Regional Medical Programs

President Johnson delivered his "Health Message" to Congress in which he announced the establishment of a Commission on Heart Disease, Cancer and Stroke.

The Report of the President's Commission on Heart Disease, Cancer and Stroke was issued, presenting 35 recommendations - including the development of regional complexes, medical facilities and resources.

President Johnson delivers a special message to Congress on "Advancing the Nation's Health."

Companion bills--S. 596 and H.R. 3140--were introduced in the Senate by Senator Lister Hill (Ala.), and in the House by Rep. Oren Harris (Ark.), giving concrete legislative form to the recommendations of the DeBakey Commission.

Anthony J. Celebrezze was replaced by John W. Gardner as Secretary of the Department of Health, Education and Welfare.

P.L. 89-239, the Heart Disease, Cancer and Stroke Amendments of 1965, was signed. The Commission concepts of "regional medical complexes" and "coordinated arrangements" were replaced by "regional medical programs" (RMP) and "cooperative arrangements," thus emphasizing voluntary linkages.

Luther L. Terry was replaced by William H. Stewart as Surgeon General of the United States Public Health Service.

Philip R. Lee takes office as Assistant Secretary for Health and Scientific Affairs, DHEW.

National Advisory Council on RMPs met for the first time to advise on initial plans and policies.

Dr. Robert Q. Marston appointed first Director of the Division of RMPs under NIH. He also served as Associate Director of NIH. James A. Shannon was NIH Director.

First planning grants approved by National Advisory Council. Original emphasis of RMPs placed on continuing education, patient- care demonstration projects, and development of new manpower resources.

First operational grants approved by National Advisory Council.

The Surgeon General submitted the Report on Regional Medical Programs to the President and the Congress, summarizing progress made and recommending extension of the program.

61 RMPs designated; only four were operational.

Wilbur J. Cohen becomes Acting Secretary of HEW.

Reorganization of Public Health Service. All functions of PHS transferred from Surgeon General (William H. Stewart) to Assistant Secretary for Health and Scientific Affairs (Philip R. Lee). Surgeon General was made Deputy Assistant Secretary.

Companion bills to extend RMPs were introduced in the House by Harley 0. Staggers (W.Va.) as H.R. 15758 and in the Senate by Senator Lister Hill (Ala.) as S. 3094.

Wilbur J. Cohen takes office as Secretary of HEW.

The Health Services and Mental Health Administration (HSMHA) is created, with Robert Q. Marston as first Administrator; RMPs transferred from NIH to HSMHA. RMPs combined with eight programs of the National Center for Chronic Disease Control to form, within HSMHA, the Regional Medical Program Service. Stanley W. Olson made Director of Regional Medical Programs Service.

The chronic disease programs included the Cancer Program; Chronic Respiratory Disease Program; Diabetes and Arthritis Program; Heart Disease and Stroke Program; Kidney Disease Program; Smoking and Health Program; Neurological and Sensory Disease Program; and Nutrition Program.

Meeting of all RMP program coordinators in Alexandria, VA. Five regional groups established: Northeast, Southeast, Midwest, Southwest and West.

Robert Q. Marston leaves HSMHA to become NIH Director.

P.L. 90-574, extending RMPs for two years., was signed. Changes included -- expansion outside the 50 states; funding interregional activities; permission of dentists to refer patients; permission of Federal hospital participation.

Joseph T. English becomes Administrator of HSMHA.

Robert H. Finch takes office as Secretary of HEW in the Nixon administration.

Roger 0. Egeberg takes office as Assistant Secretary for Health and Scientific Affairs, DHEW.

National meeting of coordinators of RMPs and chairmen of Regional Advisory Groups in Warrenton, VA.

Jesse L. Steinfeld takes office as Surgeon General, USPHS.

44 RMPs were operational. Membership in various Regional Advisory Groups exceeds 2000. Over 400 operational projects were under way.

Vernon E. Wilson becomes Administrator of HSHMA. Harold Margulies becomes Director of Regional Medical Programs Service.

Bills extending RMPs introduced; hearings held.

Elliot L. Richardson takes office as Secretary of HEW.

P.L. 90-515 was signed into law. New provisions: emphasis on primary care and regionalization of health care resources; added prevention and rehabilitation; added kidney disease; added authority for new construction; required review of RMP applications by Areawide Comprehensive Planning agencies; emphasized health services delivery and manpower utilization. New manpower included "physician extenders" such as nurse practitioners.

Of the nine original chronic disease programs, the following five were phased out: Cancer, Diabetes and Arthritis, Chronic Respiratory Disease, Heart Disease and Stroke, and Neurological and Sensory disease.

The RMP Service consisted now only of RMPs, Kidney Disease Program, and National Clearinghouse for Smoking and Health.

54 RMPs were operational. Membership in various Regional Advisory Groups was 2,400.

Merlin K. DuVal takes office as Assistant Secretary f or Health and Scientific Affairs, DHEW.

Herbert B. Pahl becomes Director of Regional Medical Programs Service.

Jesse L. Steinf eld leaves office as Surgeon General, USPHS. Post is vacant until July 13, 1977.

Caspar Weinberger takes office as Secretary of HEW.

Charles C. Edwards takes office as Assistant Secretary for Health, DHEW.

HSMHA is split into the Health Services Administration, the Health Resources Administration (HRA) , and the Alcohol, Drug Abuse, and Mental Health Administration. RMPs placed in the HRA. Harold 0. Buzzell was Administrator of HRA.

Peak year of funding of RMPS, with $140 million appropriated. Emergency medical services were playing an increasing role, receiving larger share of funding. Nixon administration proposes health spending cuts, including zero funding for RMPs in FY 1974. Bureaucratic and local support gains a one- year extension.

The National Health Planning and Resource Development Act of 1974, P.L. 93-641, consolidated RMPs with the Hill-Burton and Comprehensive Health Planning Federal programs. Kenneth M. Endicott becomes HRA Administrator.

In response to a law suit filed by the National Association of Regional Medical Programs, the court ordered the Secretary of HEW to release the $126 million in impounded fiscal year 1973 and 1974 funds to the nation's RMPS.

Herbert B. Pahl leaves post of Director of Regional Medical Programs Service.

Theodore Cooper takes office as Assistant Secretary for Health, DHEW.

David Mathews takes office as Secretary of HEW.

After a transitional period, independent RMP operations ceased.

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