PROFILE: KANSAS REGIONAL MEDICAL PROGRAM Grantee: University of Kansas Medical Center Coordinator: Robert W. Brown, M.D. Originally prepared by: Frank G. Zizlavsky Original date:. September 1, 1969 Updated: TABLE OF CONTENTS .,I. Geography II. Demography III. Politics IV. Historical Review V. Core Staff VI. Overall Organization VII. Grand Design VIII. Operational Projects APPENDIX I. GEOGRAPHY The Kansas RMP reiional boundary is the state. The Region is often ,considered a coherent area in terms of problems of economic develop- ment, population trends, type of agriculture and medical care patients. Kansas City Topeka Great Bend Wichita II. DEKOGRAPHY 1. Populatiorr: 2,200,000 (1965) a. Urban 61.0. b. 95% white 2. Land area: 82,048 square miles 3. Health Statistics: selected causes of death/100,000 1967 a. Mortality rate for heart (slightly higher 373.4) b. General Arteriosclerosis (higher 24.7) c. Diabetes Mellitus (much higher 20.5) Facilities statistics: a. University of Kansas School of Medicine enrollment 426 b. There are 19 Schools of Nursing - 5 school or University affiliated. c. There is one facility for cytotechnology training at the University of Kansas Medical Center and 11 Schools of Medical Technology. d. There are 158 hospitals with 18,174 beds in the region. 5. Personnel a: As of 1966 there were 2,,455 (108.1/600,000) medical doctors in Kansas. The number of active medical doctors was 2,216. b. There were 173 doctors of Osteopathy. c. As of 1962 there were 10,154 nurses (455.9/100,000) of which 6,509 are active (292.3/100,000) POLITICS' Governor: Robert Docking (D) 1969-1971 Senators: James Blackwood Pearson (R), 1962-1973 Appropriations Commerce Robert J. Dole (R), 1968-1975 Select Committee on Nutrition and Human Needs Congressmen: Chester L. Mize (R), Banking and Currency Garner E. Shriver (R), Appropriations Joe Skubitz (R), Interior and Ins ular Affairs Interstate and Foreign Commerce V. HISTORICAL REVIEW January, 1965 Dean C. Arden Miller appointed a committee 0 ive w t n t e University o Kansas Medical Center to study the Regional Medical Pro-ram as it would pertain to the University of Kansas Medical Center, metropolitan Kansas City, and the State of Kansas. November, 1965 After approval of the concept by the Kansas State Board of Regents, Governor William H. Avery appointed an Advisory Committee of fourteen people to work with the University of Kansas Medical -Center which is the official agency for the State of Kansas in planning and applying for grants provided under the Regional Medical Program. March, 1966 Kansas Adv4.sory Committee voted unanimous endorsement of the initial list of agencies to be involved in planning, the administrative organization for planning, the multi-state and sub-regional concepts, and the budget to be submitted. April, 1966 The first year planning application was submitted to DRMP. Comments of the Ad Hoc Review Group: 1) General reaction to-the application was favorable. 2) It was pointed out that the University of Kansas Medical Center had one of the strongest continuing education programs in the country but two questions were raised: A) to what degree did the continuing education portion of this planning request constitute planning and to what degree was it either a continuation of already existing activity or actual operational activity. B) What had the Medical Center accomplished in having ef f ect on community medical af f airs. 3) Relationship to other organizations. involved in health affa@-rs in the Stat@ should be more clearly delineated. 4) Expansion of the Advisory Committee to be more widely representative of community interests. June, 1966 01 Planning grant award. This'period begins. July 1, 1966 through June 30, 1967. $180,520 (DC) 17,425 (IC) $197,945 Total award October, 1966 Kansas MIP submitted 01 operational grant. November, 1966 Site Visit included: Dr. George James, Dr. Ruhe, and Dr. Robert J. Slater. Impressions: 1) Prospect for a RMP in Kansas is excellent. Medical School is definitely taking leadership role, greater involvement by the State Health Department, voluntary agencies, and others is being sought and seems likely in time. 3) Large costs of hardware que stioned. February, 1967 Review Committee requested that staff, based on its analysis of the application against t@e background of the site visit report, come up with a proposal as to the amount. It was suggested to the Committee first year support of $1 million (± 10%). Council was strong in support of the recommendation of the Review Committee. Council was also concerned about the representation of minority groups on the Advisory Committee. Observation was also made that the proposal is very general in nature, with little emphasis given to specific programs in heart disease, cancer, and stroke. April, 1967 01 operational grant awarded. The period is from June 1, 1967 through May 31, 1968. $1,000,000 (DC) Seven out of the eight 76,600 (IC projects proposed were $1,076,600 funded. September, 1967 Staff visit: Stephen J. Ackerman, Dr. Mathewson. A member of the Planning and Evaluation Branch observed the Kansas RAG in action and me,'- with Dr. Letqis, his staff and representatives of several local action groups. December, 1967 Kansas PUMP visited Division of Regional Medical Programs Subject matter included discussions on computer problems, continuing education, and revision of organization plan which would merge the planning and operational grants. February, 1968 Council's action on lst year supplemental operational grant. Five projects were approved in general but with recommendation of deferral to allow for site visit. February, 1968 Amended notice of grant awarded for Operational grant. This is for the period June 1, 1967 through May 31, 1968. $592,248 (DC) 107,604 (IC) $699,852 total Amended notice of grant awarded for Planning Grant. This is for period of July 1, 1967 through May 31, 1968 $223,700 (DC) 57,927 (IC) $281,627 total February, 1968 Council recommended conditional approval of the first year supplemental operational grant application contingent upon the results of a Council site visit. April, 1968 Site Visit Committee: Alfred M. Popma, M.D., Chairman, Donal R. Sparkman, M.D., Robert E. Jones, Robert A. Tolman', Ph.D. Comments: Regionalization is progressing in an organized manner so as to maximize gross cost participation, most especially through the involvement of Local Action Groups. Kansas RMP staff assistance is provided in the formation of Local Action Groups and in assisting them to develop project activities. Site visitors were impressed with number of competent staff. May, 1968 Second year continuation operational grant application awarded. This is for period June 1, 1968 throuah May 31, 1969 $371,307 (DC) 82,617 (IC), $453,924 total May, 1968, Council action on second year supplemental operational grant application was: Conditional approval was recommended as follows: (1) Continued support of core staff. at present level (approximately$686,000) plus 10% for administrative increase. (2) Deferral of personnel increases and the five new operational projects pending clarification. May, 1968 Third supplemental operational grant submitted in a composite of ten projects. May, 1968 Council approved grant application for Hypertension (earmarked funds) for two years with lst year budget of $203,956 plus indirect costs. Grant period starts June 1, 1968 through May 31, 1970. June, 1968 Award of 2nd year supplemental operational grant. Ten projects approved including core planning. Multiple hospital stroke project based in Wichita was deferred subject to site visit. This is for period June 1, 1968 through May 31, 1969. July, 1968- Division decided to defer formal action on all new operationals and operational supplements. August, 1968 The 2nd part of the 2nd supplemental operational grant was submitted as the fourth supplemental for the October-November Review Cycle. The two projects are Project #30"Mobile Workshop for Medical Technologist" and Project #31 "Subregional Office in Topeka." November, 1968 (1) Council deferred all twelve projects submitted in 2nd operational supp ement till January-February 1969 Review Cycle. (2) Kansas RMP submitted single project entitled"'Institute for Dietitions." January,'1969 Site Visitors: Paul D. Ward, Executive Director, California Committee on PIT; Stanley D. Truelson, Jr., Librarian, Yale Medical Library; Robert P. Lawton, Special Assista-,it to the Director; Robert E. Jones, Grants Review Branch. Background: The Review Committee and the Co' uncil requested more information on the regionalization process in Kansas and, specifically, they wished to know how the projects under consideration .related to the ongoing regional plan, and they felt that there was inadequate information on how the decision-making process functions, including the setting of priorities. Comments: 1) Significant progress had been made in the process of regionalization, although an overall concept may not be apparent from the projects submitted. 2) The KRNP has brought health professional people together in Kansas in many areas for the first time and there is evidence that especially facilities, and in several instances manpower, are attempting to develop plans that will provide better health services for the people. 3) Priorities have been determined in a ver pragmatic fashion by the local area y committees. The region-wide committee and the KRNP staff have not attempted to superimpose priorities on the local areas and there was little evidence that there was any intention to proceed along these lines. Priorities can best be described-as what the region-wide committee and the local area committees'agree that they need at any given time when proposals are under consideration. February, 1969 Kansas RMP submitted a renewal application for three of six projects which were funded in the first operational grant two years ago; the other three projects are being terminated. Support for five new operational projects is requested. February, 1969 Council approved application for the 2nd year supplemental operational funds for $396,230. Project #20 has been accomplished; Pro'ect #27 requires additional planning, and i Project #30 returned for revision. April, 1969 - 3rd year supplemental operational May, 1969 - Council recommended only one of five new operational projects funded. This was entitled "Care of Patients with Fluid Electrolyte and Renal Problems," Project #37. Approval was recommended for the three renewal projects. November, 1969 Kansas RMP submitted seventh supplementary Operations Reuest. Project #38 is entitled "Basic Educational Program for Medical Record Clerks." V.- CORE STAFF SIGNIFICANT NAME TITLE % of TIME AFFILIATION Robert W. BroA7-n, M.D. Coordinator 83 1/3 1/6 Associate Prof. of In- ternal Med. Charles W. Hines Associate Coor- 100 dinator Wilbur L. Morris Assistant Coor- 100 dinator in Charge of Special Serv. Jesse D. Risin M.D. Associate Coor- 50 Chairman of the dinator, C.E. 50% Dept. of '@@postgraduate Medical Ed. Barbee J. Cassingham Assistant Coor- 100 dinator, Nursing Education Loanna E. Biers Assistant Coor- 100 dinator, Related Health Professions Richard V. Watts Acting Executive 100 Director, Research & Evaluation Desi Schaffer Executive Director, 100 Library Services John P. Fullilove Executive Director 100 Communications Systems Gordon W.. Titus Executive Director 100 Sommunications Systems South Central Kansas Sector Office - Wichita Alfred H. Hinshaw, M.D. Sub-Regionsl Coor- dinator 'Great Bend Office - Great Bend James W. Wiggs, M.D. Neurologist (Project Director) Hubert H. Bell, M.D. Cardiologist Martha E.-Claypool Sub-Regional Coor- 100 dinator Capital Region Office Topeka Robert L. Lichtenhan Sub-Regional Coor- 100 dinator Northwest Kansas Office - Colby William Leggett Sub-Regional Coor- Part- dinator Time BIOGRAPHICAL INFORMATION 1) Robert W. Brown, M.D. Coordinator a. Born - Atwood, Kansas 1923 b. B.A. - University of Colorado 1949 M.D. - University of Kansas 1955 c. Intern Kansas University 1955-56 Resident and Fellow - Internal Medicine Kansas University 1956-59 d. Assistant Professor of Medicine - Kansas University 1962-65 Associate Professor of Medicine - Kansas University 1965 e. Member, Executive Committee of'Departmen't-- of Medicine - 1966 f. Certified State of Kansas 1955 American Board of internal Medicine 1962 2) Jessie D. Rising, M.D. a. Born - 1914 'Kansas 1935 b. A.B. - University of M.D. - University of Kansas 1938 c. Assistant Professor of Medicine and Pharmacology, University of Kansas 1946-53 Associate Professor of Medicine and Pharmacology, University of Kansas 1953-61 Chairman, Department of Postgraduate Med. Ed. - University of Kansas 1960 Professor of Medicine, University of Kansas 1960 d. Private general practice of medicine, Kansas City,' @issouri 1939-53 e. Present Position Chairman, Department of Postgraduate Medical Educ ation, University of Kansas, School of Medicine Professor of Medicine and Associate Pr6fessor of Pharmacology, University of Kansas School of Medicine Chairman, Therapeutics and Pharmacy Committee, University of Kansas Medical Center f. National Coimittees: Commission on Education (AAGP), 1953-59 Committee on Continuing Education (Association of American Medical Colleges 1962- ) . Committee on Medical Education and Research (American Therapeutics Society) 1962 3) Charles M. Hines a. Born -.1920 b. B.S. - Jackson College, Honolulu, T.H. 1954 c. 1962-64 - Served as Administrative Officer to the Division Surgeon, lst Marine Div., Fleet Marine Force, Camp Pendleton, Calif. d. 1964-67 - Served. as Assistant Administrator St. Margaret Hospital,. Kansas City, Missouri e. 1967-69 - Associate Director of the Memorah Medical Center, Kansas City, Missouri f 1969- Associate Coordinator 4) Alfred H. Hinshaw, M.D. a. Born - 1907 - Kansas b. Pre-Med - University of Kansas B.S. in Medicine, University of Kansas 1931 M.D. - University of Kansas School of Medicine 1933 c. Residency in Pathology - University of Kansas Medical Center 1947-48 Residency in General Surgery - VA Center, Wichita, Kansas 1948-51 d. American Board of General Surgery, 1952 e. Assistant Superintendent, University of Kangas Hospital 1936-42 Assistant Chief, Surgical Service, VA Center, Wichita, 1951-52 Chief, Surgical Service, VA Center, Wichita 1952-60 Chief of Staff, VA Hospital, Dallas, 1960-67 f. 1967-69 - Subregional coordinator for Wichita area 5) Robert L. Lichtenhan a Born - 1939 - Kansas b: A.B. - 1962 - Washburn University, Topeka, Kansas c. 1963-64 - Public Health Service, Kansas City, Missouri Health Department d. 1964-66 - Public Health Service, Ohio Department of Health, Dayton, Ohio e. 1966-68 - Public Health Service, North Carolina State Board of Health f. 1968-69 - Public Health,Service, Oregon State Board of Health g. 1969 - Subregional Coordinator for Capital Regi'onal Office, Topeka, Kansas VI.. OVERALL ORGANIZATION Regional Advisory Group Members of the Regional Advisory Group are appointed by the Governor of Kansas. New members shall be appointed annually during July of each year for three-year staggered terms. George A. Wolf, Jr., M.D., Provost and Dean of the University of Kansas Medical Center is Chair- man of the Kansas RAG elected by fellow RAG members. Regularly scheduled meetings are held bimonthly. The Provost and Dean of the University of Kansas Medical Center (the fiscal agent for the program) and the Secretary of the State Board of Health shall be ex officio members of the RAG. The RAG is represented by nine physicians (3 from KUMC, 2 from State Medical Society, 2 practioner's, 1 State Board of Health, 1 affiliated hospitals); one registered nurse; four consumer representatives; (1 professional, 1 business, I labor official etc.) one hospital adminr istrator; five other health related (1 CA society, 1 heart Association 1 public agency, I hospital associations, etc.).which total 20 members. The person in the Dean's office responsible for liaison with the Comprehensive Health Planning Committee under PL 89-749 will sit with the group and the state staff person responsible for 749 and the lay member of the 749 planning committee shall all be invited guests of the RAG. If the Covernor has an assistant for health and welfare purposes, the Governor's assistant will also be invited. Greater Kansas City Liaison Committee Three members of the Regional Advisory Group are appointed with the consent of the RAG annually to serve on the Greater-Kansas City Liaison Committee. The Executive Secretary of the State Health Department and the Dean and Provost of the Medical Center and the'Coordinator of the RMP shall be invited to sit at all meetings of the Liaison Committee. Since the KRNP is just two blocks from the Missouri state line, a committee was appointed with representatives of the Missouri Regional Medical Program and the Kansas RMP. The major responsibility of this committee is to.accept or reject applications for projects in the Greater Kansas City area. The Coordinator chairs Research, Planning& Committee.- The ad hoc Lead Committees are appointed with representatives throughout the state who will have responsibility to advise-the Research, Planning & Development Committee in regard to categorical and related diseases. Responsible for: establishing prioities in terms of regionalization, projects, and thrust of program delegated to this committee. Office of Coordinator and Officer of Administration have been more closely allied with a direct line communication between Associate .Coordinator for Administration and institutions and the field.coordiiiator. Local Action GroMs (L. A. G.) The local action groups of the Kansas Regional liedical Program are composed of an overlapping membership with Comprehensive Health Planning groups. Associations with the Kansas RMP, the Kansas Hospital Association and the Comprehensive Health Planning groups have been very active in the development of subregional representation. As the mission of the subregions differentiates from planning to the operational phase, a LAG differentiates into somewhat more of a professional group. The geography for the LAG was based on the population and medical trade areas. There are a total of 21 LAGS which encompasses 50-75% of the geographic area. The primary function of the LAG is liaison with central PIIP, secondary is advisory to subregional coordinator, and tertiary is local planning or project development. Depending upon their numbers and talent, the LAG vary considerably in the scope of their activities. Subregionalization The Kansas RNP has developed four subregional offices with subregional staff members in each of the offices. Each subregional office has a subregional coordinator who serves as a member of a Core staff and relates directly to administrative office of Kansas RNP. Project Directors will be directly responsible to subregional coordinator, and in turn to the coordinator through the Office of Administration. Locally, he maintains liaison with the Local Advisory Group, and will serve as Executive Secretary to the Group. This person provides assistance in planning And development of future activities, administrative support for Directors of operational projects in the subregion, supports cooperative institutional community-based programs for medical and paramedical personnel, promotes regionalization, etc. Project-Proposals Specific project proposals are submitted to the Local Action Groups (L.A.G.). The Subregional Coordinator meets with the L.A.G. and reviews the project. If the project is approved at this level it is submitted to the Research Planning and Development Committee. If it is disapproved, the original project director has the option of resubmitting or not taking any further action.- Coordinator appoints two members to act as primary and secondary reviewers. If.proposais need technical review, Scientific Advisory Subcommittee (SAg) reviews the project. This group is not concerned with overall involvement of total project, just technical merits. With the approval of the Research, Planning and Development Committee and/or Scientific Advisory Subcommittee, the Project Director presents project proposal before the Kansas RAG. If the project is disapproved, the project director has the option of rewriting with corrections or not resubmitting the project. If the project is approved, it is submitted to the Division of PIT Review Cycle. Division of Regional Medical Program Services Governor Kansas-Regional-Medi-cal:Proqram <- Regional Advisory Group (Coordinator) Research, Planning, Development Committee Related Lead. Coordinator for: Continuing Special Health' nmittees Physicians-- --Education --Administration --Evaluatioh',---Services --Nurs,'Inq.--Professions Nurses-- -icer Related Health Professions Data Institutions-- --Processing 3rt Disease Evaluation-- Education-- --Communications -oke Special Services-- Libraries-- --Libraries lated Data Processing-- ;eases Communications-- s gional Coordinators Project Dire LAGs KANSAS REGIONAL MEDICAL PROGRAM ORGANIZATIONAL CHART VII. GRAND DESIGN Objectives. The s ecific short term objectives for this region include p - - the followinc,: 1. Development of a Core Staff support base in communica- tion services, library services, and data informational services to provide support for local action groups and sub-regional centers to study their needs and assist them in project developments. 2. To provide support through the Core staff and affiliated institutions and organizations in Kansas for feasibility studies and demonstration units to lead to region-wide or inter-regional cooperative efforts. 3. To include all institutions and organizations concerned with the health care delivery system in the region in the operational aspects of projects. 4. To ascertain the position of RMP and the educational institutions and resources of the region in manpower development. 5. Throuoh the development of sub-regional centers, have the entire region effectively participating in @IP function group planning and project development. Goals of the Program I. LONG TERM GOALS (Estimated Time for Achievement: 4-8 years) No. 1. To improve the quality of patient care with special emphasis on heart disease, cancer, stroke, and related diseases. No. 2. To create manifestations of the expressed concern with a lifetime of learning for health professionals in several critical areas throughout the region, thus insuring the _per- petuation of sub-regional foci for the aggregation of physicians, other health related professionals, and the resources necessary to provide high quality patient care. No. 3. To promote the regionalization of personal health ser- vices in the region, with a maximal utilization of resources and reduction of the costs of medical care. No. 4. To broaden the perspective of those concerned primarily with disease or illness, to include an increased awareness of the interrelationships of this program to others concerned with the health of society. INTERMEDIATE GOALS (Estimated Time for Achievement: 2-4 Years) No. 1. To create cooperative arrangements in appropriate areas in the region where the University or non-university medicall enters may provide active continuing education based upon an analysis of health care problems, in situ, i.e., Great Bend, Kansas. No. 2. To provide certain learning support services to all health professionals in the region, through a netxTork of re- gional, subregions, and local.activities, i.e., library services,. educational communication, nursina circuit courses, self-instruc- tional centers, cooperative nurse retraining courses,,- etc. No. 3. To provide special demonstrations of types of patient care, on a sub-regional geographic basis (to close technological- care gaps), and training programs to provide necessary new types of personnel (to close obvious personnel gaps.) VIII. OPERATIONAL PROJECTS 01 EDUCATIONAL PROGRAMS GREAT BEND, KANSAS Objectives: To develop a model educational program in a selected community. A full-time faculty, which will be affiliated with the Kansas Medical Center, will be in residence. Included among a compre- hensive program.are plans for continuing physi- cian and nurse education and clinical trainee- ships for health-related personnel. Studies will'be made of community needs, resources, etc. #2 REACTIVATING'NURSES GREAT BEND, KANSAS Objectives: A proaram of clinical and didactic training for inactive nurses in Great Bend or within commuting distance. Eight four-week sessions are to be offered annually with emphasis on cancer, heart disease, and stroke. Evaluations will be made six months after each course or session'. Trainee- ships will be made available. #3 CIRCUIT COURSE FOR ACTIVE NURSES - WICHITA, PARSONS, EMPORIA, CONCORDIA, COLBY, GARDEN CITY, GREAT BEND, AND SABETHA Objectives: A circuit course program using didactic presen- tations, demonstrations, films and panel discussions. These various teaching methods will be used to highlight the changes that have emerged in pro- fessional clinical nursina care of patients sufferin- from dancer, stroke, and-heart disease. The circuit teaching team will visit each of the above cities three times annually to provide one day sessions in each locality. Participants will be asked for their evaluations immediately followin- each presentation. #4 --.CARDIOVASCULAR NURSE TRAINING Objectives: To develop an in-service training program to prepare nurses with basic physiological knowledge of coro- nary care, ability to use instruments and equip- ment in coronary care units, experience in ome care, and familiarity with social acetcies that can aid in the-rehabilitation of patients. #7 CARDIOVASCULAR WORK EVALUATION Objectives: 'To demonstrate the Cardiac Work Evaluation Unit and show its usefulness for the evaluation and -rehabilitation of the patient; to develop.an . effective technique for showing physicians and the community at large the ability of patients to return to work. #8 CONTINUING EDUCATION FOR CARDIAC CARE Objectives: Wesley Hospital, in Wichita, would initiate a training program for nurses in the following techniques: providing care for heart patients, utilizing self-instructional media, preceptor- ships, and teaching conferences as well as lectures. The project will also involve St. Francis Hospital, St. Joseph Hospital and Wesley Medical Center, utilizing medical educa- tional faculty from each, as well as a visiting faculty when needed. The program will provide an intensive course for ten days, two hours a day, and repeated every three months, for nursing as well as other paramedical personnel in the cooperating institutions, and subregional commun- ith hospitals. The evaluation methods will: be pre-test and post-testing methods, as well as per- sonality tests. #9 METROPOLITAN KANSAS CITY NJRSE RETRAINING PROGRAM Objectives: All metropolitan area hospitals except one in the greater Kansas City area, will participate in a program for nurse reactivation. This ia the first interregional project. The proposal represents a coordinated effort of providing an ongoing opportunity for the inactive nurse-to become updated and or retrained. The course will last for six weeks and will provide clinical ex- perience in each of the associate hospitals. Six courses will be offered annually. HEAL #10 TH DATA BANK Objectives: This project will be concerned with the first phase of the development of a Health Data Bank. It will thoroughly document: (1) the need(s) for the system; (2) benefits; (3) cost in terms of manpower and time to develop the system; (4) type and cost of computer equipment which would be used as a central core to the system-,-, and (5) the funding requirements for the system. #11 SELF-INSTRUCTIONAL CENTERS Objectives: This proposal requests funds to establish two other health self-instructional centers at small community hospitals along the lines of the @reat Bend Project. Its objectives will: (1) reinforce, using established centers for the continuing edu- cation of health professionals, and (2) provide for the distribution of educational materials of the Kansas Heart Association; the American Cancer Society, Kansas Division, Inc.; the Kansas Tuber- culosis and Health Association; and the Univer- sity of Kansas Department of Postgraduate Medical Education. The Department of Postgraduate Medical Education will be responsible for-the supervision of the project. #14 PERCEPTUAL MOTOR DYSFUNCTION ASSESSMENT AND TREATMENT Objectives: A three-day program would be presented at the Institute of Logopedics, Wichita, for 100 otcu- pational therapists from Kansas and six other states. Two consultants recommended by the Perceptual Motor Dysfunction Committee of ADTA will present the program. Emphasis will be given to methods of assessing perceptual motor dysfunc- tion and the sharing of information as to treat- ment approaches which have been used successfully by others. The project will be evaluated by the Postgraduate Education Department of the University of Kansas Medical Center and by Regional Medical Program staff. #18 CORE PROGRAM Objectives; Sixty-one persons are indicated as currently employed full or part-time in the ten offices organized under the program. The offices are designed functionally as those of: (1) the Coordinator, (2) Administration and Institutions, (3) Continuing Education, (4) Nursing Education, (5) Health Related Professions, (6) Research and Evaluation, (7) Data Processing, (8) Medical Communications, (9) Library Services, and (10) the Wichita Coordinator. #19 HYPERTENSION (E A R M A R K E D) Objectives: Multiphasic screening of OEO-organized population in KC. Referral to private physicians other medical facilities, and possible a nurse-staffe@ clinic (whose treatment results would be compared with ED clinic). An attempt will also be made to deter- -cultural and psychological mine some of the socio stress actors.related to hypertension among Negroes. #20 A CONTINUING EDUCATION PROG@L FOR OCCUPATIONAL THERAPISTS (Approved but not funded) Objectives: (1) To increase the occupational therapists' professional value to patients with stroke and post-cardiac disability by training them in this more current and basic treatment method; (2) to bring.patient treatment in this area of the country up to the highest current level; (3) to train occupational therapists, not in a particular method but in a concept of treatment which is the foundation for many neuromuscular facilitation techniques; (4) to most effectively resent this involved method of treatment, the p Rood Technique, throuah live demonstration and supervised practice in order to teach the correct application and gain an understanding of this modern neurophysiological concept; and, (5) to disseminate this knowledge so that the par- ticipants will be able to competently teach other staff the concept and technique. #21 CEREBROVASCULAR AND NEUROLOGICAL NURSE TRAINING Objectives: To increase: (1) understanding and participation in the multi--disciplinary approach to patient care; (2) understandin- of the interrelatedness of patient, family and community; (.3) ability to assess and analyze nursing problems peculiar to patients with cerebrovascular and neurological disease; (4) knowledge and skills necessary to ive direct care to patients with cerebrovascular 9 and neurological conditions; (5) skills in preven- tive measures of complications from prolonged bed rest; and (6) ability to help patient move from dependence to independence, i.e. activities of daily living. #22 BIOMEDICAL LIBRARY INFORMATION CENTER Combined with #23. #23 YANSAS MEDICAL LIBRARY SYSTEM Objectives: Medical library services include: (1) development of a collection of books,.Journals and other materials pertinent to the biomedical sciences, (2) maintenance of special subject references, files and indexes, (3) circulation of material by photo-copying, (4) filing and indexing of internal reports, (5) maintenance of reference services, and (6) compilation of bibliographies on biomedical topics. In order to provide adequate medical library services in the state, an organ- ized network provides knowledge of medical library services to health-related personnel; assistance to hospital administrators in.building basic medical literature and to medical librarians, a source of material not available at their local level. .#24 FOOD SERVICE PE@-,',SOMiEL USING THE DIETARY CONSULTANT APPROACH (Approved but not funded) Objectives: (1) To contribute to patient care through improve- ment of menu planning, food preparation and service, sanitation, and related topics and, (2) to supple- ment the existing knowledge of non-professional food service personnel concerning menu planning food preparation and service, sanitation, and re- lated areas. #25 COORDINATED SYSTEM FOP, CONTIN UING EDUCKTION OF MEDICAL AND PARAMEDICAL PERSONNEL Objectives: (1) To establish and maintain coordinated efforts of existing in service training procrams in Newman and St. @lary Hospitals, Emporia, Kansas; (2) to extend these programs to other area hospitals and C) nursing homes and other community groups concerned with patient care in the areas of heart, cancer, stroke and related diseases; (3) to provide a -common community resource for continuing edu@a- tion, consisting of personnel facilities, equ-ip- ment, and libraries; (4) to stimulate continuing education for medical and paramedical groups in the areas of heart, cancer, stroke and related diseases; and, (5) to improve patient care through consumer education and better trained medical and paramedical personnel. #26 CANCER CARE CONTINUING EDUCATION PROGRAM Objectives: The program will combine the clinical teaching resources and medical experience of this region with the educational resources of the University of Kansas Medical Center. The educational re- sources of the Kansas Division of the American Cancer Society Wesley Medical Center, St. Francis and St. Joseph hospitals in Wichita will also be used. By properly utilizing and coordinating all of these existing resources, we believe we can develop a very effective cancer care continu- ing education'program for nursing and paramedical personnel. #28 SEMINAR ON BASIC MEDICAL LIBRARIANSHIP Objectives: To impart the basic st@ills of medical librarian- ship to subprofessionals in order to improve medical library services in the state; (2) to improve acquisitions, cataloging, reference services, and inter-library loans; (3) to increase inter-library cooperation; and (4) to indoctrinate the sub-pro- fessionals in ways and means of keeping up to date in the art of medical librarianship. A two-day symposium will be held on May 15-16, 1969 at the University of Kansas. #29 KANSAS CITY-COUNCIL ON HEALTH CAREERS HEALTH MANPOITER RECRUI@IENT PROGRAM (Approved but not funded) Objectives: In cooperation with the state medical society, state nurses association, high school counselors and directors of health professional schools (1) to create an increase in numbers of student applicants to allied health professional schools; (2) to create an increase in numbers of student h@alth professionals entering schools from families with incomes less than $5,000;-and (3) to develop more effective and efficient methods of health science recruiting. A 7-point program will en-, compass the following: High school biomedical career programs and assemblies, counseling, tutoring, academic program, job placement, tours, and testing. #31 SUBREGIONAL OFFICE IN TOPEKA Objectives: This is a request to establish a second sub- regional office in Topeke similar to the one in Wichita which is functional. The Topeka sub-region is described in the narrative and represents the third lar-,est grouping in health personnel and facilities in the Kansas Region. The Topeka subregional Coordinator would work with a local action group in defining health needs and in identifying appropriate programs to meet them, promotion of effective utilization of health r6soueces, and in assisting with the coordination of training or retraining programs for health manpower.' #32 INSTITUTE FOR DIETITIANS Objectives: Would be in two parts: a two-week institute designed to update knowledge preceeded or followed by a second two-weel, institute in dietary department management which would carry two hours graduate credit. The program would be sponsored by Kansas State University. #37 CARE OF PATIENTS WITH FLUID ELECTROLYTE AND RENAL PROBLEMS Objectives: Provide continuing education in fluid electro- lyte and renal problems for physicians and nurses. Two postgraduate courses will be conducted by the Kansas University Medical Center staff for physicians. An intensive course in both theory and techniques of fluid and electrolyte and renal problems will be given to four or five nurses from each of the five participating hospitals. The nurses trained in this six-day course will then conduct courses at their own hospitals.