for nor do we want regulatory power. We can do our part of the job with information and education.

And second, give us enough funding to do the job. The law asks for a lot from us, but the appropriations have not matched the task. Now is the time to make the appropriation match the assignment. The reason given before was that not all agencies were organized and ready. Well, now they are organized, by and large, and if you want to test the capacity of HSA's to succeed you must give them the wherewithall to do so. To some vested interests in the health care field, the only acceptable health systems agency is an ineffective one. You have the interest and the obligation to see to it that HSA's are effective adequately funded.

which means:

I and the people here with me are doing our part to guarantee

effectiveness, ladies and gentlemen of the Committee. We hope and trust that you will also do yours.

Thank you for your attention.

ORANGE COUNTY HEALTH PLANNING COUNCIL

Activities Since HSA Designation

123/76

OCHPC designated HSA under P.L. 93-641.

115

12/76

1/77

1/77

3177

4/77

4177

4177

4/77

4/77

4/77

5177

5177

OCHPC denies request by American Medicorp to merge West Anaheim and Garden
Park hospitals. 4/77: OCHPC approves merger on condition that 25 beds be
dropped.

OCHPC organizes and cosponsors (with OCMA) symposium on regionalization of
perinatal services. Symposium attended by more than 100 hospital adminis-
trators, OB/GYNs and other interested individuals.

OCHPC reviews application by HMO Concepts for federal developmental loan. Review committee recommends denial; applicant gets temporary restraining order to prevent Board from ratifying committee's recommendation; applicant then withdraws application and submits revised application incorporating revisions suggested by OCHPC; applicant wins OCHPC endorsement.

Mental Health Review Committee reviews 50 idea statements submitted by local agencies for 314(d) mental health grants and forwards 9 to state. State then asks three of these agencies to submit full applications. OCHPC provides technical assistance to all three and one is eventually funded.

OCHPC helps Medical Quality Review Committee organize and publicize symposium to get consumers' views on health problems.

Mental Health Review Committee sponsors two-day seminar on "Grantsmanship and
Proposal Preparation" to assist agencies in grant writing.

OCHPC conducts public hearing on application for renewal of conditional desig

nation.

OCHPC reviews County's request for EMS funds. Application endorsed by OCHPC, subject to modifications suggested by OCHPC.

Health Facilities Review Committee recommends conditional certification for 12
end-stage renal disease facilities and conditional certification for 2 renal
transplantation centers in county.

OCHPC asks DHEW to change wording in proposed regulations to avoid loophole
that would have permitted 715 additional beds in this county.

OCHPC petitions Attorney General, Governor, and State Department of Health to
terminate Medi-Cal payments to Brea Hospital (for adding 49 beds after OCHPC
had denied their request to expand). Brea used 366-day loophole in old 1451
review law.

OCHPC officials send letter to lending institutions known to have financed hospital construction. Letter offers OCHPC's assistance, encouraging potential lenders to use OCHPC data before proceeding with loans.

OCHPC publishes "A Guide to Emergency Services for Orange County Residents," encourages cities, large employers and others to duplicate it for their own residents or employees. City of Brea is first city to print Guide and have it distributed to every household in the city.

388

6177

6177

7177

7/77

7177

9/77

9/77

10/77

10/77

11/77

11/77

12/77

1178

EMS Review Committee recommends approval of application by UC Irvine College
of Medicine for continuing medical education program, subject to revisions
suggested by OCHPC. (Cost: $108,000 first year, $325,000 over three years.)

OCHPC Assembly of Delegates meeting features presentation by UCI on its long-
range plans for the Medical Center.

OCHPC Board passes resolution urging state and its legislative and executive branches to "move as expeditiously as possible to regulate and control the proliferation of expensive diagnostic and therapeutic equipment wherever located in the state." Resolution aimed at closing loophole in state 854 Certificate-of-Need (C/N) law which permits purchase of such expensive equipment as CT scanners and locating them in physicians' offices and other locations outside of acute care hospitals.

OCHPC cosponsors workship organized by Gray Panthers on medical alternatives for
senior citizens.

OCHPC Board passes resolution endorsing AB 1755 which would prohibit the sale of
low nutritional foods at pre-high school levels through vending machines or in
cafeterias, sends copies of resolution to all 33 school districts in the county.

As a result of questions raised by OCHPC and Martin Luther Hospital, state conducts
hearing on legality of Anaheim Memorial Hospital installing a linear accelerator
in an adjacent office building without planning approval. State rules that project
would have qualified for an exemption from C/N but warns that in the future, similar
projects, if operated as part of a basic hospital service, would be subject to C/N,
whether on hospital premises or within an adjacent medical center.

State designates OCHPC to conduct Chapter 854 C/N reviews.

Assembly of Delegates meeting features panel discussion on problems of undocumented workers.

OCHPC helps DHEW publicize, and provides panelists for, public hearing on national
health insurance, one of a series of hearings conducted by DHEW throughout the
country. DHEW reports that Orange County hearing was one of best attended anywhere.
OCHPC holds public hearing on first two HSP documents (Basic Data and Interim Guide-
lines for Planning and Review), plus Review Procedures Manual.

OCHPC sponsors one-day conference on language barriers to health care, attended
by more than 80 individuals.

Health Facilities Review Committee recommends approval of proposal by Hoag Hospital to expand ICU from 13 to 20 beds. Proposal would not increase overall bed inventory because beds would be transferred from other units.

Health Facilities Review Committee hears request by Fairview to reclassify 236 skilled nursing beds to intermediate care and close 84 skilled nursing and 46 acute psychiatric beds. Staff analysis raises a number of questions about appli cation and recommends denial. Applicant submits revisions, based on staff recommendations, and committee recommends approval.

OCHPC conducts public hearings on next two HSP documents, reports on CT scanners and HMO's. HMO report calls for 25% market penetration by 1983.

OCHPC executive director testifies before Congressional committees in Washington on extension of P.L. 93-641. Congressmen send letters to OCHPC to effect that his testimony was the best presented at hearing.

Mental Health and Social Service Programs Review Committees screens more than 30 idea statements for 314(d) funds, forwards 10 to state. Three of the 10 applicants were asked to submit full applications; all three forwarded again to state by OCHPC.

OCHPC questions the state's guaranteeing a construction loan for Anaheim Memorial's
$15.7 million project without, at least, attaching some strings to the guarantee.
Although OCHPC had no authority to stop the guarantee, their opposition resulted
in the state's postponing a decision until AMH signed an agreement with OCHPC.
The agreement includes provisions for their providing a certain amount of uncom-
pensated care, spending at least 10 percent of income in community service; and
consulting with OCHPC and the state on its long-range plans.

OCHPC conducts public hearing on EMS report, another component of the HSP.
Hearing attended by almost 100 citizens; discussion centers on pros/cons of
trauma centers.

Assembly of Delegates meeting features presentation on cost containment by
Steve Rosinski, vice president for industrial relations at Rohr Industries.
OCHPC conducts public hearing on ESRD report. Open versus closed
staffing and home dialysis are major topics of discussion.

OCHPC conducts public hearing on 1978 inventory. Inventory includes cost data
from hospital financial disclosure reports.

Health Facilities Review Committee considers proposal from La Habra Convalescent to add skilled nursing beds. Staff analysis recommends intermediate beds instead. Applicant changes request to intermediate, gets endorsement of review committee. OCHPC conducts public hearing on perinatal document. Proposed regionalization of perinatal services gets considerable publicity.

Health Facilities Review Committee recommends approval of requests by St. Joseph for a computerized laboratory information system ($357,000) and by CHOC for relocation and expansion of its intensive care neonatal unit ($842,000)..

OCHPC conducts public hearing on next HSP component on behavioral health services (mental health, alcoholism, drug abuse, developmental disabilities).

OCHPC EMS Review Committee supports request by county for EMS funds to establish and begin initial operation of EMS system.

OCHPC HMO Review Committee opposes request by Family Health Program for federal grant of $1.6 million.

OCHPC conducts public hearing on application for full designation as an HSA.

7/78

7/78

7/78

7/78

8/78

8/78

9/78

9/78

'20/78

OCHPC conducts public hearing on final document in HSP
Area Health System.

-

the Framework for an

OCHPC July Board meeting includes approval of Annual Implementation Plan (AIP). The AIP includes the following two issues which have already sparked considerable controversy and promise to continue to do so:

1) Determination of the appropriateness of OCHPC requesting legislation
to restrict physicians and other providers of inpatient services or
supplies from holding financial interest in a hospital. (This was in
response to a request by the Grange County Grand Jury.) The OCHPC Public
Issues Committee will conduct public hearings and comparative analyses and
then develop a position paper to be presented to the OCHPC Board.

2) Promotion of inpatient capability for an established federally qualified
HMO, individual practice association or group practice association.
OCHPC expects Kaiser Permanente to submit a certificate of need application
for a hospital for their members. Although many people have the misconception
that OCHPC has approved Kaiser's building a hospital, this is not true.
Kaiser would have to provide clear and convincing evidence, in its C/N
application, that the proposed project satisfies state criteria.

AIP also includes giving special priority to creation of a citywide health care authority in Santa Ana to merge existing hospitals, consolidate special services, increase availability of primary care, especially to barrio residents, and establish lower-cost programs for health care and health insurance.

Health Facilities Review Committee recommends approval of request by Hoag to
modify existing scanner to reduce scan time (cost, $399,000) and request by
UCIMC to replace outdated equipment in radiology diagnostic division ($1,068,690).
Health Facilities Review Committee favors request by Hoag for radiation treatment
simulator ($312,452).

Health Facilities Review Committee favors purchase by UCIMC of head scanner but
opposes request for a body scanner also. (Cost for both scanners: $1.8 million)
OCHPC conducts public hearings on first component of new Health Systems Plan
on health problems of ethnic minorities and persons with low incomes.

-

Assembly members hold series of workshops to discuss implications of HSP and AIP and how OCHPC's activities relate to the organizations they represent.

Regional Health Administrator of DHEW announces that OCHPC has been awarded full designation, under P.L. 93-641, effective Sept. 29, 1978.