Connecticut Regional Medical Program Records

The Connecticut Regional Medical Program (CRMP), one of fifty-six similar programs throughout the United States, was a federally funded, locally-controlled organization. It was designed to work with and through already existing health care agencies and institutions to improve Connecticut's health care system. Its major goals were to promote regionalization of health services and, through cooperative arrangements, to improve the quality, accessibility, and economy of the state's health services.

CRMP originated in Public Law 89-239, which was signed by President Johnson in October, 1965. This act provided for grants to encourage the establishment of regional cooperative arrangements between medical schools, research institutions, and hospitals for research, training, and demonstrations of patient care in the fields of heart disease, cancer, strokes, and related diseases. Supporters of P.L. 89-239 thought that the establishment of such cooperative arrangements would allow the medical profession to make the latest advances in the diagnosis and treatment of these diseases available to the public. They also thought it would improve the health manpower and facilities available to the nation.

In November, 1965, to implement the new legislation in Connecticut, Governor Dempsey appointed a committee of lay and professional health care leaders to recommend a plan of action. The resulting guidelines authorized the Deans of the Yale and University of Connecticut Schools of Medicine to develop a request for a planning grant which they were to submit to the National Institutes of Health. The Deans in turn created a twenty-member advisory board with Arthur Rogers, a Waterbury industrialist, as chairman. Under the advisory board's supervision, a committee of university faculty members prepared a two-year planning grant application. After the grant's approval by the National Advisory Council for P.L. 89-239, the Connecticut Regional Medical Program began operations on July 1, 1966.

From 1966 to 1968, CRMP conducted an intensive investigation of the state's health care system through the activities of nine task forces. A series of program goals and plans of action to achieve these goals emerged from this period of study. To facilitate planning, the state was divided into ten health service areas. Each area commanded a sufficient array of resources to allow its development as a relatively self-sufficient unit of the Connecticut medical care region.

CRMP Director Henry T. Clark, Jr., and his staff essentially proposed to focus on utilizing more fully Connecticut's high level of medical resources and technology rather than creating new facilities and technology. They saw such rationalization of existing health care resources in a given area as the most practical and economical way of enabling medical personnel at the local level to provide optimum care for their population.

CRMP's basic mission was to promote relationships and linkages among the elements of the health care system within each of the ten health service areas. Equally important, CRMP sought to promote alliances between the health service areas and the state's two medical schools, which could provide specialized services not normally found in local communities. CRMP was to function as a convener for the different parts of the state health care system, as a catalyst to stimulate analysis of health care problems, as an agent of change to encourage new solutions, and, when necessary, as a source of funds for new programs.

On January 1, 1969, CRMP received its first operating grant, enabling it to begin the implementation phase of its program. Between 1969 and 1976, when CRMP was terminated under "The National Health Planning and Resources Development Act of 1974" (P.L. 93-641), the program received approximately twelve million dollars in federal funds to augment Connecticut's resources. Typical programs sponsored by CRMP include the following: affiliation agreements between thirty of Connecticut's thirty-three community hospitals and either the Yale or the University of Connecticut School of Medicine; a network of hospital-based, full-time chiefs of service; a statewide blood program operated by the Connecticut Red Cross; an emergency medical services system; and assistance to local communities in resolving health problems through Yale and University of Connecticut resources.

For a more extensive overview of CRMP's origins and development see the bound copies of CRMP's newsletter,The CRMP Story,Vols. I and II, in Series III, box 10; the folders labelled "Historical Background Data" also in Series III, box 10; and the articles and speeches on CRMP in Series VII, box 29. A more detailed listing of CRMP sponsored programs is available in Vol. II ofThe CRMP Story,pp. 184-189.

The records of the Connecticut Regional Medical Program are significant from several points of view. First, the records provide relatively complete historical documentation, on the state level, of the origins, development, and day-to-day activities of one of the nation's major health care planning efforts. Second, the records document the strengths and weaknesses of one of President Johnson's Great Society programs. They also document problems which resulted from the Nixon Administration's efforts to cut federal spending. Third, the records, particularly the planning memoranda and grant applications, contain information of potential use for future health care planning.

The CRMP records are arranged in eight series which reflect the general organizational scheme of the CRMP files. The records within each series are in their original order.

Series I, PLANNING COMMITTEE, ADVISORY BOARD AND EXECUTIVE COMMITTEE: MINUTES AND CORRESPONDENCE, 1965-1976, contains the records of the three policymaking bodies of CRMP. These materials document CRMP's major policy and planning decisions.

Series II, TASK FORCE REPORTS, documents the state of the Connecticut health care system during the mid-1960's; prior to CRMP's appearance. It contains the recommendations for improvements that became the basic frame-work for CRMP's planning and operations.

Series III, PROGRAM IMPLEMENTATION AND DEVELOPMENT: ANNUAL REPORTS, GRANT REQUESTS AND PROGRAM DESCRIPTIONS, 1967-1976, contains records which document the implementation of the CRMP program: annual reports, budgets, grant and program applications, program descriptions, and newsletters.

Series IV, PROGRAM REVIEW AND EVALUATION, 1970-1976, contains records relating to reviews and critiques of CRMP programs: minutes, reports and correspondence of the CRMP Review and Evaluation Committee, and Public Accountability Group reports.

Series V, CRMP ORGANIZATIONAL CHARTS AND STAFF PERSONNEL FILES, contains the drafts and final version of CRMP's governing instrument, as well as organizational memoranda and staff personnel files.

Series VI, MISCELLANEOUS SUBJECT AND PROGRAM FILES, contains staff resource data, notably on federal legislation effecting health care planning. It also contains subject files on several CRMP programs: The Connecticut High Blood Pressure Program, The South Central Connecticut Agency on Aging, and others,

Series VII, BIBLIOGRAPHIES, ARTICLES AND SPEECHES ABOUT CRMP OR BY CRMP STAFF MEMBERS, contains speeches which give an overview of CRMP organization and development, articles on the philosophy of health care which underlay CRMP policies; and a bibliography of selected studies and reports supported by CRMP up to 1975.

Series VIII, CORRESPONDENCE FILES, 1965-1976, is divided into sixteen sections according to organization or subject. This series documents CRMP's daily activities and relationships with other programs and agencies. For CRMP's relations with the federal government see especially the following sections: Regional Medical Programs Service and other RMPs, Department of Health, Education and Welfare, and National Institutes of Health. For CRMP's relations with state agencies, institutions, and its congressional liaison see especially: State of Connecticut Miscellaneous Offices and Agencies, State of Connecticut Congressional Delegation, and State of Connecticut Medical Society. The section entitled Outgoing Daily Correspondence contains a complete series of CRMP's out-going correspondence from 1967-1976; it is arranged in chronological order. The material in this series duplicates much of the correspondence in other sections.