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Nature of representativeness disparity Only 1 consumer out of

16 has a family income under the median income in the health service area. 12 of the 16 consumers are men.

Is the Governing Body self-perpetuating?

No

Method of selection 9 consumer members are appointed by local government officials or bodies (county commissioners, mayor, federal coordinating agency); the remaining 7 are chosen by the board after being nominated by a nominating committee composed exclusively of representatives of government officials and providers.

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Is the Governing Body representative? No

Nature of representativeness disparity 12 of the 16 consumer members have incomes of $15,000 or more. This compares to the 1975 median family income of $12,400 in the health service area. 13 of the 16 consumers are men.

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Method of selection Entire governing body is selected by the

governor.

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No

Is the Governing Body self-perpetuating? Method of selection The Utah HSA is a public regional planning body created by state statute. It has a Governing Board which is appointed by the Governor and confirmed by the State Senate. The Governing Board, which is composed of a majority of elected officials, appoints the governing body (Health Planning Council).

Senator KENNEDY. It has been very, very interesting and very constructive. I am a firm believer, if we are able to get these HSA's the way they should be in terms of the consumer, what that can mean in terms of the whole range of health care issues, health insurance and all the rest, are really going to be built upon these kinds of successes, and if we get off on the wrong foot on this we are going to be right back where we are, so this is terribly important. I think it is absolutely essential, so we will work with you. We have got to deal with it. It is one of the very, very important parts of the whole program.

I thank you all for your testimony. We look forward. Our doors are open and we keep counting on them. We look forward to a responsible

response.

Thank you very much.

The subcommittee stands in recess till 9:30 tomorrow.

[Whereupon, at 12:52 a.m. the subcommittee recessed, to reconvene at 9:30 a.m., Friday, February 3, 1978.]

HEALTH PLANNING AMENDMENTS OF 1978

FRIDAY, FEBRUARY 3, 1978

U.S. SENATE,

SUBCOMMITTEE ON HEALTH AND SCIENTIFIC RESEARCH
OF THE COMMITTEE ON HUMAN RESOURCES,

Washington, D.C.

The subcommittee met at 9 a.m., in room 1318, Dirksen Senate Office Building, Senator Richard S. Schweiker presiding pro tempore. Present: Senator Schweiker.

Also present: Stuart Shapiro, M.D., professional staff member, Robert Wenger, J.D. counsel, David Winston, professional staff member, Polly Gault, professional staff member.

Senator SCHWEIKER. The Senate Subcommittee on Health and Scientific Research will please come to order.

Today marks the second day of hearings by the Health Subcommittee on S. 2410, the Health Planning Amendments of 1978. Yesterday we heard from a number of interesting witnesses, and our schedule today is also full with groups representing many different points of view.

I have the pleasure of chairing today's hearings as Senator Kennedy has been unavoidably called elsewhere. I look forward to exploring with all of the witnesses their proposals as to how we can make the National Health Planning and Resources Development Act more effective in national planning, and more successful in accomplishing the dual goals of cost containment and accessibility of quality health care.

I would like to make one observation before we begin. Yesterday's witnesses spent most of their time discussing possible amendments of Public Law 93-641. S. 2410, the legislation Senators Kennedy, Javits. Williams, Chafee and I introduced as amendments to the National Health Planning and Resources Development Act, has not, as yet. been discussed in any detail. The members of this subcommittee devoted a great deal of time and effort to develop this legislation, and we would appreciate some detailed reaction to it. This is particularly critical in light of the fact that S. 2410 will be the legislation which comes before this subcommittee and the full Human Resources Committee for consideration.

Of course, all of the testimony we have received so far will be helpful. However, it would be beneficial to everyone's interests if, in preparing testimony, some reaction to S. 2410 were included.

We would like to begin by calling our first witness today, the Honorable Terrance L. Pitts, supervisor, Milwaukee County, Wis., for the National Association of Counties.

Mr. Pitts, would you please come forward?

(533)

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