I write to you both as a Board member of the Agassiz Health Systems
Agency and as a hospital administrator in the area concerned.

I ask you to consider imput into the hearings now being held on
PL 93-641 for increased minimum funding for HSA's. In addition

I ask that consideration be given to funding the Area Health Services
Development Fund - congressionally authorized but never funded.

My reasons are:

1. While all RSA's must perform the same functions, rural HSA's usually do not have the same funding capabilities as metro HSA's.

a. Last year Agassiz found it necessary to use $10,000 of
local funds; this year about $20,000 over minimum funding
and next year there will be little or none - which means
a reduction in staff, already at minimum.

b.

Although I believe the law intended matching funds based
on population but we have not been able to apply for this
because of our population base (314,000 in 27,000 suare
miles).

Additionally it would seem appropriate to consider additional funding for bi or multiple state agencies because additional costs are incurred.

1. We have a large area to cover
Committees.

2.

We must meet with SHPDA's in two states in order to arrive

at common development and implementation plans - no small
task with different viewpoints with which to contend.

In order for Agassiz and other rural HSA's to remain viable it is
imperative that:

1. Minimum HSA funding be increased to at least $225,000.

2.

Some change be made to allowing matching funds based on a
different population formula.

3.

Additional funding be made available for those HSA's which
cross state or regional lines.

Your serious consideration of these matters will be most appreciated.

J... Connor

William Decoteau

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Honorable Arlan Stangeland
4th Floor, FM Center

403 Center Avenue

Moorhead, MN

56560

Dear Congressman Stangeland:

I first want to wish you a warm holiday season and tell you how much I enjoyed visiting with you at the Chamber of Commerce offices in East Grand Forks. (I'm the Councilman who told you the train slowed down so people could wave at you.)

I did mention that I would be getting back to you because of the
expected changes pending in the Health Planning and Resources De-
velopment Act P.L. 93-641.

There are some changes our agency would like to see in the law, and
I will get back to you detailing out changes necessary to assist
health planning in our rural area of Northeast North Dakota and
Northwest Minnesota.

The most critical issue we face at this time is the need for a higher minimum funding level for our rural Health Systems Agencies.

We are expected, in fact we are required, to perform the same functions as any large metropolitan based health systems agency.

I do not particularly desire large federal handouts to accomplish those things we can do at a local level, but P.L. 93-641 is a good federal strategy to give local planning areas an opportunity to plan and determine the services we want and need.

L

As the attached letter documents, without a higher minimum funding level our agency will go belly-up.

If there is anything (information, visits, etc.,) I can do to assist you in this endeavor please call on me. My Board of Directors (of

64 - representing consumers, providers, and elected officals of your district) has encouraged this contact, and I am writing this letter with their support.

Again thanks for a pleasant evening, and I look forward to your response and help.

December 12, 1977

Mr. Bernardo Benes, President

American Health Planning Association
2560 Huntington Avenue, Suite 305
Alexandria, VA 22303

Dear President Benes:

I am writing this letter to share with you the deep concern our
agency has for its very survival. Our bi-state health systems
agency of 27,000 square miles and 314,000 citizens under present
funding levels will soon not be able to function.

This year our agency will have to spend $15-20,000
over the minimun funding of $175,000.

4.

Next year will reduce any local monies we have to
about zero; and if there is no increase in the minimun
grant I will be forced to let go staff (a catch 22
since I'm supposed to have five professional staff).

To compound matters - because of our population base
we have not been allowed to match for monies over
the $175,000 a process I believe was intended.

Rural Health Systems Agencies must perform the same major 18
regulated functions as any metropolitan HSA. They usually can
only afford five professionals (and they must compete with
adequate salaries). Rural HSA's also attempt to retain their
staff longer (we can't afford a 20% turnover regularly) and this
contributes to salary increases etc.

For the above noted reasons, I emplore you to have your legislative committee recommend minimum funding levels of $225,000 to $250,000 to Congress.