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SOUTHEAST

GEORGIA

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HEALTH SYSTEMS, INC. P. O. Box 1455 Brunswick, Georgia 31520 912-264-3525

February 28, 1978

The Honorable Edward M. Kennedy, Chairman
Senate Human Resources Subcommittee on

Health and the Environment

United States Senate

Washington, D. C. 20510

Dear Senator Kennedy:

Please accept this letter as testimony before the Subcommittee on health
and scientific research regarding the Health Planning Amendments of 1978
incorporated in S.2410. Our testimony addresses prior testimony given
before the committee on February 2, 1978, by the Atlanta Legal Aid Society,
the Georgia Legal Services Program, the New Orleans Legal Assistance Corp-
oration, the National Health Law Program, Inc., and specifically the testi-
mony of Melissa Greene, a paralegal with the Georgia Legal Services Programs.
We are compelled to make this testimony since Ms. Greene's testimony contains
misstatements and factual inaccuracies.

We must first call to your attention the fact that the issue of "broadly
representative" consumer board members of Georgia HSA's is presently under
litigation in Rakestraw, et al., vs. Califano, et. al., Civil Action No.
C 77-635 A Plaintiffs, defended by the Georgia Legal Services Program, have
alleged that among other things, the consumer complement of the Boards of
Georgia HSA's are not broadly representative. While the HSA's have been
dismissed from the suit because plaintiffs lacked subject matter jurisdic-
tion, the plaintiffs have asked for an evidentiary hearing to demonstrate
individual monetary damages. Hence, the entire matter is somewhat sensitive.
You will be receiving additional correspondence from the firm of Kilpatrick,
Cody, Rogers, McClatchey and Regenstein, attorneys for the defendants in
the above mentioned civil action.

Two specific samples of misstatements in Ms. Greene's testimony which we
must correct for the record are as follows. The last paragraph on Page 70
contains the statement that the criteria to become a voting member "are
practically secret" and that the (Southeast Georgia) HSA "does little and
ineffective outreach to area residents." For the record, we have attached

The Honorable Edward M. Kennedy
February 28, 1978
Page 2

a description of our election process which indicates that over 1600 solicitations for nominations were made by SEGHSA. The enclosed form is the vehicle by which these solicitations were made. Please note that one entire page is devoted to definitions of slot titles and that there was indeed no secrecy as to the criteria for becoming a voting member.

Page 72 of the testimony indicates that SEGHSA hired a consultant out of state for $5,000 to complete the secondary/tertiary committee's work. This is completely erroneous. When the development of the secondary/ tertiary portion of the plan became bogged down because of poor attendance at committee meetings, SEGHSA enlisted the assistance of Health Planning/ Development Center, a technical assistance center authorized and funded under P.L. 93-641. The Center located a consultant and reimbursed him for his services. No agency funds were used, and we have no idea what actual charges were made.

We hope that these comments serve to correct the record. We would be happy to provide you or any members of your committee with elaboration on further misstatements should you desire.

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1977

ELECTION PROCESS

A Nominating Committee was nominated by the President of SEGHS, Inc., and was approved by the Board of Directors. This committee was composed of 12 members of which 6 were providers and 6 were consumers--3 were minority, 9 were non-minority--5 females, 7 males. In addition, there was representation on the committee from the aged, private practicing physicians, other health professionals, nurses, hospital administrators, nursing home administrators, handicapped, public health physicians, economically disadvantaged and regional planning bodies.

Approximately one-third of the agency's 71 member governing body rotates off the Board of Directors each year. In addition, any person appointed during the past year to either fill an unexpired term or any person appointed for the purpose of otherwise balancing the Board representation geographically, racially, etc., must also be replaced.

Accordingly, the committee determined that 25 Board positions were open for nomination--11 consumers, 14 providers--4 elected officials, 4 private practicing physicians, 3 hospital administrators, 2 registered nurses, 1 retired person, 2 minority consumers, 1 mental health provider, 1 mental health consumer, 1 health care purchaser, 1 public health officer, 1 other health professional and 2 not otherwise slotted.

Further, the committee determined geographic parameters to apply to the various slots in order that the area representation was equitable.

(i) the

The committee reported back to the Board advising election process (ii) the slot openings and area and (iii) the slot definitions. This was approved by the Board along with a list of proposed "official nominators" for the various slots.

The Nominating Committee next mailed a notice to 1,560 corporate members advising the date and location of the Annual Meeting and the procedure for making nominations. Letters were also sent to each director inviting them to make nominations and finally, letters were sent to over 80 "official nominators" soliciting nominations. These official nominators spanned the whole

spectrum of the service area. They included 22 city and county officials, 19 professional associations, 20 chambers of commerce, 4 retired/senior citizens groups, 3 physically or mentally handicapped groups, 7 children and family groups and also organizations representing environmentalists, minorities, economically disadvantaged and others.

Sixty-five nominations were received--28 from the corporate membership, 15 from present directors and 22 from official nominators. Of these 45 were determined by the committee to meet the qualifications of their respective slots. In addition, the Nominating Committee made 6 nominations.

The committee made a "Report to the Membership" which by now had grown to approximately 2,000 persons. The report stated the name, nominator, slot, area and county of the nominees. Press releases were issued to all the media giving names of nominees and the date and place of the annual meeting.

The Annual Meeting was held on October 20, 1977 in Jesup, Georgia, the geographic center of the service area. The meeting was attended by approximately 400 members who voted by secret ballot. The results of the election are shown in Section VI in The Beacon, Volume 11, Number 3.

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Several months ago you wrote to me seeking responses to several questions relating to the comprehensive review of the National Health Planning and Resources Development Act of 1974. I have waited until now to write, at the time of the actual renewal hearings, because I wanted to give you the benefit of the latest developments in State-level health planning activities in the State of Alabama.

I am Chairman of the North Alabama Health Systems Agency, and represent
my agency as a consumer member of the Statewide Health Coordinating Council
(SHCC). Recently, I was appointed Chairman of a SHCC Committee to evalu-
ate the structure and functioning of the Alabama State Health Planning and
Development Agency (SHPDA) to determine the reasons why SHCC activities
were not being properly implemented and assisted by the SHPDA.

The evaluation was quite clear: namely, the SHPDA in Alabama is the State
Board of Health. By long-standing statute in our State, the State Board
of Health is the Board of Censors of the State Medical Association. The
State Board (or Medical Association) has traditionally carried out such
activities as approving the State Health Plan and State Medical Facilities
Plan, functions now the prerogative of the SHCC under Public Law 93-641.
The SHPDA staff, working for the State Board of Health, has assisted the
State Board in attempting to maintain its former functions, resulting in
its attempt to frustrate the SHCC at every turn.

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