a would, it cover the full retire of 1-kialt'i-related and %-7oulet not i,?.2arently he I'specifiwlly related" to the specified diseases or purposes as required by the statute. Section 910(c) contains no such catc-orical disease It-,aitation. Tt does, bo%7ever, limit title triiiiin-, authority o@, the Secretary to those activities i;hic'.i are "designed to utilization o4A7 Pianpo@ier ii the delivery of hea t services." This Ian,-,Yuao,e is o@ously comei-iliat rr.-.@iguoLis. T'le le,-,ic;lative histor,l of P.L. 91-515 (17'ii;-ch a,4ded the provision) -13, moreover, of little heap in determining i.'iat %.,ar. intended by it. @ its face, hoi7ever, v7e su&@gest that section :910(c) ias not intended to serve as authority for the trainii-i,., of entire iic;i cadres of Health and allied health professional per-.ori-Lel; ratlier, tlle "riaxL-ni"-a ti%o utilization Oi' see,." to cont@lato tialr.in- Care of@'ective a-,ick ii-..Iprovin,-, the sl:ills of L,.va4lable ,,act. 'rAiis mi-)Lit , for e@--.-ni le, include trainin,-, to Health perso Depend the resl)onsibilitic!3 vnd siills of certain types of health personnel, or to onable.pliyaicians to mko more extensive use 1-ir. Raywnd D. Cotton of allied health I)rofcE;oioiialo, or to enable licnltli aOr-iinistrators e@-@7 to utilize personnel r-@ore L.Lecieiitly.2/ it i,,ould not, in our viaxq, include recruitment and tra@ng of students for "initial entry into healtli occupations." In this re"ard, we mi-,it point out tliit Conr-,ress l@-s recently enacted the 'L'IanDcAier Act of 1971 (P.L. 92-157) i-@id t7,,-- '7iiurse Traiiin-, Act of l@071 (P.L. 92-158). Thdse @-t @-i7,--nLIed 'J'itle Xrll ind irell, rcs,.)cct:ivaly of- tlio PIIS Act, considerably broadening and increasing Federal sti.nilort of trainin;,7 -for hoalt',.i prof -n-id nur3ii-i- perroiiiel. In addition, Part C of Title V-il-L contains a nl-ur.)or of siriilar programs for the production 0-@ -illicl health pro;'es,,,-@ons existence of ti@at legislation, Lynch to p-.-ovid(-. specific authority for all of the types oAl activity conte=@@lated for AIIF.Cla, would in our vic%l cast furtl;ler dojbt on the availability or sect ion 910 for support of i.-iy trainin.- programs not clearly authorized thereby. 'We e-!,mliasize tliqt tlta conclitsiong (L.", -ozised -ibove are intended to apply only to t'L,.e t@I)d CescribLd in attached docuncnt, ,ind r4iay not apply wl-It.-Ii c@- I force to a of nore limited scope. ror a trainin- pro.-ra:-a i?lio,@oole purpose :Ls to the utilization o@-- ma-.tpoi@r" in health services delivery, and ii'i-iich does not iwrolve the triininf,, of students for initial e-@itry into health occupations, i,7ould clearly be Supper -le u-,i-l tab "er section 910(c). This fill confirm our earlicr advice gives to you in the form ot a draft L-.emorandura dated liarch 3. 1972. Attacbmnt In this connection iqe note that tlc t@'anate A,,Dprapri,,itions Committee in its report on t's,e 1972 tinprot)riation Act (I.I.L 92- 80, in dincuosin.-, the availability of cor-,Dsrient in IIEDII,:C and i= pro.-r,@,=, ur,-,ed their training as physician v-ss;-stants 'It',,.rou-.,, @-o@,rim and the 1,11'A Health manpoi@-er pro-ram." (L7-qpliasis rup-,)lied.) S. rcpt. 92-316, p. 6. Prepared by: GII DNYOIDIG, @, 4/13/72 0 cc: Dr. I-largulies Dr. Pahl f I I