. -M ,ill , , s 6A Of, N@TAOF HEALTH EDUCA@tiON,--@@-AND WELFA RTGIOIIAL @IEDICAL PROGRAM SERVICE COUNCIL ME@ETING EXECUTIVE SESSION" n 'Rockville, liaryla d Tuescq-ay, Novenber@ 1971 ACE - FEDERAL REPORTERS, INC. Ofi@cial Reporters 415 Second Street, N.E Telephone. Washington, D. C. .20002, (Code 202) 547-6222 -WIDE COVERAGE NATION CR#4157 G I B S ON ht DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE REGIONAL MEDICAL PROGRAM SERVICE COUNCIL MEETING EXECUTIVE SESSION 7 o (conference Room GH Parklawn Building L 5600 Fishers Lane Rockville, Maryland Tuesday, 9 Novenber 1,971 -?2 24 25 5 7 in 'L;c) r tL !,i a c c:@ @L2 call"30, iou @l@ll 1 T is ti-ic- Di@-c c in T' - bi re,, -II. C(-@ tc) le,-,)C@ 0 Ca i@ I L v@, a, n a, n cL i j- o@ St@ t@l a t ni vr@ rs i@ In cr)Ti@zs eL,)il-, "lo c,) r t-i - re. c o"7;= 4'.0 h @l, 0 r c r to vc- re @3 o tf,@ t 7, i. n. c,, s -t n a, .7L ri. a i'@ i oil V;l tell O! r, 10 @l c o n x\7'i c- to into i are -.C-ortG 1.2 'f.-)eforE; not O'Ll. t: @'3 53 @:7 @L c to !3 !i c a n .@t. n t f rv i ti ona Pn i--l i a v i-i r r ,L. 0 Thi,3 1 c in o u @i c r,ta c -,,a s.-@ on . thc-n e @,7 a eL-,) and v@@ a @art to @r to l@,@ @@l T o ri -',I0 i- in s r 'rich @l a v to ort c)n ;7 r,t c @ln (-It r c) ri oui- @i ric,' i.-). c a. @n, f.- @i -r(,) r,.- cc, t ci t t."ia4 S t not r a n.@,.ronr,- ri, i t r r t' r r) r@ in n c!7@. f rnr-i t t@ -ti t,7@ r ;,i,!i i- n. s t@--, i, r F,, t i @l@'i e@@ c -I, t II @)!7, t-. th@- b@c-c a.,-is 2 5 V-Ihat w4'did in practical terms at the meeting of 2 the Council befoi6@last was to say that we,would give them 3 six months' funding, which would carry them through December 4 31, and in-order,,,io sharpen their attention to the issues, 5 which it tended to'do. 6 We theng.,"in extending the support for those pro- 7 grams beyond December 31, as we had to this late in the@yearr 8 ranking principles c@f agreed that we had to follow the relative 9 the RMP'S, and so they have been reduced from the level at 10 which they ate operating because they come cloarlylin at the 11 bottom end of the scale. They protested a little but I said 12 that they still were the same programs that thev were, and 13 no change had occurred. 14 Now,what is before you is a consideration of what 15 you would like to propose be donei about what is at the ore- 16 sent time in their view a clear-cut application for a separate and new status for the new programs which want to combine, anl 18 A continuation of the status of the one which wishes 19 main as it was in Northeast Ohio. 20 my immediate reaction to'that, which I'd like to 21 he Coucil as yet, present f our.con@ideration, is that t Y 2@ in fact., this staff has engaged in these discussions not at 23 all reach any kind of conclusion about arfd that before we 24 whether:they had done as far as they should or could or 25 whether!, this is nleffective arrangement, we need to ave on 1 the part of staff, and I would like to think on the part of 2 Council, some direct involvement with the decisions that they 3 went through, how they reached them,, and report back to 4 Council based upon, in this case, a visit which would include 5 representatives from the Council and probably from the review 6 committee, to talk with them how about how satisfied they were 7 with this solution. 8 There are a lot of questions left unanswered in this whole series of events, and it has not come out viith a 10 complete consolidation of the nrograms in Ohio. I rather sus- 11 pect At this point in the whole series of circumstances that 12 there is not a likelihood that Northeast will in fact join the 13 other groups. 14 Now, the arrangement that Ohio is proposing is the 15 "establishment of the program under the aegis of the Ohio sta,-- 16 Fothdation, which is similar to the Ohio Valley RMP, that is 17 A kind of separate cor dy which thev believe is di porate bo s- tindt from the universit and which would not therefore be y 19 controlled by Ohio State, University. They have set up an in- terim group which represents a kind of reaional advisory grouF 21 of the combined programs, and they have an ihtekim coordinat6x 22 in the form of Dr. Pace, who currently is the official c6ordi- 23 @nator of the program at Ohio State. 24 Now, Sewall@i you may be able to add considerably to that 25 account. 7 1 MRS. 14ARS: What population factors are involved 2 in each program? 3 DR. DIARGULIES: In fact, the area which Northeast@,, 4 Ohio serves represents a very large segment of the populations 5 because that's the Cleveland areai and the contiguous regions. 6 As a matter of facti when you lop off the part that Ohio 7 RMP has, it probably accounts for over 50 percent of 8 the population of Ohio. Isn't that the case with'Northeast? 9 MR.@MILLIKEN: It's 40 percent, actually, in about 10 four counties. It.'s 50 percent if you add another ring of 11 counties. 12 PR@ BRENNAN: That would include Cleveland, Youngs- 18 town, Dayton? 14 DR. MARGULIES: No, Dayton 3'.8 different. 15 DR. BRENNON: I mean Akron. 16 DR. MARGULIES4 Yes. 17 MR. MILLIKEN: And 60 percent of the professional 18 health manpower for the State. MRS. MARS: How does it compare as far As rural and @20 urba ? 21 DR. @GULIr@,S: T think the Northeast area is 22 pretty much urban. 23 MRS. MARS: Ohio really has very little rural. 24 MR. MILLIKEN: Highly industrialized and high pet-@, 25 centage of labor involvement in health services, organized labor. 2 ey liter DR. PIILLIKXT: How long have th ally been 3 without a full-time coordinator? 4 DR. MARGULIES.- The Northeast Ohio -program has beer without a ful 1-time coordinator for about a year-and-a-half. 6 They have an acting coordinator. 7 One of the problems there, and I think we all undez- 8 stand, is An extension over time of the internal warfare in 9 the city of Cleveland, which is:leqendary, involving Case 10 Western Reserve, the Cleveland Academy, and so forth, and 11 they somehow don't seem to be able to resolve that, and the 12 RMP is offering the on ortunity to prove that they still p 13 haven't resolved it. The problem of getting a coordinator haE 14 much note to do with those issues, I think, than an thing else. y 1.5 MR. @l!LLIKEN: Dr. Robbins told me,,yesterday that 16 they have three applicants, two of whom look very good,@and 17 they are willing to come, and they expect a decision within a 18 few days. 19 DR MARGULIES: Well, what they have asked for is 20 a recognition of this new activity in thel.two that are joined 21 as of December 31st, and-I can't see how the Coqn@il@dan re- 22 spond to that request on the basis even@of the extensive 23 correspondence which we have had. So what I would like is to 24 have t and extend this period,(?f interim ar angemeht you accep a little longer period, and for at least two members of the 9 Council andl@ot-hers-to' go out and spend some time with the 2 various Participants and get a clearer picture of what their #3 expectations@are, hGwl they reached their decisions, and then 4 come to@the conclusion about what could be done. 5 --my own impression of the Northeast program is that 6 it does in fact have@ far:greater potentiality as a total re.- 7 source than the rest of the group. People like Robbins, 8 leadership and you've got some real some real imagination. 9 I've been very disappointed in Toledo, that the dean of t e 10 medical school, who is a very imaginative person, has been 11 relatively uninvolved in RMP, but I Understand, Sewall, that 12 recently he has become more involved. I don't know whether that's true or not. 14 MR. MILLIKEN: This is a man who has resigned and 15 left now. 16 DR. 14ARGULIES.- That's the president of the inqti 17 ttition, but the dean is a guy of some real Competence. 18 MR. MILLIKEN: Right. 19 DR. MILLIKAN: You are talking about six months' 20 continuation of the interim arrangement 21@ DA,. MAR@GULIE8: I am thinking about taking no 22 action until there has been an opportunity to come back -- 23 other six but we would have to.ekt8nd them certainly for an 24 months as the into July 1, and then take any interim Y are,,, 25 consideration in February when the Council meets again. 10 DR. CAMION: So move. 2 DR. MILLIKAN: Second. 31@ DR. MARGULIES Any further discussion? 4 All it favor say aye. (Chorus of ayes.) 6 Opposed? 7 (No response.) 8 I was going to try to find someone on the Council 9 to go out, who had been there before, but interestingly 10 enough no one on this Council has been in the Ohio program in 11 the past that I know of. 12. DR. BRENNAN: It's Probably a good thing. DR. MARGULIES: It probably is. So we will,have. tc 14 get with somebody in the very near future and find out whose @15 schedule will fit in and work it out accordingly. 16 We have had people on the review committee who have 17 End been there in the past. Smi tlh 18 (The remainder of the executive session was 19 not reported.) 20 2:L 29 23 24 25