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Comprehensive Health Planning


Vol. II ;jo. 1

35 11th Avenue - Helena, Montana


February 17, 1970

CHP LEADERS FROM ALL Eighty health planning leaders - nearly all of whom are involved

DISTRICTS EXPECTED AT in local, area or State CHP efforts— are expected to attend the
LEADERSHIP CONFERENCE March Leadership Conference. The Conference will be held on

March 2,3,^ and 5 in Helena in the House Chambers, and is being
conducted by the University of California's Berkeley CHP staff. The Conference is being made
possible through a grant requested by the American Public Health Association, The first day's
activities will include orientation into CHP, which will be followed by a teaching session on
the planning process conducted by the Berkeley staff, which is headed by Henrik Blum, M.D.
During the next two days, participants will gain insight into the planning process by working
on pertinent state-wide health problems which the CHP staff has been documenting. There are
four problem areas available to participants including dental caries, manpower, migrant health
and environmental health. The Conference will be broken into four units to study the four
problem areas with the faculty and Montana resource persons. The fourth and final day of
activity will consist of a half day seminar attempting to explain, "where to from here."
Those persons attend ing, who are interested in grants and grant programs, wi 1 1 have the oppor-
tunity to discuss their questions with a representative of the Denver CHP office.


It became apparent shortly after the EMCHA was refunded by OEO
that one of the partners in this health effort - the indispens-
ible phys ician - was not altogether satisfied v/ith the progress
being made. A meeting was held January 17 at which time physicians and the Executive Board
of the EMCHA met. The existing differences were resolved when the EMCHA accepted a resolu-
tion by the physicians which will create a medical advisory committee consisting of various
health professionals appointed by their respective health organizations.

LOW- INCOME TASK FORCE The first meeting of the Task Force established by the Personal
HOLDS FIRST MEETING Health Services Committee of the State CHP Advisory Council to

investigate the delivery of health care to low-income people
in Montana was held January 19 in Billings. Members of that Task Force include Paul Carpino,
Missoula, chairman; Mrs. Lorraine Montoya, Butte; Ruth Phillips, Anaconda; June VanPelt,
Missoula; Sister Providencia, Great FaHs; Milo Dean, Great Falls; Donna Hatton, Missoula;
P.R. Crellin, M.D., Billings; Alice Snodgrass, Ashland; John Daniels, M.D., Missoula; Pete
Coffey, Wolf Point; Doris Archuletta, Great Falls; Bob Fabel, Rocky Boy; George Richter,
Helena; and. Jack Carlson, Helena. Activities at this first meeting were largely organiza-
t ional .

SIGNIFICANT CHANGES IN Although the text of the new legislation dealing with CHP,
NEW CHP LEGISLATION which is being proposed to Congress by the Administration,

has not yet been made available, there have been numerous re-
ports about various sections of it which are of interest to us all. First, is the omission
of the prohibition against the interference with existing patterns of private practice.
Second, the major focus of the draft proposal is to provide authority and encouragement for
experimentation in the development of effective health care systems. More consolidation of
CHP and Regional Medical Program activities is seen as one step. CHP agencies would need
representation from RMP agencies, something which already exists in Montana, and RMP pro-
posals would be referred to state and areawide CHP agencies for review and comment on their
consistency with comorehens i ve health planning efforts. Third, there exists the feeling
that not enough emphasis is being placed - in this proposal — on the ecological perspective
of health planning; that is, one that doesn't separate man from the environment in which he
I i ves .

MEDICINE & HEALTH President Nixon's budget asks %2h7 2 million for the CHP pro-

DETAILS CHP BUDGET gram, an increase of $37.9 million over the request for Fiscal

1970. The increase includes $3^ million more for health ser-
vices project grants, $30 million of which actually is a transfer of funds from OEO along
with responsibility for ongoing Neighborhood Health Centers.

MISSOULA SEEKING Representatives of the Denver Regional CHP office will be in

COMMUNITY HEALTH CENTER Missoula this month to discuss with CHP and the Low Income

Group on Human Treatment (LIGHT) leaders the possibility of
31^(e) funding of a community health center.

BILLINGS MAKING EFFORT There are indications that the South Central Regional Health
TO SERVE LOW -INCOME Planning Council is seeking a solution to the problem of pro-
PEOPLE viding health services to its low-income populace in Billings

via the health center out-patient concept. Colvin Agnew, M.D,
president of that organization was recently in Denver to discuss the matter with Regional
representat ives.

SCRHPC REQUESTS The Board of Directors of the South Central Regional Health

SITE PERMITS Planning Council met in Billings January 23. Of special

interest was a resolution coming from Thomas Moylan, M.D.,
Roundup, which stated: "A Problem for this organization to consider is that of land use
designation. There is an urbanization process occurring on some of our irreplaceable
agricultural and recreational lands. Factories and other installations have been and are
being built without serious consideration of effects upon existing populations in the area."
The resolution then urged development of a system of industrial site permits, legislation
to protect the flood plains of the State's streams and rivers from a subdivision, and State
rivers and State plains designation. Dr. Moylan pointed out that open space and unmodified
land are essential to the health of Montanans in this increasingly crowded world, and that
many other states are taking steps rapidly through legislative and community action to re-
serve these precious commodities.

GOVERNOR'S HEALTH A Governor's Conference on Health Care Delivery Systems will

CONFERENCE SLATED be held in Helena April 17 and 18 in the House Chambers.

FOR APRIL 17, 18 Scheduled speakers for the Conference will include Hon. John

Melcher, representative of Montana's Eastern Congressional
District, and Max Fine, Executive Director of the Committee for National Health Insurance,
Washington, D.C. Keynote speaker for the Conference will be John Hogness, M.D., Executive
Vice-President of the University of Washington, who will speak on "Challenges in Health
Care." A series of speakers will discuss the "Status of Health Care in Montana," prior to
the presentation of "A Model Proposal for Montana," which is to be presented by Walter
Uphoff, HEW Project Director, University of Colorado, and instigator of the meeting. "The
Pros and Cons of National Health Insurance" will be discussed. Sidney C. Pratt, M.D. will
chair a group discussion dealing with "How Prepaid Group Practice Concepts Might Be Adapted
as a Dual Choice in Montana." The Conference is being sponsored jointly by Montana's
Comprehensive Health Planning and Regional Medical Programs.

DISTRICT 2 TO This last December the membership of the North Central Montana

ELECT OFFICERS Health Planning Council elected a Board of Directors, which

includes: Martina Arnoux, Browning; Gilbert Horn, Harlem;
Mr. Lloyd Billy, Rocky Boy; A.J. Hirschfleld, M.D.; Thomas J. Underriner; Fred K. Holbrook;
Margaret Ferguson; Orin Cure; Mrs. Ernest Elespuru; Floyd J. McDowell; Vincent Bosh; Don
McClintock; Milo F. Dean; John Sunchild; Frances Gosney; J, A. Ross, M.D., Great Falls;
Ester Sheets; Mrs.Moody Matheson, Chinook; Jim White; John C. Soderberg, Fort Benton;
Otto Jensen; James R. Adams, Lewistown; Ed Morse, Denton; Frank Krshka, East Glacier;
Robert Howard, Cut Bank; Fritz Naber; Bruce Thomson; Dennis Caldwell, Havre; Pat G. Kirby;
Wendell Hansen, Stanford; Charles D. Good; Clarence J. Peterson, Chester; Stanley E. Wiggins,
Rudy Glatz, Winnett; Joe Preputin, Brady; Mrs. Alicia O'Brien, Conrad; Mr. Roy Goodell,
Dutton; J.R. Crabtree, M.D., Choteau; Robert Sisk; Levi Taft, Shelby. These Board members
will be meeting shortly to elect officers for the organization.

Staff Members

Robert Johnson, Acting Director
David Depew, Program Coordinator
Ted Clack, Research Analyst

/4> oon c.Vs


Comprehensive Health Planning


930 East lyndale Avenue


Vol. II No. 2

35 1 1 th Avenue - Helena, Montana

i) '♦9-3121

May 26, 1970

ADVISORY COUNCIL TO The State Advisory Council for Comprehensive Health Planning

MEET IN HELENA IN JUNE will meet in Helena on Friday, June 12, at 9 a.m. in St.

Peter's Hospital. The Council is expected to take action on
numerous committee recommendations, and will also elect a ne\v chairman, as Dr. Frank McPhai 1 ,
present Council chairman, has announced that he will not run for the nositinn inain.

MARCH SEMINAR HELD The March CHP training sessions for State and areawide CHP

DESPITE Si'JOW STORMS leaders began on time and with good attendance despite one of

the year's only big snow storms. The Berkeley staff used the
first day of the seminar to discuss the philosophy and need for comprehensive community plan-
ning for health. The remainder of the seminar was used to study pertinent Montana health
problems in a manner designed to further knowledge of the planning process. The final day,
participants were asked to reflect on what had taken place and what should be done now. There
were two immediate suggestions: (1) to develop a statement of philosophy, providing goals,
objectives and activities and establish roles and relationships of the program; (2) to hold
areawide seminars. A rough draft proposal of the resulting Statement of Philosophy has been
completed and distributed to many areawide board members for comment.

WIDE COVERAGE GIVEN The 15-man task force, established by the Council's Personal

LOW INCOME TASK FORCE Health Services Committee to study health care delivery to

ACTIVITIES low- income persons, has received considerable nev-/s coverage.

Hearings have been held in Helena, Anaconda, Butte, Bozeman ,
Mineral County, Ravalli County, Missoula, Great Falls, and Billings. Participants in the
hearings, having been given the opportunity to air their views, criticized some aspects of the
health and welfare systems and complimented others. The hearings, which were recorded, arc
being transcribed and, it is hoped, findings will be prepared and presented to the Personal
Health Services Committee prior to the June meeting so the Committee can make recommendations
for future planning actions to the Council at the annual June business meeting.

.». .t. J.

GOVERNOR'S CONFERENCE The Governor's Conference on Health Care Delivery systems

EXAMINES SYSTEMS began with a look at the health status of Montanans and with

an examination of the health problems inherent in a rural state,
It then proceeded to discuss ways of alleviating health problems found in Montana. Financing
mechanisms were discussed by Max Fine, executive Director of the Committee for National Health
Insurance, and Dr. Drew Peterson, an AMA representative. Prepaid group practice was discussed
from the podium and the floor. Tapes of the sessions are now being transcribed and, when
published, will be made available to interested persons.

EMCHA HIRES STAFF Eastern Montana Community Health Association, long without

ELECTS NEW OFFICERS qualified staff, has hired Dennis Caldwell, formerly with the

Northern Montana Hospital, Havre, to direct its planning activ-
ities. Caldwell assumed duties with the 16-county health association in March. At an April 25
Board meeting, new leadership was elected to the EMCHA, including Rolph Tunby, Plevna, pres-
ident; Rev. C. Christofferson, Fallon, vice-president and W.B. Danner, M.D., Sidney, Secretary.

The EMCHA is presently attempting to recruit a planning coordinator.


tary, respectively. Dr. J.R.

Grin Cure, a Great Falls attorney, was elected president of
the North Central Health Planning Council by the Board of
Directors at its April mfeeting. James Adams of Lewistown and
Pat Kirby of Stanford v/ere elected vice-president and secre-
Crabtree, Chouteau; Milo Dean, Great Falls; John Soderberg, Fort

Benton; and, Clarence Peterson, Chester, were elected to the executive committee.

SCELCY -SWAtJ AREA Citizens of the Seeley Lake area are actively seeking a program

REQUESTS I'lURSE to make use of a nurse practitioner. A proposal for suci^i a

PRACTITIOIIER PROGRAM program was presented ay the CUP and Nursing Divisions of the

Department of Health in April. The proposed program would place
a public health nurse in this rural area which has a year round population of some 2,000 and
a summer population of more than. 30,000 on any given day. The nurse would launch preventive
programs and be available for emergency treatment. She would also be communicating regularly
with physicians in another area. The community is considering the use of subscriptions if
federal funds cannot be found to launch the program. The program would be self-supporting on
a fee-for-service basis after the first two years, if all goes as planned.

NATIO.'JAL HEALTH HEW Secretary Robert Finch recently identified the areas of

EMPHASIS emphasis he wanted department personnel to use as a guide in

RELAYED BY HEW preparing long-range plans and budgets for the coming year.

These include: (1) improving the health of the nation's child-
ren, particularly during the first five years; (2) extending the availability of family plan-
ning information and services; (3) increasing the supply of physicians and other skilled health
manpower; (4) expanding efforts to improve the organization and delivery of health services,
especially to the poor; (5) accelerating movement to prevent and control narcotic addiction,
drug abuse and alcoholism; (6) meeting to a greater extent the health needs of migratory
workers; (7) strengthening protection of the consumer and promoting a healthy environment.

DISTRICT 1^ MEETS The Board of Directors of the Southwestern Areawide Health

IN WHITEHALL Planning Council met in Whitehall April 22. Discussion cen-

tered around organizational activities and plans for the coming
months. The Gallatin component of the areawide has had significant success in its grass roots
organizational activities. Neither Helena nor Butte - Model Cities communi t ies - have been or-
ganized effectively for CHP. Efforts to correct this situation were initiated at the April
meeting. Model Cities staff from both communities discussed with the areawide planning board
their programs and possible ways to tie the organizations together. The group requested assis-
tance of the State agency in organizing some of the uninvolved counties in the area. The Board
also passed a resolution seeking the assistance of county medical societies in bringing rep-
resentatives of the MEDEX Program out to their district to discuss with local physicians the
possibility of using trained medical corpsmen on their medical teams.

CHANGE IN BYLAWS The Council's executive committee met April 29 in Helena.

TO BE SOUGHT FROM Among the items considered and acted upon by the Committee was

COUNCIL a proposed change in the bylaws. It was proposed that the

date of the annual meeting be changed from the second Friday
in June to the first Friday after Easter. The change was sought to get maximum input by the
Council into the creation of the Agency's budget and annual work program. It was also recom-
mended to the Council that the Areawide Planning Committee be expanded to include represen-
tation from the areawide organizations. The recommendation was approved by the Committee.

j« ««. .L

AMA ON CHP The text of a report of the American Medical Association's

Committee on Planning and Development has been made available.
In discussing P.L. Sg-y^^S, the Committee made the following points to physicians attending the
House of Delegates meeting: (1) medical societies at all levels should support the concept of
P.L. SS-J'jS and aid, in every way possible; efforts to establish properly constituted planning
agencies; (2) medical societies should actively support and promote the establishment of area-
wide comprehensive health planning agencies, at local levels, that have broad community repre-
sentation on their board of directors; (3) state and county medical societies should seek or,
if necessary, demand their proper representation on the executive bodies of the planning coun-
cils; (k) state medical societies should make every effort to inform physicians and county med-
ical societies of the details of P.L. 89-7^9, the role they should seek in areawide planning
and their legal recourse if they are not accorded proper representation.

EMCHA RECRUITING Dennis Caldwell, executive director of EMCHA, has announced his

PROGRAM COORDINATOR board's intentions to hire a program coordinator to handle the

association's organizational and communications activities. The
job description supplied by Caldwell is as follows: "Planning Coordinator for 16 counties in-
cluding two Indian Reservations, in Eastern Montana. Immediate vacancy. Salary negotiable with
experience and education. Must be able to communicate with others, completely understand how
to organize groups."

roORn^NATiNp'ioRK Agency staff met with members of the Butte Model Cities

COORDINATING WORK Human Resources Council June 18 to discuss with this group

. ^^ ^ ^, ^ . their involvement and the involvement of Silver Bow County
in the Southwestern Areawide Health Planning Council. A committee was established by the
Council to look into the possible relationships that should exist between CHP and Model
Cities. The State CHP staff has also met with Model Cities staff in Helena, which is
currently considering proposing reorganization of its Health, Education and Welfare
Committee, to eliminate duplication of organizational and planning efforts

* » »

pfn^S rnuR?? POP ^^^ Northcentral Areawide Health Planning Council's recently

NORTHPFNTRAf m^TRirT elected Executive Committee met in Great Falls May 14 to
NORTHCENTRAL DISTRICT chart the future course of the Health Planning organization.
.... ^ , , '^^^ Committee decided that experts in environment, facili-
ties planning, mental health, services and organization from the area should be contacted
about discussing with the general membership problems, resources and possible solutions of
health problems for which they have expertise. Letters of invitation have been sent to
thosepersonswith such backgrounds and the State CHP staff is now assisting the areawide
organization in planning for this meeting.

* * *

OF pfl^M I nV Members of the CHP staff, the Council's Environmental

HOiniMP MFFTiMr. ^f J^ Planning Committee, and members of the staff of

HOLDING MEETINGS the State Department of Planning and Economic Development * ^ .- *• . ^^^® ^®®" holding a series of meetings to examine possible

areasof duplication and redundancy existing between the two programs in the environmental
planning area. The success of these meetings will determine the final shape of the en-
vironmental planning section of the CHP Program.

* * *

Npi Rnl^F mR^ip^c "^^^ American Medical Association took a stand aimed at

Ntw KULL f-OR NURSE increasing the significance of nursing as a primary com-

. ponent in the delivery of medical services. The House of
?h! SmI^' endorsed a six-point Board of Trustees position statement which stipulated that
rprnnnl' ""^^^S" ' ^^^ !^^ "^^'^ ^°^ ^"^ will support efforts to increase the number of nurses;
recognizes the need for and will facilitate the expansion of the role of the nurse in pro-
InH^n.? +K^''!' ^"^^'^^^a^ ^"d supports all levels of nurse education; will promote
and influence the development of a hospital nursing service, similar to a medical care
service under the leadership of a chief of professional service aimed at increased in-
Zci ZTJI ^""^=-^,f '^'^^I c^^e of the patient; supports the concept of the physician-
led health team; will seek constructive collaboration with the total nursing community.
th!+^ Ir^K ^^^^^^^^ +hat, "The Board of Trustees and its Committee on Nursing believe
r,Tn Zl\l ^^""""^ i^'"^"'^ ^°' ^^^'^^ services and the shortage of manpower, the physi-
e fec?iveT ""'-'^ '^^ ^ '^ "^^^"" ^"" P°+^"+'^l ^= ^ highly coordinated and mutually

» * »

SsSEfilLf^ZTON Medicine aril Health , a publication originating in Wash ington,D.C,
uibCUbbbS HILL-BURTON stated in i ts Ju ! y 6 ed i tion that the Senate's decisive 76-19

r;,, ,k •+ « ^ . ^ote to override President Nixon's veto of the Hi I l-Burton

' + P ?' ^O'j'f action money) is certain to help crack the Bureau of the Budget's "long-
yed strangle hold on funds for health programs." The vot^ maintains the publ ication,
II lend encouragement to Congress to increase appropriation requests for health.


» * *

Comprehensive Health Planning

Robert R. Johnson, Acting Director
David R. Depew, Program Coordinator
Theodore H. Clack, Research Analyst
Donald K. Johnson, Activities Consultant
Doris Downs, Secretary
Diana Fleming, Clerk-Steno
Jeryl Waling, Clerk-Typist

\j.^y^-3 MONTANA

Comprehensive Health Planning


vo I II Uq i.

^S - 1 1th Avoniio

Hp.lPn?^ Mnn+;=.nP» SQfini

449-5121 July 20. 1970



area without the services of
framework in which the nurse
of the health team as effecti
development of an academic an
of Science in Medicine; (3) a
State system of site permits
feasibility study regarding a

The Montana Advisory Council for Comprehensive Health
Planning, at its June 12 annual business meeting in Helena,
approved funding of: (1) a demonstration project to test
the health impact of a community nurse practitioner in an
a physician, and to delineate needed changes in the legal
works and the training a nurse receives to make this member
ve as possible; (2) a feasibility study relating to the
d clinical training program leading to the degree of Master

feasibility study to test the possible effectiveness of a
to maintain environmental quality in Montana; and, (4) a
mental health assistance training program.



* * «


Dr. Bryce Hughett, Billings, replaced Dr. Frank McPha i I ,
Great Falls, as Chairman of the Montana Comprehensive
Health Planning Advisory Council. Dr. Hughett was V ice-
Chairman. William Leary, Helena, Executive Secretary of
the Montana Hospital Association, was elected V ice-Chairman.

» » *

AREAWIDE LEADER AND Mrs. Grace Bates, Manhattan, one of the prime movers in the
BLUE CROSS EXECUTIVE organization of the Gallatin County Comprehensive Health
NAMED TO COUNCIL Planning Association, and an active member of the South-

western Areawide Health Planning Council, along with Virgil
Miller, Great Falls Director of Montana's Blue Cross program, have been elected to the
State Council, replacing Supreme Court Justice John Harrison, who had resigned and Richard
White, Billings, health insurance executive, who left the State.

# * *


The State Advisory Council has changed its annual meeting
date from June to April. The change was made in an effort
to get as much committee and Council input into the prepar-
ation of the annual budget as possible.

* » #

LEGISLATIVE PROJECT The Facilities Committee recommended to the Council that a

NEEDED SAYS COMMITTEE special project be proposed to the legislature to test

whether tuberculosis can be treated in general hospitals.
The recommendation was accepted by the Council.


* * * 930 East lyndale Avenue

-'' ' ■■ !:\ '-'"nc; 5P601

Don Johnson is assisting the State staff during summer
months with organizational efforts. Johnson, a Helena
educator, has been speaking to State groups and organizing
local communities to plan for health.


« * #

TASK FORCE TAPES Some 90 hours of taped material from the low-Income Task

BEING TRANSCRIBED Force deliberations is now being transcribed. The Personal

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