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concerns us that the ECIHSA budget is excessive and priorities misdirected in a period when the costs of health care are rising.

It finally concerns us that the ECIHSA has no specific plans to allow effective public involvement in agency proceedings. PL 93-641 placed an emphasis on public notice and open meetings, on local accountability and consumer involvement. But the ECIHSA refused to conduct hearings to allow public comment and consumer involvement in developing the Project Review Manual. And in December the ECIHSA decided "that five minutes be allotted for Public Comment for each substantive item on the Agenda of board meetings." This effectively means that public involvement from consumers, providers, labor unions, women and minority groups, religious bodies and local elected officials from our 16 county area will be restricted to only five minutes per agenda item. Some agenda items involve public expenditures of hundreds of thousands of dollars. These are not our only concerns, but they are among the most important at this time.

We believe that the ECIHSA is not in compliance with federal regulations and democratic principles and that HEW should not fully designate the agency until these and other failures are corrected.

We believe that major improvements in health and health care planning will come only with the involvement of the public. We will continue to work to improve health care planning legislation and implementation under PL 93-641. But it would be a strategic mistake for us to organize only with reference to the HSA without an organized and independent agenda of our our own. We thus are deciding on the concerns which are important to

as consumers and aiming to turn the local health planning system in our direction. Providers have taught this lesson for years.

Senator KENNEDY. Excellent point. We would be glad to include that report in the record. Will you send it to us?

Mr. SEMMEL. We have submitted it.

Senator KENNEDY. Good. Perhaps the correspondence would make a point. It doesn't make any difference. Just the report is fine.

Mr. SEMMEL. Senator, I would add just one thing. We would like to submit for the committee's consideration and inclusion for the record, if you think it is appropriate, the report of the Southern Regional Council and other reports on HSA board composition.

Senator KENNEDY. We will ask the staff to go through and put the relevant parts in the record. We will include them all in the file. Mr. SEMMEL. Thank you.

Senator KENNEDY. We will now hear from Mrs. Fenerty.

STATEMENT OF ANNE FENERTY, CONSUMER COALITION FOR HEALTH, BOULDER, COLO.

Mrs. FENERTY. Senator Kennedy, I appreciate your allowing me to testify here as a board member of the Central and Northeast Colorado Health Systems Agency which takes in an area of 1.8 million people. It is the largest area in Colorado, and 20 counties, and it is funded at three-quarters of a million dollars.

As Mr. Semmel previously mentioned, it is a self-perpetuating, selfelected agency. The few words I would like to say really refer to the fact that due to our involvement in both the project review committee of that agency and also on the nominating committee of the agency, I am quite aware of the frustrations that most of us as consumer members experience because of the domination of a small hospital-oriented group.

Most of our providers-one-third of our providers members on this agency are employed by hospitals either as administrators or any other capacity and this is what the domination is. The frustrations that people experience result in resignations by either people who are very knowledgeable, involved in local government who feel that they cannot waste their time on this agency, such as, three county commissioners, one of whom was a lawyer also, and the other county commissioner was an ex-League of Women Voters president. These were people who wer knowledgeable in the ways of dealing with committees.

We had a resignation from a legal aid attorney, a nun who served the urban poor people in the area, people who represented epilepsy groups and felt that because of the fact: No. 1, our meetings are in the early afternoon where working people have a great deal of difficulty getting to it; information by the staff is not given to the committee members.

I, as a member of the HSA, had to pay 3 cents per page for a copy of our own application form. Our application went to public hearing. I found out about it in the legal notices, but to get a copy of the application that went out under my own name the staff charged me money. Staff also does not return phone calls and the president writes letters to the members of the board saying that staff is extremely busy, please do not burden us with requests. The requests I am referring to was one for the quarterly report.

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In other words, board members are really not aware of what is going on. Board members receive very little training in project review matters, for instance. Basically, we have contacted the regional office of HEW. We have contacted our Congressman.

The only other comment that I have is after contacting our regional HEW office and our Congressman we have now got an assessment of the agency by the regional office of HEW, which is a very negative assessment. It resulted in an indictment of the agency. But, when there was a discussion with the agency members and the HEW, the last statement was that "we shall bend backwards to help you to get permanent designation."

We also have taken to the newspapers several contracts awarded by the executive directors which were a clear conflict of interest and, therefore, were finally cancelled. But, I feel the difficulties involved in an agency like this, there really should be more responsibility for the taxpayers' money on behalf of the taxpayer by the regional office of HEW.

These are basically my concerns.

[The prepared statement of Mrs. Fenerty follows:]

.

My name is Anne Fenerty.

I live at 2805 Stanford Avenue, Boulder, CO 80303.

I have been involved in health planning in an

effort to change the present financial reimbursement

mechanisms for health care.

My special concern is the heavy spending for institutional, often custodial care, for older and disabled people in nursing homes.

I have been involved in alternative programs to help prople achieve their maximum level of independence.

Due to this interest I have followed Comprehensive Health Planning activities, and testified at hearings. Since May 27, 1976 I have been a consumer member of the Central Northeast Colorado Health Systems Agency.