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This was not done necessarily by our own full-time staff, but through mechanisms that are evolved through the full-time staff, to bring together the best scientific brains of the Nation to outline strategy in relation to particular broad problems.

Senator HARRIS. Without objection we will place in the record the written answers that you alluded to to these questions, which go into some more detail.

(The document referred to follows:)

EXHIBIT 4

CURRENT STATUS REGIONAL MEDICAL PROGRAMS TO COMBAT HEART DISEASE,

CANCER, STROKE, AND RELATED DISEASES AUTHORIZED BY PUBLIC LAW 89-239

The principal purpose of the grant program authorized by Public Law 89-239 is to provide the medical profession and the medical institutions of the Nation greater opportunity to make available to their patients the latest advances in the diagnosis and treatment of heart disease, cancer, stroke, an related diseases. This overall objective is to be accomplished through the planning and establishment of regional cooperative arrangements among medical institutions, which can serve as the framework for programs of research, training, continuing education, and demonstration activities in patient care conducted by medical schools, medical organizations, research institutions, and hospitals. The regional cooperative arrangements are intended to assure close contact between the development of new medical knowledge and techniques in the environment of research teaching and the delivery of high-quality patient care in the hospital and community environment.

Considerable progress has been made during the past year in implementing this new program in regions throughout the Nation. The law authorizes grants for the planning of regional medical programs, and the activity conducted in the regions to this date has been in the planning phase. As of April 7, 1967, 37 planning grants have been awarded. These 37 regions cover approximately 65 percent of the Nation's population. Planning grant applications have been received covering all of the regions of the Nation except two. Some of these applications have been reviewed and grant awards will be made in the coming month. In all of these regions, cooperative arrangements involving medical schools, hospitals, practicing physicians, and official health agencies have been established. These cooperative arrangements help to assure that the major health resources of the region will be involved in the planning and that the operational activities which emerge from the planning process will be more effectively implemented. Each of the regions has designated a regional advisory group which is broadly representative of the health interests of the region as well as members of the public. The advisory groups, required by the law, will advise on the development of the plans and the implementation of the regional medical programs and must, under the law, approve all operational activities. These regional advisory groups are now functioning and include more than 1,400 of the Nation's health leaders.

The National Advisory Council on Regional Medical Programs recently recommended approval of the first four grants for the operational phase of regional medical programs. These four grants will be awarded in the immediate future.

Examples of the types of activities included in these operational programs are: programs of continuing education for physicians and other health personnel in order to assure the rapid transmission of the latest advances in medical knowledge, the utilization of electronic communication networks between medical centers and outlying community hospitals for the purposes of training and diagnosis, the uses of central computer facilities for the physiologic monitoring of acutely ill cardiovascular patients in outlying hospitals, the provision of assistance to community hospitals in establishing intensive coronary care units and the training of nursing staff for the effective operation of these units, the development of mechanisms for the wider application of advanced diagnostic techniques in these disease fields, and the development of information and data systems which will permit the effective evalaution of the activities undertaken. These initial operational grants are supporting the first steps in the implementation of a coordinated regional program that will explore and utilize a variety of techniques and mechanisms for bringing the benefits of the advances in medical science to patients afflicted with heart disease, cancer, stroke, and related diseases The full-scale operational programs will evolve over several years and will utilize the information gained from the initial operational experiences.

Attached is a list of the regions for which planning grants have been awarded as of April 7, 1967. Also attached is a map indicating the regions for which grants have been awarded or for which applications are being reviewed. A brief chronology showing the development of the program is included.

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CHRONOLOGY OF REGIONAL MEDICAL PROGRAMS (Public Law 89-239)

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17 17

REVIEWED

Planning

dev and revised Operational

GRANT APPLICATIONS

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Planning grants for regional medical programs approved and funded as of Mar. 1, 1967 (with supplement updating to Apr. 7, 1967)

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EXHIBIT 5

Preliminary planning

region

Population esti

mate, 1965 1

Regional designation

Coordinating head

quarters

Program coordinator

Effective starting

date

Alabama.

Alabama

1, 1967

Albany, NY.

Northeastern

New York,
southern
Vermont, and
western Mas-
sachusetts.

3, 500, 000 | University of Joseph F. Volker,

Jan.
Alabama

D.D.S., vice president
Medical

for health affairs,
Center.

University of Alabama
Medical Center, 1919
7th Ave. South,

Birmingham, Ala.
1, 900, 000 Albany Medical Frank M. Woolsey, Jr., July

1, 1966
College of

M.D., associate dean
Union Uni- and professor and
versity at chairman, Department
Albany Med- of Postgraduate Medi-
ical Center. cine, Albany Medica

College, 47 New
Scotland Ave.,

Albany, N.Y.
18, 600, 000 California Com- Mr. Paul D. Ward, Nov. 1, 1966
mittee on

executive director,
Regional

California Commission
Medical

on Regional Medical
Programs. Programs, 655 Suter

St., San Francisco,

Calif.
1, 800, 000 Upstate Medical Richard H. Lyons, M.D., | Jan. 1, 1967

Center, State professor and chair-
University of man, Department of
New York at Medicine, State Uni.
Syracuse.

versity of New York,
Upstate Medical
Center, 766 Irving
Ave., Syracuse, N.Y.

California.

California

Central New

York.

Syracuse, N.Y.,

and 15 sur-
rounding
counties.

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University of C. Wesley Eisele, M.D., Colorado

associate dean for Medical

postgraduate medical Center.

education, University
of Colorado,4200 East
9th Ave., Denver,

Colo.
2, 800, 000 Yale University | Henry T. Clark, Jr., July 1, 1966
School of

M.D., 272 George St.,
Medicine and New Haven, Conn.
University of
Connecticut
School of

Medicine.
4, 400, 000 Medical As- J. W. Chambers, M.D., Jan.

1, 1967
sociation of coordinator for
Georgia.

Georgia regional medi-
cal programs, Medical
Association of Georgia,
938 Peachtree St. NE.,

Atlanta, Ga.
800, 000 University of

Windsor C. Cutting, July 1, 1966
Hawaii

M.D., dean, College of
College of

Health Sciences, 2444
Health

Dole St., Honolulu,
Sciences.

Hawaii.
4, 900, 000 Indiana Uni- George T. Lukemeyer, Jan. 1, 1967

versity School M.D., associate dean,
of Medicine. Indiana University

School of Medicine,
Indiana University
Medical Center, 1100
West Michigan St.,

Indianapolis, Ind.
2, 200, 000

University of C. Hilmon Castle, M.D., | July 1, 1966

Utah School associate dean and of Medicine. chairman, Department

of Postgraduate Education, University of Utah, Salt Lake City, Utah.

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Colorado

Wyoming.

Colorado and

Wyoming.

83-470-67—8

Connecticut.

Connecticut--

Georgia.

Georgia

2, 300, 000

Hawaii.

Hawaii.

Indiana

Indiana.

Intermountain--- Utah and por

tions of Wy-
oming, Mon-
tana, Idaho,
and Nevada.

See footnote at end of table, p. 115.

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