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This is an incomplete edition of VOLUME I, PROPOSAL FOR COMPREHENSIVE HEALTH PLANNING All pages considered crucial to the intent of the proposal are included here. Other work, denoted here by missing pages, is in process of completion. �Foreword lo the Proposal THIS PROPOSAL REPORTS WORK SUPPORTED BY AN ORGANIZATIONAL GRANT TO THE COMMUNITY COUNCIL OF THE ATLANTA AREA FROM THE U. S. PUBLIC HEALTH SERVICE , AND CONTAINS RECOMMENDATIONS FOR THE ESTABLISHMENT OF A PERMANENT COMPREHENSIVE HEALTH PLANNING AGENCY FOR THE METROPOLITAN ATLANTA AREA. THE PROPOSAL CONSISTS OF THREE VOLUMES: PROJECT SUMMARY, BUDGET AND STAFF, AND TASK FORCE REPORTS. Agency Responsible he Community Council of the Atlanta Area, supported by organizational grant No. 41008-01-69 from the U. S. Public Health Service, has b e en the age ncy responsible for conducting the work and, with the cooperation of many other offices, groups, and organizations, making the recommendations herein for the establishment of a permanent comprehensive health planning agency for the Metropolitan Atlanta Area. Staff The material was prepared by the Comprehensive Health Planning Project staff , directed by Raphael B. Levine, Ph.D., under the general supervision of Duane W. Beck, Executive Director of the Community Council of the Atlanta Are a. Consultation and Other Assistance A numbe r of persons gave continuing support to the Proj ec t on consultant basis, and several hundred persons from governments, health professions, educational institutions, commerce, and the population of health "consumers" gave invaluab le assistance in the compilation of information and in the formulation of conclusions. The staff tenders its sincere thanks to all these individual s . Funding 50% of the costs of this effort mentioned above. The remainder c ount y g o v e r nments, foundations v olun tary he alth o r g a n i z a tion s , g rati tude to the s e dono rs . were borne by the Public Health Service grant was contributed by iocal sources, including and the Community Chest, public , private , and and individual s. The communi t y owe s muc h Or ganization o f the Pr opo sa l The propo sal is divided into three and tas k force re ports. Each pa i r "story". The gist of each " sto ry " material alone, with details added volumes : projec t s ummary, budge t and s taf f , o f f a c i ng pages makes up a se lf-con tained ma y b e gained from the b ord ered summary in t he text and illustrative material. i �COMMUNITY COUNCIL OF THE ATLANTA AREA Eugene T. Branch, Chairman of the Board Duane W. Beck, Executive Director A. B. Padgett, Chairman, Committee on Comprehensive Health Planning COMPREHENSIVE HEALTH PLANNING PROJECT Raphael B. Levine, Ph.D., Director Alloys F. Branton, M.B.A., Assoc. Director Harriet E. Bush, Director of Research Clifford Alexander, Jr., Environmental Planner Katharine B. Crawford, Organization Liaison CONSULTANTS Mary Lou Ashton, Senior Secretary Mildred W. Thorpe, Secretary ( on continuing basis) Frank A. Smith, Atlanta Metropolitan Mental Health Assoc. Loretta B. Roberts, RN, Community Council of the Atlanta Area Ella Mae Brayboy, Community Council of the Atlanta Area William F. Thompson, Administrator, Cobb County Health Department Carolyn L. Clarke, Health Educator, Gwinnett County Health Department Edna B. Tate, Health Coordinator, Economic Opportunity Atlanta ORGANIZATION OF THE PROPOSAL Volume I. Summary of Project ~ Section 1. Introduction and Supportive Material Section 2. Narrative Project Summary Section 3. Appendices Volume II . Budget and Staff Section 1 . Budgetary Material Section 2 . Personnel Volume III. Task Force Reports ii �. I TABLE OF CONTENTS ·' Forewor~ to the Proposal • • • . i SECTION 1. INTRODUCTION AND SUPPORTIV1': ?vii~TERIAL A. Description of the Area Planning for Planning: TechnicP.1 and Corrnnunity Involvement Aspects . • • , . • . . . • . • • 2 The ,Atlanta Area, the flanning Area 4 Atlanta Area Governmental Units, Current Population . • • • • • . • • • • • 6 Standard Metropolitan Stat5-stical Areas Cl~sc to the Atlanta Area • • • • • • • . • • & 10 Atlanta Area, a Place of Gr~0th and Variation Populati_o n Trends Require Review of Health Needs . . . . . . . . . . . . . . . . . . 12 The Planning .Area · Obs erves Other Programs and Anticipa ted Expansion • • • • • • ll~ Organizatioµa l and Procedural Arrangements for ComprehensiveHealth Planning. • • • 16 Cooierat{ve Arrangements .~ade for Funds, Personnel, -Facilities and Se~vices . • 18 Planning is Ba sed on Corrnnonly Available Date 20 \. B. The Atlanta Area 's Need for and Ability to Support Comprehens ive Health Planning Principa l Teaching and: Service Facilities in the Atlanta Planning Area ~ • • • • • • • • • 22 Implications for Comprehensive Health Planning -in Environme ntal Hea lth Fields • . . • • • • 24 Atl anta 's Ur ban Redev e lopment Project Program -iii- 26 �Atlanta's Model Cities Program 28 Relationships with the_Georgia Regional Medical Program • ' . . . . .. . 30 The Urb an Life Cent er : A Solver of Urban Health froblems for the Future . • . 32 Local Health Departments in the Atlanta Area 34 Major Voluntary Health Groups an0 Profession~l Associations in the Atl2nt3 Area 36 Water and Sewer Districts. . • . 38 Facilities, including Hospitals, Nursing Homes, Outpatient Clinics and Neighborhood tlealth Cent ers . • • • . . . • . . 40 . Existing Manpower Resources Economics of the Atlanta Area as Relater to Health Services . • • • • . • • • • SECTION 2. NARRATIVE PROJECT SUMMARY A. Project Outline Goals and Objectives of Comprehensive_ Health Planning . . . . . . . . . . . . . . . . . 48 Community Council has Extensive Involvement in Health ~rid Planning • • • • • • • • 50 Organi zatibnal History of the Applicant 52 _Scope of Program Health Concerns • • • • • 54 \. Cooperative Arrangements with Participating Agencies • ~. . • • • • • • • • • • • 56 Health Planning P~o~ess: 58 Systems and Retrieval. Information Gather}ng and Anaiysis Techniques 60 The Need for Planning,Programming System for ·_Comprehensive Health Planning • 62 Procedure for Policy Implementation 64 Example of Experience: Cobb County Comprehensive Health Planning . • • • • • • • • • • • • • • 66 _- iv:.:·-·. _I �Corrnnunity Involvement in Comprehensive Health Planning . • • • . 68 Atlanta Area Coordinat{~ri with the Off ice of Comprehensive Health Planning, Georgia Department of Public Health . 70 Facilities and Equipment Available for the Staff of the Applicant Agency~ • 72 -B. Supportin0 Dat a The Plan has Continuing Input from Existing Re Jources . . . . . 74 Personal Publications. 76 C. Work Program ~urrent Problems Carried Over • . First Year Activities . . 78 · 80 Phasing into Systems Analysis 84 Future Deve lopment • 86 D. Agency Or gani za tion Staff Organization. 88 Council Or gani za tion. 90 Council Membership • 92 Nominating Proce dures. 94 Training for Counci~ Effectiveness . 96 By-Laws of the Council • • • • • • • 98 - v- �Planning- for Plann·ing-: Technical and Community Involvement Aspects SUMMARY: IN ORGANIZING THE ATLANTA METROPOLITAN COMMUNITY FOR COMPREHENSIVE HEALTH PLANNING, EXTENSIVE ACTIVITIES IN TWO MAJOR ASPECTS HAVE BEEN NECESSARY: THE TECHNICAL ASPECTS OF IDENTIFYING, PROJECTING AND SEEKING POSSIBLE SOL"UTIONS TO HEALTH PROBLEMS AND THE COMMUNITY INVOLVEMENT ASPECTS OF BRINGING TOGETHER THE VARIED ELEMENTS OF THE COMMUNITY INTO A PARTNERSHIP FOR HEALTH PIANNING AND POLICY-MAKING. Technical Aspects The technical objectives of this project have been (1) to identify the community·' s principal heal th problems and the probable, most urgent planning efforts which will have to be undertaken by the permanent organization during its first year of existence - 1970; and (2) to specify the r>.umbers and qualifications of the technical staff whe\, will be needed to carry out such planning. Some of the activities bearing on these objectives have been: identification and scoping of health problems through the medium of technical "task forces;" some 25-30 of these groups have worked up descriptions of problem areas, trends, resources, obstacles and suggested solutions to the problems; identification of planners and planning groups whose work is directly or indirectly in health areas; some 50 of these have been named and approached for fuller understanding of their work; a major portion of the technical task of the metropolitan planning staff will be to coordinate the activities of these planners to avoid duplication and to "cross-fertilize" their activities; developing a "systems approach to planning for the health field;" this involves cost-benefit analyses, the building of community health "system"models, etc.; education of as many citizens of the community (and being educated by them) about heal th problems and comprehensive heal th planning a.s possible; Community Involvement Aspects The organizational objectives of this project have been (1) to develop the largest possible degree of community involvement in establishing and operating a comprehensive health planning organization and (2) to formulate an organizational structure for such operation, including corporate identity, policy c~uncil and its selection,and by-laws. Some of the activities bearing on these objectives are: identification of community interest and de.c ision groups involved in health activities; holding small and large meetings of such groups and se.lection of a "steering committee" to recommend detailed structures and policies; working with the steering committee in the development of a corporate mechanism capable of operating a comprehensive health planning agency; working with the steering committee in the formulation of a policy Council and methods for naming its members, together with the various health interest and action groups in the comrnuni ty; writing- by-laws; obtaining acceptance and endorsement of these plans by the interest and action groups in the community - governments, health a,gencies , consumers' groups , other planning groups, etc. selecti ng and convening a council for action on this proposal. - 2 - �- • ESTABLISHMENT OF METROPOLITAN COMPREHENSIVE HEALTH PLANNING AGENCY •111 :1111111111111111111111111•1111111111111111111111·111111111111 111111111· .1111111 1111111•11 11 1111111111111111 1 1111111111111111111111 "Organizational" funding Local Sources DHEW Community Council ' of the Atlanta Area Oct 68 Community Invol vement Aspect s 20 Jun 69 Proposal Review 1 Funding_ Met r o CHP Council 5 Jun 69 1 Jan 70 METROP0LITAN CHP AGENCY - 3 - �The Atlanta Area SUMMARY: THE ATLANTA AREA, PRESENTLY INCLUDES SIX COUNTIES, THIS IS NOT IDENTICAL WITH THE OFFICIAL BOUNDARIES OF THE CENSUS BUREAU, WHICH DEFINES THE ATLANTA AREA AS A STANDARD METROPOLITAN STATISTICAL AREA CONSISTING OF FIVE COUNTIES. TO MAKE THIS DISTINCTION THESE BOUNDARIES ARE DEFINED. BOUNDARIES: At lanta Area: Douglas, Clayton, Cobb, DeKalb, Ful t on and Gwinn ett counties. Atlanta Area (SMSA): Gwinnett counties. Clay t on, Cobb, DeKalb, Ful t on and PRESENTLY: ATLANTA AREA IS: • the "regional capital" of the Southeastern United States resulting from continued growth and a central transportation network; • the"major growth c e n ter" in the ·s t ate of Georgia; and • the central "regi onal city" f or the ATLANTA AREA and contiguous counties . • t he "medical center" for t he surrounding counties. \. THE ATLANTA AREA COMPREHENSIVE HEALTH PLANNING DESIGN: permits additi on of contiguous counti~s or other planning areas whenever feasibility or desirabili ty are indicated. (Douglas County, the newest member of the ATLANTA AREA has shown initiative and set a precedent for non-SMSA's joining its sister counties for health planning.) �SOUTHEASTERN UNITED STATES STATE OF GEORGIA SIX COUNTY ATIANTA AREA ~ �Atlanta Area Governme ntal Units and Current Population SUMMARY: BESIDES THE SIX COUNTIES, THE ATLANTA AREA CONTAINS APPROXIMATELY 50 INCORPORATED MUNICIPALITIES, OF WHICH 10 HAVE POPULATIONS OF MORE THAN 4,500. THE LARGEST CITY, ATLANTA, COVERS PORTIONS OF FULTON AND DEKALB COUNTIES, AND HAS A POPULATION IN EXCESS OF 500,000. THE TOTAL POPULATION APPROXIMATES 1,300,000. The Atlanta Area, Compared with the Standard Metropolitan Statistical Area The Atlanta Area SMSA is comsposed of five counties: County Fulton DeKalb Cobb Clayton Gwinnett Population (1968) 605,400 353,500 174,600 78,700 59,800 Douglas County, with a population of 23,900, is the sixth county that makes up the entire six-county ATLANTA AREA for purposes of comprehensive health planning. Principal Cities in the Atlanta Area The largest city, Atlanta, extends into Fulton and DeKalb counties and had a population of about 500,000 in 1968. Other principal cities, their counties, and size are as follows (See Appendix for complete list of munic i pal itie s and populat i on distribution.): NOTE: MUNICIPALITY COUNTY College Park East Point Hapeville Decat ur Forest Park Marietta Smyrna Lawrenceville Douglasville Fulton Fulton Fulton DeKalb Clayton Cobb Cobb Gwinnett Douglas POPULATION (1 ~68) \. 20,691 39,257 9,268 20,943 18 , 766 28,003 16,365 4 ,561 6,000 These figures are estimates made by the Atlanta Region Metropolitan Planning Commission, 1 April 1968. -6- �ATLANTA AREA GWINNETT ,--' COBB .... ' \ ~L...-i[IIQ[\IILLI[ V ..-,.. ,.,,.- ..... t \LIL ...... ' I I ' ...,.._.,,., ' ,

. f,... \\ ,,, \COJGi..t.SVILL[ ...... ,, ) DOUGLAS \. -7- ......, ',, . .\ 1Ga'.A't'IOII tllllLLVILLf �Ne arby Citi e s Af f ec t t he Marke t and Service Pa tt erns of t he Atlan t a Area STANDARD METROPOLITAN STATISTICAL AREAS CI.OSE TO THE ATLANTA AREA: Within a 100-mile radius of the ATLANTA AREA (SMSA) there are 14 smaller SMSA's which are close enough to affect the economy, commerce and health service trade patterns of the ATLANTA AREA. These are: Macon Columbus Chattanooga Albany Augusta-Columbia Birmingham-Tuscaloosa Montgomery Huntsville Gadsden Greenville Asheville Charlotte Knoxville Nashville \. - 8 - �Atlanta Area, a Place of Growth and Variation SUMMARY: THE ATLANTA AREA IS A RAPIDLY GROWING METROPOLIS WITH BOTH URBAN AND RURAL TERRAIN AND WAYS OF LIFE. THE MAJOR DEMOGRAPHIC CHARACTERISTICS INDICATE A CONTINUING PRESSURE AND A GREAT CAPACITY FOR INCREASED AND APPROPRIATE SERVICES. Ma j or Characteristics: AGE of the population is young: The number between 20 and 29 will double between 1960 and 1980, DENSITY of population covers a wide range: 5 to 52 persons per acre . SIZE is expanding: 27% increase from 1960 to 1967, passing 2 million by 1980. CLIMATE is warm and humid: 48 inches annual precipitation. URBANIZATION is increasing moderately: 6% from 1960 to 1967. EDUCATIONAL opportunities are numerous: About 175 schools, nine 4-yr. colleges, 6 special purpose institutions, 3 area technical schools. OCCUPATION's largest demand is in retail and wholesale trade, government, se r vice business, manufacturing. INCOME va r ies greatly: One county with 36% over $10,000 another with 25% below $3,000. CAPITAL I NVESTMENT was near 300 million from 1963-1967, much of this for transportation equipment . TRADE is active: 3 interstate highways intersect, 8 airpo r ts with 800 dail y flights , 13 railroad lines of 7 systems. FINANCIAL headquar t e r s of Sixth Federal Reserve District . OFFI CE SPACE abunda nt : Fi fth in nation , ~ COMMUNI CATIONS e x ten sive v i a telephone s , mai l, 4 dai l y and 20 we ekl y news paper s, 5 t elevision and 19 radio st ations . Note : This information taken from "Atlanta Silhouettes," ARMPC, Atlanta, Georgia n , d . ; "The Georgia Piedmont Regional Economic Investme nt Plan," State Planning Bureau, Office of the ,G overnor, Atlanta, Georgia, n.d . - 10- �1960 - 1980 Population, Estimates a nd Proj e ctions 1960(l) County (1) (2) (3) 1975 1970 1980 556,326 256,782 11 4,174 46,365 43,541 16,741 599,300 350,400 150,900 66,000 54,600 21,339 649,425 485,5 41 209,722 93,483 58,077 29,700 704,046 658,520 281,481 135,988 66,192 36,500 829,163 757,518 337,019 161,126 76,094 45,000 1,033,929 1,242,539 1, 525,948 1,882,727 2 , 205,920 Fulton DeKalb Cobb Clayton Gwinnett DouglasC 3 ) Total 1965 <2 ) U.S. Census Long-Range Plan, Hospital and He alth Planning Dept., CCAA, Atlanta, Ga., J an . 1968, p. 6 (mimeographed). Douglas County Figures, 1965-1980, interpolated from Land Needs, 1968, Douglas Count y, Ga., ARMPC, Table ;D, DIRECTIONS OF POPULATION GROWTH ATLANTA 1960-1968 SMSA FOR SY Tt-' BA RTO W ,- ... , t,_.,,JSJ'ft "- l i ([ GWI NNETT ' ---',_ \ ~ t\~L- 'M RC: NC( Vt LL [ V 17 ·. 9 % ()c.p:. ,so'1 . ~, ' ~S,.(LV,111,.L [ \r .....'• PAU LDI NG ,-, .. ' \ 0. ,111 ,ui u,1.., ~ -, ,-, ,__

~ £:ir)O~ H ENRY COW El A CL AYTON NOTE: Perce n tages show s h are of SMSA ( jnc l uding Dou g l as County) growth t h at h as occ u rred in each direction . SPALDING - �Po pulation Trends Require Continuous Review of Health Needs. SUMMARY: THE NUMBER OF PEOPLE IN THE AREA IS GROWING AT A RATE OF 2.8% ANNUALLY. THERE IS ALSO A MARKED INCREASE OF YOUNGER AND OF OLDER PERSONS. THE MIGRATION OF PERSONS INTO THE AREA FROM NEARBY TOWNS AND PLACES IS ACCOMPANIED BY A GROWTH TOWARD THE OUTER COUNTIES. Text: The needs for health facilities, manpower and services must be anticipated well in advance. Present information allows a reasonable prediction of the size, constituency and settlement patterns of groups of people. An increase in numbers of people indicates a greater demand on the amount of facilities, manpower and services. A change in the proportion of people in certain age groups indicates a change in the need for particular types of care - home care, impairments, maternal and child care, etc. A change in the geographical distribution of people indicates a need for review of environmental health, communicable diseases, etc. - 12 - �t' 5 & 85 & o ver ov er 1960: U. S. Census 1975: Rand Corp. FEMALES MALES 60-6 4 25- 29 5-9 THOUSANDS 90 75 60 45 30 15 0 15 30 45 60 75 00 �The Planning Area Bounda ries Observe other Programs, Anticipate Expansion SUMMARY: THE STATE OF GEORGIA IS DIVIDED INTO MANY DIFFERENT AREAS, DISTRICTS AND REGIONS FOR SPECIAL PLANNING OR IMPLEMENTATION OF PROORAMS AND ACTIVITIES. SOMETIMES THE FIVE COUNTY "STANDARD METROPOLITAN STATISTICAL AREA" OF ATLANTA IS USED AS A UNIT. SOMETIMES PROORAMS ARE SUBDIVIDED BY COUNTIES OR COUNTIES ARE COMBINED IN OTHER WAYS. THE SIMILAR JURISDICTIONAL AREAS ARE CONVENIENT AND THERE IS A TENDENCY TOWARD MAKING BOUNDARIES OF RELATED PROORAMS IDENTICAL. IN ANTICIPATION OF THIS TREND AND EXPANSION OF ATLANTA (SMSA) BY THE BUREAU OF CENSUS, THE COMPREHENSIVE HEALTH PIAN WILL HAVE ADJUSTABLE BOUNDARIES. (1) AREA G R O U P I N G S - - - - - -~~ \. (1) Much of this material taken from An Atlas of Multi-County Organizational Units , Department of Geography, Univ. of Ga . , 1968 - 14- �PH0 13LEMS IN DELINEATING REGIONS C, t 0 C C, ~ ,... (D

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I 2! 2 ..\re :i Pl :i nnin!! and Dev elooment Commis s ion (") 0 Ill I §g- l:l9- N N N N N N ves 6 1 6 6 3 6 2 9 9 Cl .A 9 9 Ca 9 Cl ves yes G M yes 4 9 9 4 7 yes 9 I I I i I ! Georg i a Bur eau of Investiga t ion Districts 9 2 Medica l Fac ili ty Serv ic e Ar ea s D2 R3 Pu blic Hea l t h Dis t r ict s 28 29 X (<*> -::r, (0) Does not part i c ipa t e Appa l achia & Piedmont A At l anta Di stric t D Decatur Dist r ict <•> (¢ ) (.) N WC Ca Cl M No r thern Di s t ric t Wes t Cent r a l Distr i ct Carrollton Distri ct Cl ayto n Dist r ict Mar i etta Di s tric t 1 Dl n"I 1 Bl D3 9 D2 ves yes 36 38 30 28 ves ce, T 1 Ta ll atoon a - 15 I �Organizational and Procedural Arrangements for Comprehensive Health Planning SUMMARY: THE PROPOSED COMPREHENSIVE HEALTH PLANNING AGENCY WILL BE STRUCTURED SO AS TO BE IN CLOSE COORDINATION WITH THE METROPOLITAN ATLANTA COUNCIL OF LOCAL GOVERNHENTS AND WITH THE COMMUNITY COUNCIL OF THE ATLANTA AREA THE ARRANGEMENT ALSO ENCOURAGES COOPERATION AND COORDINATION WITH THE ATLANTA REGION METROPOLITAN PLANNING COMMISSION, THUS INVOLVING ALL THE AREA'S MAJOR PLANNING AGENCIES. OTilER PLANNERS IN HEALTH OR HEALTHRELATED FIE1IY: \.JILL BE INVOLVED TO VARYING DEGREES. 0 Applicant: In order to facilitate interaction of the major planning groups in t he metropol i t a n area, the Metropol i tan Atlanta Counc i l of Local Governments (MACLOG) will be the applicant agency for comprehensive hea lth plan• ning. In order to do this, MACLOG is taking action to change its status as a voluntary association and become an incorporated entity. In the event that the necessary legal arrangements require more time than is available prior to submission of this proposal, the interim applicant agency will be the Community Council of the Atlanta Area, Inc. (CCAA). The organization f or supervising and conducting comprehensive health planni ng is indi cated herein as the Me tropolitan Comprehensive Health Planning Council (Metro CHP Council). Relationships among MACLOG, Metro CHP Council, and CCAA: Using as a model t he r e l a tionship be tween the Georgia Regional Medi ca l Program and the Medica l Asso c iation of Georgia, in which the l a tter is the a pplica nt agency , and t he f ormer a ctua lly conducts the program , inc luding final policy f ormula tion, the proposed relationship is that MACLOG will be the applicant agency, Metro CHP Council conducts the program and formulates poli cy, and a dministrative support is provided by the CCAA. There wi l l be ind ividua ls serving on the CHP Council who are also members of MACLOG or the Boar d of CCAA . To i ns ure coopera t i ve efforts and join t p lanning in over lapping proj ec ts , it is planne d to e s tablish a "Met r opol itan Conference o f Pl anning Chairmen", bring i ng t ogether the Chair men of MACLOG, CCAA , CHP Council, and Atlanta Region Metropolitan Planning Commi ssion ARMPC) . In addition, t here wi l l be a "Metropolitan ConfereIJ,ce of Planning Directors", bringing t oge ther the execut i ves of the f our a genc ies. Fr om t i me t o time, other planners wi ll be invit ed t o participate i n these conferences . It is anticipa t e d that j o int staff a c tivit ies will occur where proj ects involve physica l pla nning (ARMPC), social planning (CCAA), he al t h pl anning (CHP) , and other f orms of planning such a s crime and delinquency (MACLOG). Of cour se , ma jor portion s of he al t h planni ng wil l con tinue to be done i n other plann i ng staffs, such a s hospital aut horities, city and county planning offices, etc. These wi ll be coordinated , insofar as healt~ aspec t s ar e concerne d, by t he Me tro CHP staf f . Facilities : MACLOG, CCAA, ARMPC, and CHP wil l be hous e d in t he same bui l ding . Thi s clos e prox i mi t y wil l make possible sharing of numer ous f a cilities, s uch as l i br a r y , public i nforma tion , dupli ca t ion and mail ing, e t c. For additiona l informa t ion, s ee the s ect ion on Facilitie s in t he s econd Section of this proposa l vo l ume. - 16 - �ORGANIZATION FOR COMPREHENSIVE HEALTH PLANNING e,o n tnu:-fu.Q.. I t'el~tiov-i " ~fAC LOG; Loccd Mea.lH, / ' Cou."c.iils ' ccAA Bd. o.dvn1n .--- .I CCAA S·b++ - - - - - - - - -· ~ Abbreviations: ARMPC CCAA CHP DREW MAC:WG Bd Conf Dir's Chmn Plng \. = Atlanta Region Metro. Planning Commission = Community Council of the Atlanta Area = Comprehensive Health Planning = (U.S.) Department of Health,Education & Welfare = Metro . Atlanta Council of Local Governments = Board = Conference = Directors = Chairmen = Planning - 17 - �Title: Cooperative Arrangements made for funds, personnel, services, facilities SUMMARY: THE COMPREHENSIVE HEALTH PLAN IS AND WILL BE LINKED FORMALLY WITH THE APPROPRIATE ORGANIZATIONS TO ASSURE THE JOINING OF ALL HEALTH EFFORTS TO COMMON RESOU~CES. - 18 - �I C:OOPERATI·VE ARRANGE MENTS WITH OTHER PROGRAMS nur111rmrmmmmmmmmmmmm11m111·111111111mmmm11111111111mm1mm11111111m1111rnu1111murm111mmm11111111111111 1111m111m111111m111111111mmuu11111111111111111 1r \· -~ DHEW Dept . . Heal th, Education & Wel fa re

•----~.,,,_o.".~___ <'/y1- """--.,,"·11111111~-·C,. 00 ~0 ~ 0"'.j Local Health Ag encies Community Council ' of the Atlanta Area; MACLOG ,Ietro Atlanta Council of Local Gov ts. Metro Comprehensive Health Planning Council Personnel Ancillary library, mailing, \. policies* Services-duplicating, etc. . Comprehensive Health Planning Staff

See Append ix for Details .

I �• Planning is Based Upon Commonl y Available Da t a SUMMARY : THE LOCAL RESOURCES FOR QUANTITATIVE DATA IN THE HEALTH CARE FIELD ARE RATHER LIMITED BOTH IN AMOUNT, AVAILABILITY, AND COMPARABILITY, THE COMPILATION OF INFORMATION IN A CENTRAL CENTER WARRANTS PRIORITY FOR FUTURE PROBLEM-SOLVING. SOCIAL, ECONOMIC, AND DEMOGRAPHIC STATISTICS ARE MORE FULLY DEVELOPED THAN HEALTH DATA. BOTH ARE OFTEN SCATTERED AND FAR FROM IDEAL. INFORMATION ALONG THESE LINES IS AVAILABLE AND COMMONLY USED FROM MORE THAN A DOZEN SOURCES. \. - 20 - �Implications for Comprehensive Health Planning in Environmental Health Fields SUMMARY: THE METROPOLITAN ATLANTA AREA HAS MADE NOTABLE STRIDES TO IMPROVE ENVIRONMENTAL FACTORS IN RECENT YEARS. NEARLY EVERY AREA CONCERNED HAS HAD SOME PREVIOUS WELL-PLANNED PROGRAMS. THE ROLE OF COMPREHENSIVE HEALTH PLANNING WILL BE THAT OF COORDINATING EFFORTS, ENCOURAGING I MPLEMENTATION, AND INCREASING EFFICIENCY IN OPERATION. Text: Environmental Health programs being developed or reconnnended for the Metropolitan area include: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15 . Water and sewer plan implementation - a natural follow-up to current water and sewer planning should include recommendations for long range pollution control systems and management of water resources. Up-dating open space and recreation plan and program for the metropolitan area . Capital improvements progrannning: a continuation of the work ARMPC is doing now . Metropolitan Solid Waste Plan - MACLOG. Mobile Home Park - ARMPC - Study of requirements on location. Vector Control Program - EOA - Demolition Project . Comprehensive study of problems and possible long-range solution for solid waste and garbage collection and disposa l. Development of a long-range plan for industrial and off ice parks throughout the area - ARMPC . A study of future housing requirements: as they relate to population forecasts, income, employment, and location. This study i s now being held in abeyance. Up- dating of Ai r port Plan - ARMPC. Study , up- da t e and r evise all element s of l and deve lopment and fa c i lities p lans . ARMPC - The need for nature preserv~s and r~lated outdoor r ecre ation fac i l i tie s has been e s tablished. Implementation is now neede d . Fl oo d cont r ol project by Cor ps of Engineers . Atlanta Housing Authority : re-deve l op pub lic housing area; rat control; health clinics for proj ect area; and neighborhood renewa l proj ect (year ly basis) . Georgia Safe ty Council: organizing Teen Safety Councils in all high s chools in t h e sta t e of Georgia ; conducting industry safety seminars throughout the s t ate; driver improvement for t r uck dr ivers ; dr iver improvement through the defensive driver cour s e ; conduct ing injury contr ol program. - 24I l. �• .DEAD END ~ ONE OF THE great community benefits of urban renewal is the removal of unsafe, unsanitary and inadequate buildings. \. ATLANTA HOUSING AUTHORITY Auditorium-Convention Hall Complex �The Urban Life Center - A Solver of Urban Health Problems For the Future SUMMARY: THE NEWLY ORGANIZED URBAN LIFE CENTER AT GEORGIA STATE COLLEGE, WHEN FULLY OPERATIONAL, WILL PROVIDE A DYNAMIC INSTRUMENT FOR SOLUTION AND PREVENTION OF HEALTH AND HEALTH RELATED PROBLEMS. IT FOCUSES THE RESOURCES OF THE MAJOR EDUCATIONAL INSTITUTIONS IN THE ATLANTA AREA AND THE STATE OF GEORGIA ON BROADENING THE INTELLECTUAL BASE OF THE POPULATION, ENHANCING THE PROFESSIONAL AND CULTURAL COMMUNITY, INTENSIFYING . AND DIRECTING MOTIVATIONAL POTENTIAL AND PROVIDING SERVICES INVOLVING PEOPLE AS INDIVIDUALS AND GROUPS. Purpose: Early in January, .1969, the Urban Life Center and the City of Atlanta were designated one of six national research centers on urban problems. · (These. centers were selected by the National League of Ci ties act,ing under contract with Departments of Housing and Urban Development and Health, Education and Welfare.) This network of "Urban Obs.e r"'.atories" represents an effort to concentrate efficiently and economically the resources of higher education in the assault on urban problems. Concept: The guiding concept is that the new problems of the cities necessitate new approaches to academic organization and operation. An important feature is the inter-disciplinary approach to the study and solution of urban problems. Emphasis is placed upon the concentration and coordination of talents from all relevant disciplines and organizational units to effect sound solutions to urban problems. The Urban Life Center embodies four basic organizational components: <) The School of Urban Studies which provides the academic training and research foundations. <) The Urban Public Service Division :hJ:, structured to provide specialized activities, including short courses, institutes, conferences, public seminars, lecture series, workshops, community extension service activities, etc. <) The Inter-University Urban Cooperative seeks to coordinate and direct the resources of all the institutions of higher learning, in the surrounding area, aiming for cooperation with a minimum of effort duplication. <) The Observatory will facilitate the effective operation of the other components of the Urban Life Center. Data col lected by the Observatory will serve as one of the bases for training programs in the School of Urban Studies and those conducted by the Division of Urban Public Service. It is de.signed to work systematically with community agencies and organizations to coordinate data and develop meaningful working relationships relevant to urban problem - solving . - 32 - �THE URBAN LIFE CENT ER SCHOOL OF URBAN STUDIES \. INTER-UNIVERSITY URBAN COOPERATIVE DIVISION OF URBAN PUBLIC SERVICE URBAN OBSERVATORY HEALTH AND - 33 - �Local Health Departments. Atlanta Area CENTERS AND CLINICS Fulton County Cobb County (cont'd.) Main Center & offices Adamsville Alpharetta Ben Hill Buckhead Center Hill College Park Collins East Point Fairburn Hapeville Howell Mill Jere Wells Lakewood Roy W. McGee Neighborhood Union Northeast Palmetto Red Oak Rockdale Roswell Sandy Springs South Fulton Techwood Austell Mableton Powder Springs Smyrna Clayton County Main Office Forest Park College Park Fayetteville Gwinnett County Main Center Buford Norcross Duluth Douglas County Main Center, Douglasville DeKalb County Main Center & offices Doraville Kirkwood Lithonia North DeKalb Scobtdale Southwe s t Dekalb Stone Mountain Tucker \. Cobb County Marie tta Acworth - 34 - �(\)Un t y l•'in:rnc ing- St ate Allotments Jul y '67 - June '68 J,'111 t nn $ 403,181 DeKa lb Cnbb Cla yton G1d nn ett Doug las Centers Manpower 24 9 6 4 4 1 269,127 122,271 52,049 18, 760 • 21, 119 - Admission by Service Mental Health V.D. 425 199 47 38 21 8 7,479 2,925 2,169 964 484 83,109 63 128 6 4 14

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DOUGLAS • PUBLIC HEALTH CENTERS • i( Metropo lit a n At l a n ta Area 19 68 - 35- HEALTH CENTERS SINCE 1967 HEALTH CENTERS �WATER AND SEWER,... .1:1ISTRICTS IN THE ATIANTA ARFA .. • SYMBOL SECONDARY e PRIMARY sEWAGE LEGEND T SE REATMENT Q UNTREATED WAGE TREATMENT SEWAGE m:::;> POTABLE WATER INTAKE

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,.,1..... o:.; :~i!':'o~ •tllOPOUIAN "ANNINO �State Health P lanning Council Advises 11 A 11 Agency in carrying out its goals Comprehensive State Health Planning ·Agency - 11 A 11 Agency Develops comprehensive state health plan. Identifies health problems. Recommends policies and programs. Provides consultation and coordinates programs. I Areawide Planning Agencies 11 B" Agencies Relates health programs in an area within a comprehensive framework. Liaison with appropriate health agencies in an area to help carry out goals. Conduct periodic evaluations and stu1ies. Revi ~w local grant applications. Gathers and analyzes data.

I I Public liealth agencies (local) Voluntary health agencies (local) \. - 71 - �C om)1:im-au n n:~~r c~~'J.."R·1:ac il 0 ~ t h e At lanta A r ea inc. EUGC::NE T . B R ANCH , Clw irn ri m of rlzi.• l l< 111n l ,,/ l Ji1,: L'f r, r .\ CECIL AL EXAN DE R , ' ' i1:t! Ch .:1in ;,·,•, ,, JO_HN 17. ARD. l'/ca Ch a i ri11 ,1r, MRS . THO MA S H . GI BSON . S ,:cn::1ar_,. DONALD H . GA RE I S , 1" ri •u 111r,•r DUANE W . BEC K . ON E THOUSAND GLENN BUILDI N G , 120 MARIETTA ST. , l'I. W. £ r ern1i1·,• Direc:or ATLANTA, GEORGIA 30303 TELEPHONE 577-. May 23, 1969 Donald F. Spille, Ph.D. Executive Director of Metropolitan Atlanta Mental Health Association 209 Henry Grady Building Atlanta, Georgia 30303 Dear Dr. Spille: As ·you know a proposal will be sent to HEW, Washington, in early June, setting up a mechanism for comprehensive health planning in the metropolitan Atlanta area, and requesting a 5-year grant to assist with such planning. HEW must be assured that the proposed comprehensive health planning will have cooperation of all parties and agencies involved. This is to request that you write us a letter, as soon as possible, assuring us of your cooperation in this project . Sincerely yours, !r!dL~k. . Director , Comprehensive Ar e awide Health Pl anning RBL:az Encl. "".6 9- �Community Involvement in Comprehensive Health Planning SUMMARY: DOCUMENTED HEREIN (SEE APPENDIX) ARE INDICATIONS OF SUPPORT FOR COMPREHENSIVE HEALTH PLANNING FROM COMMUNITY ORGANIZATIONS AND GOVERNMENTAL AGENCIES. IT IS ANTICIPATED THAT COMPLEMENTARY RELATIONSHIPS OF MUTUAL BENEFIT WILL BE SOLIDIFIED IN THE EARLY STAGES OF PERMANENT OPERATION. Note: Letter of the opposite page has been sent to following groups in the six-county area: County Commissions Mayors of Cities Medical and Dental Societies Nursing Associations Hospital Council Nursing Home Association Chamber of Commerce Colleges and Universities Health Care Centers Voluntary Health Agencies Representative Organizations of the Poor and Near-Poor - 68 - �ORGANIZATI ONAL CHART OF COMMUNITY DEVELOPMENT IN COMPREHENSI VE HEALTH PLANNING w E Key: D 25-member core of planning efforts t o direct task force assignments. 0 Chamber of Commerce Board of Directors. + Local County communities. These communities will be analyzed and local citizens (with a wide range of representative types) will be asked to participate in discussions. Some representatives to consider will be age, race, sex, income, geographic location, etc. The basic philosophy is to establish task force and community involvement simultaneously and then pool these thoughts into final recommendations. This obviously is an oversimplification of the process and many problems will have to be overcome if efforts are to be successful. -67- �Sub-Areal Healtn Councils. Cobb County: Example in Experience SUMMARY: COMPREHENSIVE HEALTH PLANNING EFFORTS IN COBB COUNTY, AS IN OTHER AREAS OF METROPOLITAN ATLANTA, ARE IN THE NEOPHYTE STAGE. ORGANIZATION OF A COBB COUNTY HEALTH COUNCIL HAS MET WITH ENTHUSIASTIC COMMUNITY SUPPORT. COOPERATION AND EFFECTIVE COMMUNICATION WITH THE METROPOLITAN COMPREHENSIVE HEALTH PLANNING COUNCIL WILL PRODUCE AN EXEMPLARY RELATIONSHIP IN EFFORTS TO MEET HEALTH NEEDS OF THE AREA. History of Cobb County Health Council: While in recent years much progress has been made, gaps in Cobb County's health services have been dramatically evident. For example, a new family found the nearest physician twenty miles away. One hospital is often overcrowded while another has many available beds. Solutions to these and other problems are necessarily a task for large scale cooperative planning. The present twenty-five member CCHC had its beginning in February, 1969, with a meeting of five health-oriented connnunity leaders under auspices of the Chamber of Connnerce. Health problems were recognized in four basic categories: Services Facilities Manpower Financing Task forces of the Council and other connnunity members have been assigned to determine needs, resources, and possible solutions in these areas. Implications for Success: 1. The Chamber of Connnerce has had a leading and beneficial role in organizing the CCHC. Support and participation have already been secured from major segments of the community. 2. Planning involves government officia~s, health providers, and consumers working together to improve the total health system. 3. From the beginning, members of the CCHC have recognized the potential for inter-relationship with the Metropolitan Council. Understanding and coordination of efforts will combine resources leading to the solution of health problems. Implications for Overall Local Liaison The Cobb County Health Council is farther advanced than those in other counties and neighborhoods, although beginnings have also been made in Gwinnett and Clayton Counties. Basically, these local Councils serve two major purposes: (1) they extend the capability of the metro Council to spotlight special needs in local areas, and (2) they bring into participation additional citizens who generate citizen information activities and buil support for CHP . - 66 - �POLICY - RECOGNITION - SUPPORT - ACTION FEDERAL, STATE $ FOR PROJECTS $ FOR PROJECTS RECOGNITION $ FOR $ FOR PLANNING ) PLANNING COUNCIL, STAFF LOCAL (RECOMMENDATIONS ~ TECH. ASSISTANCE CHAMBER OF COMMERCE FOUNDATIONS BUSINESS INDUSTRY COMMUNITY CHEST $ FOR PROJECTS ACTION ETC. PROJECTS ACTION PROJECTS -6~- �Pr ocedure for Po l icy Implementat ion SUMMARY : FUNCTIONS OF THE ME TROPOLITAN CHP AGENCY WILL I NCLUDE RESEARCH, COORDINATION OF VARIOUS GROUPS, AND POLIC Y DECISIONS IN THE HEALTH FIELD. AS A PLANNING BODY, THE COUNCIL AND STAFF WI LL DEPEND UPON ACTION GROUPS FOR IMPLEMENTATION OF ITS POLICY. FEDERAL, STATE AND LOCAL GOVERNMENT RECOG NITION OF THE AGENCY WILL BE KEY FACTORS IN THE ABILITY TO INFLUENCE ACTION WH ICH WILL I MPROVE HEALTH FACILITIES AND SERVICES . The f ollowing functions a nd rela t ionships will provide a basis for ensuring implementation of polic y . Func t ions o f t he CHP Ag ency (Polic y Boa rd and Staf f ): 1. 2. 3. 4. 5. 6. 7. 8, 9, Conduct research in communit y health problems. Dev elop background for policy-ma king; use systems analyses, cost-benefit analyses, etc. Coordinate acti v ities of all health planners in the community. Review health action projects originating in the community. Pro ide technical assistance t o action agencies. Orig inat e health a ction projects where needed, Conduct communit y liaison and education in health matters. Give adjacent areas assistance in health planning on contract basis. Make policy decisions f or the community in health matters, Rel at ionships between t he Agency and other groups: 1. 2, 3. 4. 5, 6, The CHP policy Council will be representative of all health concerns in the Metrop olitan Atlanta area, Recognition of CHP Agenc y responsibility and authority in planning areas is e x pected on all levels of governmental and health-concerned group involvement . Funds . for e x ercising agenc y functions will be sought from federal, state and local governments . Their support will indicate recognition and delegation of health planning polic y decisions to this agency. Foundations , business and v olunt ary heal t h organizations may be expected to provide some f unds f o r planning. Loc a l g ove r nments and independent health agencies will receive benefits from CHP th r oug h t echnic al assistance in planning, coordination of efforts and recommendat i on o f p r iori t i e s . Fede r al fund s f or an y given project will need approval of the CHP Agency fo r alloc at ion . The abov e b eing f a c t ors , r e s pect a n d pres ent f or imp l e men t a t i on of other pl a nning ag e ncies , hos pi ta l groups wi t h des ired assistanc e o f f or the CHP Agency will be an inherent t r ait necessar y polic y dec i sions. Recommendations made to gov ernments , author i ties and the like, will be carr i ed out b y thos e the CHP staff . ~ Ef fectiveness o f comprehensive he a l th pla nn i n g : The interre lationships amo ng CHP and o ther local gov e rnments and agen cies i s designed to ins ure mutual respe ct and depe n den c e. Where a s t he CHP Agenc y d e pen ds for its e x istence on the recognition and financia l suppo r t of t h e o ther groups, the y, in t urn, d e p e nd on the existence and r e cognition by Stat e and Federal offices o f t he CHP Agency for much of the Federal funding they req u ire. And whe reas the CHP Agency d e pe nds on t he respe ct for its competence and fairness by local gro ups for its effec t ive nes s in originat ing new plans, the local groups depend on the CH1> Agency review for implementation of plans which they or i ginate. Thus , it is in the interest s of all that r e lationships begin a n d continue on a harmon ious and mu tually helpful bas i s . - 64 - �CHOICE o OF PR'OGRAM CHOICE OF FUNDING ALTERNATIVE L E VEL t l

~ PROGRAM RESOURCES •M ONEY • PEO PLE •FA~I LI TIE$ EFFECTIVENESS* OUTPUT

--- IMPACT -- PROGRAM GOALS EFFICIENCY = OUTPUT INPUT ACTIVITY LEVEL DETERMINANTS* • REQUIREMENT •NEED • DESIRED LEVEL COMPREHENSIVE HEALTH SERVICE. AREAWIDE PLANS : ~ z z -.<.. z< 0 u, w ~ Fl NANCI AL PLAN Ill ACTION HEALTH PRO GRAM -63- ~ 0 a. z <

...... V -.( ... u N z z ;;: < ~ 1111 0 �The Ne ect for Planning Program~ing Sy stem for Compr e hensiv e He alth Planning SUMMARY: PLANNING AND PROGRAMMING SYSTEMS OFFER GREAT PROMISE TO AREAWIDE PLANNING AND OTHER GOVERNMENTAL ORGANIZATIONS AS A MEANS OF SYSTEMATICALLY RELATING PROJECT OR PROGRAM PLANNING WITH FINANCIAL PLANNING. IT IS A METHOD OF OBTAINING THE MAXIMUM BENEFIT AND EFFECTIVENESS FROM RELATED HEALTH PROGRAMS THROUGH THE EFFICIENT GOAL-ORIENTED APPLICATION OF AREAWIDE RESOURCES. Basic Purpose: The basic purposes of a planning and programming system are to: •permit rational choosing between objectives, •uermit rational choosing between programs, •facilitate selecting rational levels of programs, •facilitate review and evaluation of program accomplishment. Major Characteristics are: •the identification of the fundamental goals and objectives of the area; •systematic analysis of alternative ways of meeting the areawide goals and objectives; •the presentation of alternatives to the decision-maker; •explicit consideration of future year fiscal implications (5-year program goals) at; - preferred funding level, or - stringent funding level~ and •that proposals and decisions are properly supported by documented evidence. Benefits: In general an integrated system of planning, programming, offers: An improved process for decision-making, policy formation and for analyzing major issues. A systematic method of exploring alternative ways (more effective or less costly) for getting the health and health related business done. A procedure for coordination of health programs in the light of identified common or single goals and objectives. An examination of fundamental goals and objectivas of the Atlanta Area and the role of individual programs in meeting those goals and objectives. A strengthening of the initiative of the areawide and local governments in policy formulation. A method of relating areawide planning and programming to the financial process of the State and loc al communities . - 62 - �-- I I - .· I I I ,~.'.J.~ --~ . Type o:f trainii:ig education ~ i -Source o;f · recruitment --;> R I e.. c.. Y' tt. .· , ,/ · I .., _.~. h "'r ·l'\ .'n C\ · ct.. 1 J / ,...a,

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, ·. I • -~ --·:;-...__....:..._J/' -.. C. A.~ I O ~ 1 + rt\ -e. l'\+ _ / / ./ �Title: Information Gathering and Analysis Systems and Techniques to be Used SUMMARY: THE BASIC INFORMATION SYSTEM WILL INCLUDE THE (A) COLLECTION, (B) QUANTIFICATION, (C) STORAGE, AND (D) UTILIZATION OF DATA PERTINENT TO THE OTHER PHASES OF THE PLANNING PROCESS, PROBLEM AND RESOURCE DETERMINATION, IMPLEMENTATION, AND EVALUATION. EVALUATION OF THE PLANNING ITSELF SHALL BE DONE BY THE COMMUNITY AT LARGE THROUGH ITS EXERCISE OF SUPPORT. EVALUATION OF PARTICULAR PHASES OR OPERATIONS WILL BE BUILT INTO COSTS-BENEFITS ANALYSIS AND SUPPLEMENTED BY INDEPENDENT INVESTIGATION. Research Technique Data shall be organized according to a total functional model; i.e., under a scheme which takes into account units, their relationship to each other, and their relationship to a larger whole. The units or subsystems of the health system, the entire health system, the total environment, and the "functional flow" of the user through it is suggested in the diagram on the opposite page. This technique provides a basis for costs-benefits analysis of alternative plans for action. Evaluation Technique: A baseline for measurement of impact will be the purpose of an initial collection of information. A systematic, continuous feed-back on effectivenss of programs will be built into each program in a simple manner. Elaborate evaluations of particular phases or troublesome operations will be conducted. ' Both the subjective and objective appraisal of efforts in terms of their impact upon the particular problem and the long-range goal will be made. The entire planning process will be subject to the periodic evaluation of the organized corrnnunity in the form of their extending or withdrawing financial and cooperative support. The decision makers themselves will be subject to evaluation by "recall" or failure to election to the CHP Board by their respective groups. The "public" will be an implicit evaluator through its use and non-use of programs. - 60 - �PRIORITY AREAS FOR COMPREHENSIVE HEALTH PLANNING EFFORTS Loading on health manpower - quantity and utilization, Loading on health facilities - quantity and utilization. Discrepancy between needs and care received by the poor. Maternal and child health; family planning. Mental Health Environmental sanitation; pollution, waste disposal. Public health and prevention; vector control. Emergency health services. Injury control. · Dental problems. Drug abuse and alcoliolism. Degenerative and chronic diseases. Citizen role in prevention and care. Costs of health care; insurance patterns. - 55 - �Scope of Program Health Concerns SUMMARY: A PRINCIPAL EFFORT DURING THE ORGANIZATIONAL PERIOD HAS BEEN TO IDENTIFY THE HEALTH PROBLEM AREAS OF THIS COMMUNITY WITH SUFFICIENT PRECISION TO BE ABLE TO PROJECT THE SCOPE OF THE PERMANENT PLANNING AGENCY'S FIRST YEAR OF OPERATIONS, AND DETERMINE THE STAFF NEEDS THESE OPERATIONS ENTAIL. OF THE MORE THAN 40 SUCH PROBLEM AREAS IDENTIFIED BY THE STAFF, 27 WERE STUDIED IN SOME DETAIL WITH THE ASSISTANCE OF AS MANY "TASK FORCES", DRAWN FROM THE COMMUNITY AT LARGE, AND INCLUDING HEALTH CONSUMERS AS WELL AS HEALTH PROVIDERS. SOME 14 PROBLEM AREAS HAVE BEEN IDENTIFIED AS MOST LIKELY TO DEFINE THE SCOPE OF THE FIRST YEAR Is PROGRAM. Need for Identification of Health Problem Areas Although the staff during this organizational period is not in a position to perform actual planning for this community, and therefore does not need the detailed information about community health proble ms and preve ntion and care mechanisms which will be necessary for a systems analytical approach to planning, it was necessary to identify the health problems with sufficient precision to be able to project the scape of the permanent planning agency' s first year of operations. This scope, in turn, determines the size and skills which will be needed in the permanent staff. Study of Health Problem Areas During initial staff conferences, augmented by consultants from a number of health fields, and through the mechanism of two large · community"technical aspects" meetings, more than 40 problem areas were identified as needing attention and improvement in the metropolitan health picture. These were divide d into priority categories on the basis of the impressions developed to that time, and about half o f them were designated as needing further st udy. This, in turn ; was accomplished through the mechanism of problem area "task fo rces". Problem Area Task Forces Gr oups of interested and knowledgable persons in the community were asked by the var ious staff members to form "task forces", each of which was to study one of the assigned problem areas in the detail necessary for determining the scope of the 1970 comprehensive health planning effort. The task f o rces rang e d in size from two or three individuals to more than 20. They were given i nstructions as to how to go about gathering their data and how to report t hei r findings ( see Appendix ), and were assisted and encouraged by one of t he s taff . Some 27 of the s e task forces we re e v e ntually formed, and the ir reports, in many cases quite voluminous, are presented in Volume III of this proposal (in condensed form). A grea t deal of thanks is due to these hundreds of people, health providers and consumers alike, for the insight which the y c ontr ibuted to the understanding of t his commun ity 's problems. Scope o f the 1970 Ef f o rt The 14 problem a reas s h own on the fa c ing page now seem likely to define t he scope of the fir s t year 's effor ts of the pe r man ent compr ehe ns i ve health p lanning agency. - 54 - �- ~---------~~---~___,_ COMMUNI TY INVOLVEMENT HOUTE FOH BUILDING A POLICY BOARD BY COI,J,oENSUS • El I C~A CCAA CC.\.-\ ~ me e ti n gs FCMS ·- FC'~lS mee tings JCAHPA CCAA ,ti} 0 At .COC C's o f C l me et ing 2 me etings Communit y Invo l veme nt Pa n e l

1 0

mee ting Community Involv e ment Cl Communit y Involv e me nt .__ _ _ _ _. . SCXC 1-------t~Steering Committee 1--+"""la:::~ St ee ring Committee • lf-io mee ting meeting Ad Hoc Nominating Groups • 20 6 mee t i n g s Sm,n 11 Groups (many) Compre h e nsive Hea lth Planning Council 50 Org s. 1 mee ting 1 mee ting each. 10 Local Governments 3 Major Planning Agencies 2 0 He al t h Provide rs 2 Busine ss a nd Labor 17 Poor a nd Nea r - Poor CCAA Communi t y Council o f t he At l a nta Area , Inc. At.COC Atlanta Chamber of Commerce CISCXC Community Involveme nt Steering Committee Executi ve Committee FCMS Fulton County Me di c a 1 Socie t~· 52 Not e s: • ind i c a te numbe r of p e ople at mee ting ( s ) . o s e ve ral me mbe rs p e r organiza ti on -53 - C's of C Chamber's of Commerc e JCAHPA Joint Commit t ee of Area He alth Profe ssional Assoc i ations �Organizational History of the Applicant SUMMARY 'IHE COMMUNITY COUNCIL OF THE ATLANTA AREA , INC., A NON-PROFIT CORPORATION CHARTERED UNDER THE LAWS OF THE STATE OF GEORGIA WILL ACT AS THE APPLICANT AGENCY FOR COMPREHENSIVE HEALTH PLANNING. POLICY IN THE HEALTH ACTIVITIES WILL BE FORMULATED BY THE COMPREHENSIVE HEAL'lll PLANNING COUNCIL (CHP COUNCIL), WHICH WAS BROUGHT INTO BEI NG BY A COMMUNITY INVOLVEMENT PROCEEDURE RESULTING IN SUBSTANTIAL CONCENSUS. THE STAFF WILL CONSIST OF THE CHP ORGANIZATIONAL STAFF, AUGMENTED BY ADDITIONAL PROFESSIONAL AND SUB-PROFESSIONAL MEMBERS. COMMUNITY COUNCIL OF THE ATLANTA AREA, INC. The Community Council of the Atlanta Area, I~c . , was established as a community planning agency :in 1960; previous to that date it was the Planning Division of the Atlanta Uni ted Fund. I n 1963, the Council Launched the West End Demonstration Project with the purpose of find i ng "new ways of solving economic dependency (poverty)"; the activities of thi s Project let to the design of the initial application by Atlanta and Fulton County for funds from the Office of Economic Opportunity. The resu l t was the Economic Opportunity Atlanta (EOA) agency was established . In 1965, the Council entered i nto a contract with Atl anta to develop a long r ange pl an for Urban Renewal under the Community Improvement Project (CIP) which produced.the information, development plan, and method of "grass roots" resident partici pation in urban renewal planning . In 1965 , the Council applied for and received a Hill-Burton facilities planning grant of $112,000 for a three year period. COMPREHENSIVE HEALTH PLANNING COUNCIL (CHP) The CHP will come i ~to existance on June 5, 1969, and will assume the active role of policy making in health matters when the permanent agency is establi shed January 1, 1970. This Council was brought i nto being t hrough an ext ens i ve pr ocess of community involvement and concens us- seeki ng. Af t er several pr el i m:inary meeti ngs of possible sponsors, a group of "convenors" brought t ogether a "Communi ty I nvolvement Panel " repr es enting 170 offi ces, agenc ies , and organ iza t i ons c on cerned wi th hea lth. This Panel on March 13, 1969 elected a "community I nvolvement Steering Committee" of 36 members , and an Executi ve Committee. Thus the devel opment of organiz a t i onal gui delines , the methods of r eaching t hem , .t he nomi n ation and selecti on of permanent members of the Counci l became the goa l of t his St eering Commi t tee, which in t urn resul ted in the f orma t i on of a Comprehensive Healt~ Planning Council on June 5 , 1969. 'lbe membership (as shown on the opposite page) is drawn from five broad categories of community groups; well- distributed by geographic are as, s oci oeconomic status, ethnic backgroup, providers and consumers, public and private sectors. (Members of CJIP, representation, organiza tions and functions are on pp. 80- 85 . ) STAFF Members of t he Organizational Staff and titles and descripti ons to staff to be recruited to become the permanent staff of the planning agency are l i sted on pages 78 and 79. - 52- �BACKGROUND OF HEALTH PLANNING EFFORTS (1) Health Planning with: Economic Opportunity, Atlanta, 1964. Hill-Burton and National Institute of Mental Health, continuous. Georgia Regional Medical Program, continuous. Home Health Care Service, 1969. Nursing Homes, 1967 Ga. State College, Kennesaw College, DeKalb College, Clayton Junior College, medical personnel training, 1967. Fulton County Medical Society: Southside Comprehensive Health Center, Vine City Health Services. 1967. Appalachian Funds, 1967. Model Cities Program, 1968. Areawide Comprehensive Health Planning, 1969. Studies: hospitals, nursing homes, services, patients, physicians, senior citizens. (1) Related Planning: Community Improvement Program: Atlanta Urban Renewal Senior Citizens Agency Alcoholics Program Information and Referral Recreation: Atlanta · Parks and Recreation Community Participation organizations Neighborhood Central Information Files . (1) See Appendix for more complete descriptions . ... 51 - �Community Council Has -Extensive Involvement in Health and Planning SUMMARY: ONE OF THE PRIMARY INTERESTS OF THE COMMUNITY COUNCIL, ATLANTA AREA, INC., IS THE HEALTH OF THE COMMUNITIES, THE FAMILIES, AND THE INDIVIDUALS OF THE METROPOLITAN AREA. ACTIVE SUPPORT AND PARTICIPATION IN PLANS AND PROGRAMS RELATED TO HEALTH HAVE BEEN CONDUCTED SINCE 1960 . THE COUNCIL HAS WORKED CLOSELY WITH FEDERAL, STATE, AND COUNTY AND CITY AGENCIES, PROFESSIONAL AND VOLUNTARY GROUPS AND INDIVIDUALS TO RAISE THE LEVEL OF HEALTH. Current Status: The following paragraph taken from Health Planning" by which the Governor of Public Health as planning agent for the capacity of the applicant planning "Narrative Plan for Comprehensive designated the G0 orgia Department the S1ate of Georgia attests to group: "There are only three staffed organizations in the state directed by boards adequately representative of the total community which are engaged in human resources-heal. th planning . These are the Community Council of the Atlanta Area Inc. t h e United Community Service of SavannahChatham County, Inc., and the Georgia-Tennessee Regional Health Commissi..on. The Department has maintained liaison with these agencies throughout their existence because of their broad interest in human resources planning . This rela t ionship is e x pected t o continue." ' - 50 - �Goals and Aims of the Planning Project: SUMMARY: THE PRINCIPAL GOAL OF AREAWIDE COMPREHENSIVE HEALTH PLANNING IS THE SAME AS THAT FOR STATE AND NATIONAL LEVELS: "PROMOTING AND ASSURING THE HIGHEST LEVEL OF REALTH ATTAINABLE FOR EVERY PERSON". LOCALLY, THIS MEANS DEVISING AND ADOPTING STRATEGIES FOR THE USE OF HEALTH RESOURCES WHICH WILL MATERIALLY RAISE THE LEVEL OF HEALTH, PROGRESSIVELY, IN THE ENTIRE COMMUNITY. SUCH A TASK IS SEEN AS A PROBLEM IN "SYSTEMS" ANALYSIS AND DEVELOPMENT, BY WHICH BACKGROUND FOR POLICY DECISIONS MAY BE GENERATED. MAXIMUM PARTICIPATION BY ALL CONCERNED ELEMENTS IN THE COMMUNITY WILL BE NECESSARY FOR SUCCESSFUL IMPLEMENTATION OF POLICY. In 1966, the United States Congress enacted Public Law 89-749, the "Partnership for Health" act. · Under thi s law, the Sta tes, and .through them, are as within the States, must a•sume responsibility for comprehensive health planning. The Congress declared that "fulfillment of our national purpos e depends on pranoting and assuring the highest level of health attainable for every person, in an environment which contributes positively to healthful individual and family living; that attainment of this goal depehds on an effective partnership, involving close intergovernmentai collaboration, official and voluntary efforts. and participatio~ of individuals and organizations; th&t Federal financial assistance must be directed to support the marshalling of all health resources--national, State, and local--to assure comprehensive health services of high quality for every person, but without interference with existing patterns of private professional practice of medicine, dentistry, and related healing arts". Th e term II COillprehensive II means that every aspect of the health picture in the six-county metropolitan area must be taken intQ account in the planning process. This includes not only the treatment .of illness and injur y, but their prevention, and the canpens ation for any lasting effect s which they may leave . Thus, in addition to the manifold activitie• of medical and paramedi cal pers onnel in the variety of health treatment facilities, plannillg Jr.ust cons ider envir onme!ltal cont r ols of the air, water, soil, food ,· disease vectors, housi ng c odes and constr uction, waste d isposal, etc. It must c ons i de r nee ds for the training of he alth per sonnel , for the impr ovement of manpower and fa c i l it ies u til i za tion, and for the a ccess t o health c are . It inc l udes the fields of ment a l hea lth, dental health, and rehabi l i t ation. It must be conce rned with the means of paying for prevent ive mea~.~ es and for health care. The term "planning" means , fi rst , t hat problem areas and pot ential problem areas in the entire field must be identified,and their magnitudes assessed. The trends of the problems must also be aase•aed, and projected for future years. Technical and organizational bottlenecks must be identified and "planned around" . Second, the community's resources ·in meeting its'healtb needs must be equally carefully identified and projected, in term• of professional and •ubprofessional akilla, facilities, and financial resource•. - 48 - �Third, since a considerable amount of planning is already being done for a num b er o f projects, hospital authorities, counties, and municipalities, which aff ec t s the c ommu ni ty ' s healt h picture, ways must be found to make maximum us e o f t h is c ap ability , a nd coordina te it into a community-wide comp rehens ive p lann i ng e ff ort. F inally , pl a nning must preserve and encourage t he highe st l e vel o f pr o f ession al competence in the entire health system , a nd must make use o f the i nsights of all con cerned in the community h e alth s y st e m. T he over a ll task of putting together such an organization is thus seen to be a problem in "systems" analysis and development. Since the total resources of t he community a r e likely to remain smaller than the demands which an idea l h ealth system wil l place on the resources, r ational and just methods of a ssi g ning p r iorities t o the various needs must be developed. A cost-benefit anal y sis is e ssential to any such decision process, and, considering the lite ra ll y hundred s of specific health needs in the community, it i s l i ke l y th a t t he cost-ben e fit model mu s t rather soon ma ke use of modern compute r t ec h n i ques . The Pa rt n e r ship for Health law requires that such planning be done with pe o ple r a t her than for people. Therefore, maximum participation of health "consumers", health professionals, governmental units and agencies, and other community organizat i ons is a necessity. The law ~s telling the States and communities that t hey will be given increas i n g resp~~sibility and power to determine their own be s t hea lt h interests. In o r der to e x ercise this power mo st ef f ect i ve l y, a max imum degree of concensus must be attained among thos e community elements c oncern e d with heal t h. To t his end, participation of s u c h ele men ts is mandat ory , so that a true" partnership for. heal th" among governments, healt h p r ov i de r s and consume rs, rich and poor, black and white, urban and rura l , may ' b e ac hi e v ed .

GOAL FOR 1975: WIMBLE, I HAVE CALLED TH IS MEETING TO INFORMYOU THAT THE CLAUDE CLAY UNDERTAKIN G PARLOR SELDOM HAS MY POST MORTEM PALACE SEEN BLACKtR DAYS!. .. LOCALSHOOT- OUTS ARE DOWN 73% ... THE ACCIDENT RATE HAS IS IN THE THROES OF DROPPED TO AN ABSURD LEVEL!... A SEVERE PLAGUES ARE AT AN ALL-Tl.ME RECESSION! LOW! IN SHORT, ATLANTA IS IN THE CLUTCH.ES OF A GLOW OF H.EALTH OF NEAR EPI DEMIC PROPORTIONS' from Atlanta Journal and Cons titutio n 25 May 1969 "Tumbleweeds" by Tom K. Ryan - 49 - �government STATE OF GEORGIA NUMBER OF FEDERAL AGENCIES SERVING STATES FROM ATLANTA REGIONAL HEADQUARTERS . - 36 -46 - 31 -35 - 6-12, Rapid Transit Is A MUST ... ' ATLANTA POPULATION 1940 1950 1960 NEXT 25 YEARS 2 MILLION • SUTIQNS Wll!i • ST A TtONS W I Ttl OUT PAlh.!HQ P .\ IIIKt -. c 2 11/a ½ Number Of People (In Millions) l( O, l I' , ,11 1 ~ l!UU • REGIONAL CAPITAL OF THE SOUTHEAST - 47 - u ;cc • • 11 • o • Ol •I • • . , ... H • • •• IIH • �- provides jobs for over 13.5 percent of all non-agricultural wage and salary workers; - capital for the State of Georgia; - houses federal and state, regional and district governmental offices; - military ins t allations such as Third Army Headquarters, Dobbins Air Force Base, Naval Air Station, etc.; - U.S. Federal Penitentiary. Wholesale Trade - Concentration of wholesale trade is the most important single index to metropolitan status - 4 billion dollar business - ranks 13th in the nation; the big four in wholesaling are: motor vehicles and automotive equipment groceries and related products drugs, chemicals and allied products · machinery, equipment and supplies Manufacturing Atlanta's production activities have been growing rapidly. Atlanta is second only to Louisville, Ky. in the southeast in the number of production workers or in value added by manufacture. - Durable goods employment has risen 39% of the 1952 total to present 47.5% - Major items in transportation are automobile (GM & Ford) and aircraft (Lockheed). Communications Atlanta Area is one of the largest telephone switching centers in the U.S. - Only Class I toll center in Southeast - Headquarters for Southern Bell Telephone & Telegraph Co. which serves nine states and Southeastern headquarters of American Telephone & Telegraph Co. · - Atlanta Western Union office is one of 15 automatic high speed switching centers in the nation (it handles approximately 2 million telegrams a month) - Gross postal receipts amount to 25 million per year - Atlanta has 3 commercial, 2 educational TV stations; over 19 radio stations, news coverage by 3 national TV networks, 20 weekly newspape rs and regional operators of AP, UPI, Wall Street Journal, New York Times , Time Magazine, Newsweek and Business Week . Higher Education A major r egional function of the Atlanta Ar e a (SMSA). - Headquar ter s of the Southern Regiona l Edu cation Boar d and f or t he Southern Association of Col leges and Secondary Schools . - There are a number of r ecognized co l l ege s and universi ties in t he Ar ea of gr ea t impor tance to i t s economic pot entia l. - 46 - �The Economic Status of the Atlanta Area SUMMARY: THE ATLANTA AREA HAS MANY SPECIFIC URBAN PROBLEMS. WHILE GENERALLY PROSPEROUS DUE TO ITS GROWTH AS AN INDUSTRIAL, BUSINESS, FINANCIAL, EDUCATION, COMMUNICATION AND TRANSPORTATION CENTER, THERE ARE SIGNIFICANT AREAS OF BLIGHT, UNEMPLOYMENT AND INADEQUATE COMMUNITY FACILITIES. THE VARIETY AND QUANTITY OF INTERNAL TRAFFIC FLOW PROBLEMS IN THE VITAL MOVEMENT OF GOODS AND PEOPLE CONTINUOUSLY REQUIRE THE DESIGN AND CONSTRUCTION OF MASS TRANSIT AND CIRCUMFERENTIAL HIGHWAY SYSTEMS, POPULATION INCREASES, I HMIGRATION OF WORKERS FROM RURAL AND OTHER URBAN CENTERS, LONGER LIFE SPAN, TECHNOLOGICAL INNOVATION AND MEDICAL ADVANCEMENTS HAVE CREATED HEAVIER BURDENS ON HEALTH AND HEALTH RELATED SERVICES AND FACILITIES, BOTH SHORT AND LONG TERM. THE ATLANTA AREA PRESENTLY NEEDS APPROXIMATELY 1800 BEDS FOR l~DICARE, MEDICAID AND TREATMENT FOR THE "MEDICALLY INDIGENT". AS TRENDS INDICATE. CONTINUED ECONOMIC GROWTH WITH RELATED POPULATION INCREASE, THERE WILL BE EVEN GREATER NEED FOR ADDITIONAL HEALTH FACILITIES AND MANPOWER RESEARCH TO SOLVE UNEMPLOYMENT, LABOR AND HEALTH RELATED PROBLEMS, Topography: The Atlanta Area is centrally located in the Southeast and stands alone as the only metropolis in its population class south of Washington and east of Dallas and Houston. - Economically similar to other inland regional centers such as Kansas City, Minneapolis, St. Paul and Dallas. - Developable land areas abound in every direction. - Physically, the Atlanta Area is: --located in the Piedmont region which lies south of the Appalachian region and north of the Coastal Plains region; --north of Georgia's :fall line and bisected to some extent by the Brevard fault; --characterized by low rolling hills containing metamorphic and igneous type rocks; --generally blessed with a warm, humid climate (average winter low=45°; average sunnner high=77°) --ideally suited for impoundment of almost any size lakes due to its annual average precipitation of 48 inches: - Pine and a few other hardwood trees are found throughout the Area. - Water for the Area comes from the Chattahoochee River , severa·l cr eeks and lakes. --Lake Lanier and Allatoona Lake are within 50 miles of Atlanta - The reddish clay- soil of the Area is moder a t ely fertile, but sus cep t ibility to erosion has dive r t e d much of the land to less demand ing us es s uch as pasture and fore s t s . - 44 - �- Notable Features: --Stone Mountain (a granite peak and State Park), reputedly the world's largest granite monolith --Kennesaw Mountain, an historic Civil War battle site Transportation Key to the Area's economic growth. -Railroads - 13 main lines of 7 railroad systems radiating in all directions. -Interstate Expressways - Six legs scheduled to go through the area -Air Transport - Six major airlines serve the area; two of the airlines are headquartered in Atlanta. 800 scheduled arrivals and departures daily. -Waterway Transport - has potential for both recreation and trade. Finance One of the most significant forces in the ATLANTA AREA (SMSA) is its economic growth as a financial center. Factors effecting the financial growth are: - selection for Federal Reserve bank (based on flow of trade in 1914) - headquarters for Sixth Federal Rserve District - growth in Atlanta's correspondent bank relationships Business ATLANTA AREA (SMSA) is an office "Headquarters c~ty" with continued business growth indicated for the future. - since WW II more than 8 million square feet of rentable office space has been built - leader in advertising, blueprinting, photocopying, research, and development, etc., in Southeastern United States. Manpower (See chart page 42 , Health Manpower Resources, 1968) (See chart page 13 , Population Distribution by Age and Sex) Major problems in the Area's working population will arise from: - inexperienced individuals, in large numbers, born in the 40's and 50's who will enter the job market in the 60's and 70's; - women, who increasingly tend to accept regular employment; - middle-aged males, industry's supervisory personnel pool, who will scarcely increase in number; - older people, gr owing in numbers, who will cr eate a demand f or ret ire~ent homes, medical care facilities and passive re crea tion equi pment; this will affect constr uction and indus tria l production ; - i mpact of automation which will accelerate competition f or available jobs. Government Government is big business in t he ATLANTA AREA. - 45 - �SELECTED RANKINGS & CHARACTERISTIC OF GEORGIA (From State Data & State Rankings, Part 2 of 1966-67 edition of Welfare Trends) HEALTH MANPOWER U. S.Rank Physicians 38 Dentists 48 Professional Nurses 43 General & Special Hospital Admissions 48 Mental Hospital Admissions 19 Tuberculosis 27 Expenses (total) 47 Expenses (General Short-term) 39 Expenses (General Long-term) 2 Expenses (Mental) 46 - 43 - �- - ----~-- - - - -~- - -- - - - - -- -- - -- -- - - -- - - -..! ! • Existing Ma npower SUMMARY: THE NUMBER OF PRIVATE PHYSICIANS AND DENTISTS AVAII.ABLE TO THE PATIENT IN THE 6-COUNTY AREA IS AIMOST THE SAME AS THE NATIONAL RATIO. OTHER PARTS OF GEORGIA HAVE REIATIVELY FEWER PHYSICIANS AND ABOUT HALF AS MANY DENTISTS FOR THE POPUIAT ION. REGISTERED NURSES ARE CONSIDERABLY MORE ABUNDANT IN THE ATI.ANTA AREA THAN NATIONALLY OR ELSEWHERE OVER GEORGIA. THE NUMBER OF SANITARIANS ALSO COMPARES FAVORABLY WITH OTHER AREAS. THE COMPARISIONS MADE HERE ARE NOT REIATED TO NEEDS, WHICH IN MANY CASES IS GREATER IN METROPOLITAN AREAS, THAN IN SMALLER AREAS. HEALTH HANPOWER RESOURCES, 1968 A I Physicians Dentists Private !Persons '. Registered ! Persons Practice ! per Phy •. : per I 1I Dentist 6 Dougl as 3983 \. 7 3314\ Area Registered Nurses Active Persons per Active Nurse Sanitar.ians· 1- -~ ____ _ __ 34 493 1 538 3 Gwinnett 16 3738 9 6478 \ 81 Clayton 20 3935 14 5564 \ 125 371 - - 2 135 1294 52 ~3242 ! 358 319 7 3452 : 1,571 164 1 1440 1 730 2152 3744 3,899 12,368 322 266 502 35 49 2157 909,131 329 324 Cobb ·, DeKalb 216 1637 109 Fulton 864 6 County 1257 Georgia 3165 701 1031 1143 419 603 1296 u.s. 1036 188772 National & i State data are taken from Health Resources Statistics,1968,U.S. Dept. HEW Sanitarians: Provided by Mr. Furman B. Hendrix, R.S., Ga. Society of Professional Sanitarians, May, 1969. Nurses: Roster of Registered Prof. Nurses, Board of Examiners of Nurses for Ga . ,1968. Dentists: Physicians: Office of Dental Health, Ga. Dept Public Health, June, 1968. Bio-Statistics Service, Ga. Dept. Public Health Fo r mor e complete table see Appendix. - 42 - �:;o G, t-<

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rt MARIETTA AREA 209,200 Cobb , Paulding, Douglas o---t-+--+-.,.........._,_-t--1,........,...-; SOUTH FULTON AREA South Fulton, Clayton Coweta, Fayette DECATUR AREA DeKalb, Rockdale North Fulton CITY OF ATLANTA AREA 221,700 437,200 460,000 LAWRENCEVILLE AREA 95,800 Gwinnett, Barrow, Walton

Based on the Georgia State Plan for Hospitals and Related Facilities, Revised 7/1/68, Branch of Medical Services and Facilities Planning, Georgia Department of Public Health - 41 - • D �Facili lie s: Indluding Hosp ital s, Nursing Hom es , Outpatient Clinics and Neighborhood Health Centers SUMMARY: THERE MUST BE DESIGNED A COMMUNITY PLAN FOR THE USE OF FACILITIES IN AN ORGANIZED ARRANGEMENT OF MEDICAL RESOURCES SO AS TO BRING THE INDIVIDUAL, WHEREVER LOCATED, INTO CONTACT WITH HIS PHYSICIAN AND OTHER MEMBERS OF THE HEALTH CARE TEAM AT THE LEVEL OF CARE THAT HE REALISTICALLY NEEDS. Problem: 1. General shortage of medical and surgical beds and a corre spondin g underutilization of obstetrical beds and pediatric beds 2. Need for development of rehabilitation services which pre vent or lesson the demand for acute health care. (see Profile) 3. Lack of extensive diagnostic and treatment centers, and of night clinics to serve the poor who work during the day. 4. Lack of agreement on providing expensive facilities such as a £Ommunity radiological treatment center. 5. Lack of geographical distribution of 24 hour emergency care services; need for an independently powered radio communications system between hospitals in the event of a major disaster. 6. Lack of nursing home facilities (2-3000) in the medium price range, and particularly in counties outside Fulton. Current Status 1. Utilization of general hospitals has far exceeded the population trend; particularly in metropolitan areas have increased population brought additional demand for services. 2. The average patient stay has increased since 1962 due to Kerr-Mills and Medicare programs. 3. The cost per patient day (average) has increased from $12.95 in 1950 to $43.97 in 1967 and still going up. Trends 1. At least six major hospitals are building or planning nursing h ome units and two are planning ambulatory care units. 2. Organized Home Care and Homemakers services are beginning to be sought. 3 . Hospitals are developing emergency care 24 hour services with f u l ltime paid physicians. 4. Utilization committees in hospitals and nursing homes are gaining status. Obstacles 1. Traditions in patient management which waste manpower and facilities. 2. Lack of money for major changes in the health care system. 3. Underutilization of manpower and delegation of f unctions to lesser trained patient care personnel. 4. Distorted insurance benefit structure which require inpatient st a tus to pay for diagnostic services. Possible Solutions 1. Build new hospital and nursing home beds only based on effective demand. 2. Give greate~ attention to r ehabi litation of patients. 3. Develop progressive care facilities such as ambulatory self care. 4. Develop - "Day Hospitals" diagnosti c outpatient services, night clinic s . 5. Operate full services of the hospital on Saturdays and Sundays, or "round the clock" double shifts for surgery etc. 6. Remove the stipulation that the patient occupy an inpatient b e d in order to get insurance coverage for diagnostic and minor treatment services. - 40 - �The Plan Has ContinJl.'.:,5!. In-Put from Existing Resources SUMMARY;. NOT ONLY HAS THE INVOLVEMENT OF RELATED GROUPS REDUCED THE THREAT OF CHANGE, BUT IT HAS BROUGHT INTO REALITY THE BASIC THEME OF THIS PROPOSAL: PAi{TNERSHIP -- SOUGHT AND DEVELOPED. THE COMMUNITY COUNCIL'S HOSPITAL AND H'.:<:ALTH PLANNING STAFF HAS BEEN IN CLOSE TOUCH, BOTH FORMALLY AND INFORM..A.LLY' w:;xt{ 0'I'HER RS:i:,~TED PROGRAMS, PROJECTS, ACTIVITIES AND RESOURCES. NUMEROUS PRIVATE AND I'UBLIC ORGANIZATIONS HAVE CONTRIBUTED IN SIGNIFICANT WAYS TO THE PREP/1RA-' TION OF TI-ri S PLAN 1\ND HAVE BEEN INCORPORATED INTO TI-IE DESIGN FOR A CONTINDING PLANNING PROCESS TO IMPROVE -THE LEVEL OF HEALTH IN THE ATLANTA AREA. F J..> _ ' e Methods of Involvement: Joint board members (mandatory and voluntary) 3t;ff exchange Review procedures Referral arrangements Information exchange · Consultation (formal and informal) (l) Umbrella organizations Staff meetings (regular and calle.d) (l) Committee and Task Force memberships (L) See Appendix for Chart of INTERAGENCY RELATIONSHIPS: HEALTH PLANNING, which lists some specific contacts. - 74 - �. ~._;-,:;--:::-,..,..,--. Curr ent Resou rces: -~ ~\\.l 11ic REGION ~ . . ........l. •:., , · !·'· ' ;+ I olJt~ ~~ • u::;.;c::r: . 1De pt. ~. , . . , .-..e "7~ ; ~ 3 ; - n--::::::::::,,r:-~"*< ',, 4 _ .;s"i--"+ Office Economic Opportunity (inf o. exch an.;e ) Dept . Hea l th, Education , We l fare ( in fo . exc k1.11ge , con s u 1tation) De pt. of Labor, Dept. of La b or St at i s tic s ( consult at i on , in fo exc h a n ge ) J Emory Un i ~ .' ~~ ~.,,,,...,.....- ~..co~.: u ~_t a~i~ ....:...==.!.= ity l\lecli..s_~! -, ~.~ -; • ..-~r::::::;::::;:::;::::.; ' ' "T"'l-::-r--·=--:;;;z-~ ....... ., . -.b;..~,r::::;;:::;----.-:::;;:;:J':".:':tt=;:,7 ~ o f Publ~c He a l t~ : Plann~ng Oi f ~ce'. Ofl'ice of Com 1~rt.: l_1c ns h·L ~ .1 Health Planning , Off ice of Bio-S tatistics , Branch o l t nv1ron -' . m~n~a~ He a ~th , Facil iti es and Con st r\1c t i on Division, Lic cn s ~1re 1 . Divi s ion (info . excha n ge , -consu l t a t1on , b oa rd memb e r s, revi ew) Univ . of Ga . Cente r for l\Ianageme n t S ystems , (in fo . exch n ng-c , consultation), Georgia St ate Co ll ege ( consultation ), Ga . Tec h , School of Sa nit ary Engineering ( con s ul tation , in fo . exch ange ) Georg ia Hospit a l Association (consultation) 1 l\Iedic a l Association o f Georg ia ( cons ult at i o n) Ga . Stat e Leagu e for Nursing (st a ff exc h a ng e ) Ga , Nursi ng Home Assoc . ( staff exch a nge ) Health I ns uranc e Cou nc il (info. exch ange ) ~7e AREA -~ a1~~-~~;:.143.215.248.55 13:06, 29 December 2017 (EST),i_~~-~,=-~~-~~J f';!'.:::.;i::;:!,'.;:z:;:-,li · c:z;;:,,: i : ; . : : ~ : : ; ~ ~- ~ · STATE . .. • _Dept . ll e a lth, Educ at ion , Wc lJarc, Community FEO.E_RAL ] Profil e Ce nt er (i nfo . exch a nge , c ons ult at i on · Atlant a Reg i ~ n · t r :;-~l i t a {{ ' p'1~1~ i 1~~ ' C~n;~i'i cxc il a n;;- ~ ~ ~ sult ation, board members ) Georg i a Reg ion a l Med ic a l Prog r a m (umb rella org a ni zat ion,r cv i e~ ) Georg i a District Hos pital Associ at ion (c onsu lt at ion, j oint bo ::1rcl ) Atlant a Are a Soci ety of Registered Profe ss iona l Sanitarian s (i ~Io . e x change , consultation) l\letro. Atl anta l\Ienta l Hea l th Associat i on ( staff exchange ) Ga . Soci e ty for Crippl e d <;;hilclren & Ad ul ts (c onsu l tat i o n, in fo . exchang e, sta ff exc h a n ge , join t b oa rd) Visiting Nur ses Association ( staff ex ch a nge , joint board) Ga. St ate Nurses Assoc i a tion Tr a ining Prog r am ( staff exchange ) Blue Shi e ld & Blu e Cross (info . excha nge , cons ult at ion) American Ca nc er Soci ety , Georg i a Di v . (j oint b oa rd, con s ult at ion) Ga. Heart Assoc i at ion, Inc. , (join t board, c onsultation) Com~unity Chest , Age ncy Relations & Al l ocations Division (j oint board/staff ) Se nior Ci tj_ z ens Serv ic e of l\Ietro Atlanta I nc . (staff exchange ) 1 ~ ~G~-c'l ~f~- ~ LOCAL .Mode l C-i ties ( consultation , s taff e x chang e) Atlant a Univ e r s ity (c onsultation) Economi c Opport u n i ty Atl a nta ( staff exc hange , c ons ul ta tion, joint board ) County Pub li c Hea l th Depts. ( staff exchange ) Fulton Coun ty Med ical Soci ety (c onsu lt ation , join t boards ) Cobb County Med i ca l S oc i ety (c onsu l tat i on) City o f At l anta, Air Pollution Control Divisi o n (consultation, joint b o ::1rcl ) Atlanta School System, P . T.Associati on and Adu l t Educ a t ion (info. exc! 1:;.n ~e ) .... �The Comprehensive Health Plann ing Staff r;~~; ··-:··· ' ·~ TI-ill FUNCTIONS OF THE COMPREIIENS I VE HEALTH PLANNING STAFF ARE (A) TO CONDUCT RESEARCH IN COMMUNITY l-IEALTI-I PROBLEMS, (B) TO DEVELOP BACI<GROUND FOR POLICYMAKING THROUGH SYSTEMS ANALYTICAL METHODS , (C) TO COORDINATE THE ACTIVITIES OF ALL-HEALTH PLANI'IERS IN THE AREA', AND (D) TO PERFORM CONTMCT SERVICES AND TECHNICAL ASSISTANCE ACTIVITIES. Tl-IE STAFF INCLUDES A DIRECTOR OF COMPREHENS I VE AREAVHDE HEALTH P LANNING A~rn OTHER P ROFESSIONAL AND S UB-PROFE38IONAL PERSONS . 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«'t r:~ . ~ C !3 -: ....;, . ' J - Planning Ftmctions The planning functions of the staff consist of two major sections: ( a ) the coordinat ion and r ev iew of plans orig ina-:: j_ng j_n t h e hc2.l th and h ea l th- re l a ted offj_ces _ throug hout the com1mmj_ ty, and (b) the or i g j_natj_on of plans in are::::. not covered b y other offj_ces and agencies . The l a tter is expected to consist in large part of systems- analytical studies, :iLnc lud:ing c ost- benefit a naly ses , which cover the entire r a nge of health problems a nd possible solutions. I .r

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88 �.< COMPREHENSIVE HEALTH PLANNING STAFF INITIAL ORGANIZATION Director Secretary 4 II Associate Director Admin. & Organ iz at ion a l Li aison Associ~tc Direc tor Syst ems Re8earch & Evalua"~ion Organiza tion Li a i son Sy stems An a ly st Resear ci1/Eva luat ion Pl a nner Enviro nmenta l Hea lth Planner Liais on Planner Stat istician Secre tary 3 Secretary 2 l'Ie ighborhoocl Liaison Plan Review/ Techni cal Ass i s tanc e Secret a ry 3 ' - 89 - �The ·Me tropolit a n Atlanta Cow1cil for Health (Comprehe n s ive Health Plannin g Counci l) SUMMARY : ,THE FUNCTIONS OF THE METROP OLITAN ATLANTA COUNCIL FOR HEALTH ARE (A) TO l\'1AKE POLICY FOR TI-IE METROPOLITAN _.COMMUN ITY IN HEALTH MATTERS AND (B) TO SET POLICY FOR GUIDANCE OF STAFF ACTIVITIES. THE COUNC IL· REVIEWS HEALTH ACTION PROJECT PLANS ORIGINATING WITHIN THE COivTivIUNITY, AND ORIGINATES I-IEALTH ACTION PLANS WI-IERE NEEDE D . THE C0UNCII, . IS HESPONS IBLE FOR COlWUCTING COMMUNITY LIAISON AND EDUCATION IN HEAL':'.'H .MATTERS, Cow1eil Structure As provided in t he By-Laws, the Cotmcil is struc tured as a '\-wrking bo2.rd" . All policy matt e :rs are decide d by the ftill CounciJ.. To facilitate such activity, the Council will form several groups of committees for spec ific tasks, e a ch group supervised by a vice preside nt, The cornmit te,es will r e port to the Council, and recommend actions in their areas of competence. A number of the committees will work clo se ly with the s t a ff in such areas as project review and community liaison . I N C O MP L E T E - 90 - ,., �COMPREHENSIVE HEALTH PLANNING COUNCIL - STRUCTURE Qouncil President r-Vice-:Pre siden t Project l;8vj ew Vice- President Counc. Function Vice- President Speci a l Needs Vice- President Vice- President Liaison & PR Administration Facilities proj. rev. Organi z a tion revj_ew J~eighborhood 1 i2. j_ " 011. State & Fed. liaison Bud get & Finance Environmental proj. rev. Program & orientation Needs of the d isadv2.,. t::1.e,;ed Local Council 1 iaison Personnel Mental Health p roj . rev. Long-:tange planning Needs of youth Public rel ations & information Fund Raising .Legal counsel Manpower proj. r ev .

Earh crn~mittee is chaired by a Council member; Vice-Presidents

of Coun ci l oversee and encourage activi t ies of the groups of committees shown. Nominating Committ e e: Executive Committee : President of Council ' Vice-Presidents (5) Secretary Duti es : Carry on activiti e s betwee n Council mee tings; recomme ndations subj e ct to Council revi e w S e l ected from memb e rship of Council, with due regard to makeup of the Council. Duti es : Nominate a slate .of offic e rs prior to the annual me eting Nominate a new nominating committee prior to the annual meet.ing Nomin ate organizat ion s, on a ro t ating basis, whtch will name me mb e rs of the Council to take offic e at th e next annual me e ting Nominat e replac eme n t s for vacancies as th e y occur P e rsonn e l Comm itt e e Select e d from Council me mb e rship and community at large . Duti e s: Re commen d s e l ection a nd salary of Director for Cou nc il act i on Formulat e p e rsonne l polici e s, including s a lary rang es _ 91 _ �Membe rship on the Council ~ - .. SUMMARY: MEMBERSHIP ON THE COUNCIL SHALL BE DRAWN F ROM TWO Ivl4.JOR GROUPINGS: THOSE WHO WILL SERVE DY VIRTUE OF OFFICE HJ ,A MAJOR PLANNING ORGANIZATION OR LOCAL GOVER.N1VIBNT, AND THOSE WHO SERVE THROUGH BEING NAMED BY APPROPRIATE ORGA.t'fIZATIONS OF HEALTH PROVIDERS AND CONSilliffiRS . MEi\'lBE:tSHIP IS DRAWN FROM SOURCES BROADLY REPRESENTING THE ECONOMIC, ETHNIC , AND C:EOGR/1.PHIC BACKGROUND OF' THE COM:AIUNITY. ~ I N C OMP L E T E ' 9~ - - �I IIIBMBERSHIP ON COUNC IL - Sche me G Number 3· Group Select ed/e l ected by

"-------- MACLOG, CCAA, ARMPC virtue of office (chairmen ) Count y commis sions virtue of bffice 1 City of Atlanta virtue of office (mayor ) 3 Mun ic ipal governments of counti es municipal a ss ociations 0r count y commissions ( in rotation ) 20 I~e:- 1 t h provid e rs: 4 !Ill's 1 ivw , psychiatry 2 DDS's 2 Public h e alth 2 Heaith faciliti e s 1 Me di cal educator 1 Parame dic a l e duc at or 1 RN 2 Voluntary health agencies 1 Social worker 1 Skill e d parame dic a l 1 Se mi - Skill e d parame dical '\ 1 He alth ins. industry 17 Atl - Gw i nn ett , Clayton, DeKalb-Rockdal e 3 PTA's Cabbagetown, Cobb, Doug l as (othe rs in rotation ) NWRO, Sout h side He al th Ce nt e r,. TUFF, NAACP, Urban Leagu e (1 each ) ( others in rot at ion) Chamb ers of commerce , union s (in rotati on) 5 other org anizations 52 ' medical societi es (in r ()tation) Ga. Psychiatric Assoc. dental soci~ties (in rotation ) public h ealth d e p artments (in rotatiun) (recommended : 1 MD , 1 other special ty ) - hospital, nursing home associations, etc . (both private and authori ty -- in rotation) school o f me dicine I alli e d scie nces schools, etc . ( i i, rotac"o:, I nursin~ associati ()n S (in. rotation) CCAA P erman ent Confe r e nce and State Association of v oluntary agencies (in ro tat ion) NASW local cha pt e r t e chnic a l associations ( in rotation) o rgan ization s , · if any; otherwis e nomina ted as an individuat He alth Insurance Council Poor and n ear-poor 7 EOA' s 2 Mod e l Cit ies 2 (qhairmen) Busine ss and labor TOTAL Th e ·term of "vir t u e of office" membe rs to coincid e with oc cupancy of of f ice . Te)rm of othe r me mbe rs , thre e years, one -t hird rotating off eac h y e ar. "I n rotation" indicat e s that at s u cc e ssive e l e ction s d i ff e r e nt org a n i z ations or group s wit h i n · the same cat eg ory will b e aske d to s e l e ct me mbe rs . A nominating committee of the Counc il will b e responsible for assur ing s u ch rotation. For the first el e ction ad hoc nominating committ e es in the major categ orie s above are b e ing aske d to submit name s of org anizations, for r e vi e w by CCAA Exe cuti ve Committ e e . - 93 - �Title: Working to Ensure Effectiveness of the CHP Council E13:06, 29 December 2017 (EST);143.215.248.55;;~;;143.215.248.55;~E::;;143.215.248.55 13:06, 29 December 2017 (EST);;~;~~;:;~;143.215.248.55 13:06, 29 December 2017 (EST):;:7i . EXTENT TO WHICH MEMBERS PERFORM SPECIFIED FUNCTIONS OF BOARD }fENBEL SHH. A WIDE RANGE OF COMMUNITY RESOURCES WILL BE USED IN TRAINING FOR BOARD ACHIEVEMENT. -r• • w;.o · I S ' ~ ,. , . t; "'c .i:.'1', .., .._ ; ;:, ~ .? 11LY:,s j' .· 1 t,

$ ·' ~., · f_"i",j '>'r•:t:' .. •;, 'A~:f ;;;:1 f:q , 15.- ;>½ -·,.;;.e1r1 ~ : _ n n : ~ ~ ~

-?f54t•@9a£ .,g Chara~t e ristic s of the CHPC Board:

,/. \;,;}---------~--~-Consume rs and_ providers, 0 <> economic and ethnic mix, geosraphic distribution. Ve ':eran policy-makers and persons with little group and no policy-making experience. Wide range of educational and social backgrounds. Traditionally, health providers and consumers (particularly low inc0 ~~ ~roups) have not planned together or worked as equals. Perception of health problems will be influericed by the special interest which each mernb~r represents. Thus, succes~ful functioning of the Board will depend upon effectiv~ participation of members both as representatives of suhgroups ard a8 citizens in the community of solution. Some Specific Training and Familiarization Activities After the Council's initial action of accepting responsibility for the policy aspects of comprehensive areawide health planning in this metropolitan commLmity, beginning 1 January 1970, some 6½ months .will elapse before the Council is called on for official functioning. During this pe riod, a number of activittes are planned for . the purpose of familiarizing the Council members with the extent of the he a lth planning actions which they wil~ be called on to evaluate and guide. The period will also be used to acquaint the CoLmcil membe.rs, one with another, so that they can select Personnel Conunittee and Nominating Committee members most effectively, several months prior to the Annual Meeting in January, 1970. Some of the traini~g and familiarization activities contemplated are: o introduction to principal hea lth problems in the area o field trips to health facilities and areas of severe health need o training in effective Council and committee participation o e x perience (with Community Council staff) in reviewing plann ing projects o introduction to systems analytical procedures, and methods of basing decisions on cost-benefit analyses, etc. o joint meetings with other planning groups and with health activity s taffs - 96 - �IMPLEMENT LEARNING EXPERIENCE EVALUATE EXPERIENCE THROUGH COUNCIL BEHAVIORS DETERMINE NEEDS (ASSESS STATUS OF COUNCIL MEMBERSHIP FUNCTION 97 - • .z. - . , ·-~ _,._ �By-Laws of the Council KE , . tr

s f-J.,

! F SUMMARY : THE BY-LAWS OF THE COUNCIL ARE DESXGNE D TO FACILITATE MAXIMUM POSSIBLE PART I CIPATION IN I-IBALTH POLICY MATTERS BY THE MEMBERS OF THE COUNCIL, AND TO "BUILD BRIDGES II TO LOCAL ORGA.t'l"IZAT IONS CONC'ERNED WI TH HEALTH MATTZRS. T HEY SPECIFY TI-ill BROAD FUNCTIONS OF TI-ill COUNCIL AND STAFF , BUT ARE INTENDED TO PROVIDE FOR SUFFICIENT FLEX I BILITY TH~T THE COUNCIL CAN COPE WI TH CHANGING AREA CONFIGURATIONS AND HEALTH 1'iT'EDS . 1 . The By-Laws consjst of 13 Articles: I. Name and Location II. Purpo se III. Membe r s hip IV. Duties and Powe rs of the Council V. Meetings Officers a nd Executive Committee VI. VII. Committ ees VIII. Legal Com1Se 1 IX . Audit Genera l x. Adoption XI. Assoc;: i ate and Affiliate Memberships XII. Ammendments XIII. Import ant Provisions£ · Some of the principal by-law provisions are shown on the facing page {9 9). Other By-Laws : Current By-Laws of the Me_tropo li tan Atlanta Council of Loca l Governments of the Community qounc il of the Atlan~a Area, Inc. are inc luded in the Appendi c es to this vo l ume of the propos a l . . 98 - and �CHP COUNCIL - PRINCIPAL BY -LAW PROVIS IONS ., A. Council Membership and Terms 1. Chairmen of major agencies (3) and of cc-unty commissions shall serve for the duration of their terms 2 . . Representatives of organiza t ions shall serve three-ye ar te~ms ( excP~~ for some elected at the first election); 1 /3 Jf these shall be selected each year. 3. Two three-year terms, maximum 4. · Majority shall he health "consumers" 5.. Approximately 1 / 3 shall be poor and near ··poor consume:rs 6. Selection process shall ~.:.~e into account g;eographi.c and ethnic distribut.i. 01,s in the community 7. Selection process shall be determined by a nominat~11g committee mad e up of Council members. In selecting organizations and groups who will name members to the council, the nominating committee shall achieve rotation arnong eligible groups and organizations.Typical eligible organizati0ns or g~ol ·s ai ~ 1~jicated in the following: a. municipal governments group: municipal a~sociations b. health provid e rs g rou_p: medical societie&, d en~i:tl scci.?ties , ho s pitals and other facilities, mental health professional organizati~,s , public health . d epartments , · v·oluntary hea l th organizations, nursing associations, skilled· paramedical- associations, unskilled ;,aramedical groups, social work aienc ies, educational institutions, insurance councils. c. business an.cl labor groups: chambe rs of c01mnerce, labor organiza ti ons d. poor and near-poor: EOA's , PTA's, HUD projects (e.g. Model Citi e s), volun tary agencies (e.g. Urban Leagu e , Legal Aid), spontaneous organizations ( e .g . Welfa~e Rights, TUFF, etc.) 8. Alternat es may be designated; specifically und erst ood that they act for r egular members B. Council Meetings 1. 2. 3. 4. C. At l east six p er year (contempla't;e ·monthly) Quorum is 20 vo~ing _memb ers Majority of voting memb ers shall ·decide Roberts Rules govern Council S truct ure 1. 2. 3. 4. 5. Officers nominated by nominating commi ttee, or from floor; elected by majority vote of Council Executive Committee shall con.sist of the officers ( 7 ) h andl es business b etween Council meetings action s su~ject to review by Council at ne xt meeting Nominating Committee selected from me mbers of the Council Personnel Committee s e l ect e d from Council me mb e rs and o t h e rs Othe r standing and ad hoc committees as n eed e d . .... -~ - 99 · - �. BY-LAWS ARTICLE I - NAME AND LOCATION 1. The name of this orga niza t ion shall be "The Met ropolitan Atlanta Cou nc il for Health", h e reinaft e r referred to as the "council". 2. The Council's principa l office shall be located in the City of A~~anta, Ge orgia. ARTICLE II - PURPOSE 1. The principal objective s and purposes of the Council are: A. To es tab lish and ma intain compre h e nsive areawide health plannin g activities, id ent ify ing hea l t h needs - and go a ls of the ove rall communit y and its sub-areas to stimulate ac t ion to coordin ate and · make max imrnn use of existing and planne d facil it ies, servic es and manpower i.n ·the fielc1 s of physical, mental and environmental he a l t h. B. To establish a system for gathering and analyzing data on the characteristics of h ea lth problems in this area. C. To recomme nd goal~ and methods of achie v ing them, and to make policy decisions for the community in heal t h planning matters. D. To coordinate activities . of all h e alth plann e rs· in the community. E. To collabor a te with adjac e nt h ea lth planning areas, and t-0 p e rform h e alth planning s e rvices on a con t ract basis for adjacent area units, as requested. F. To review h ealth action project plans -Originat ing in the community. G. To provide technical assistance t o public and voluntary action a ge nci es in preparing pl a ns and p ro c ed u res for the at ta inmen t of h ea lth goals; to p rovi d e similar assistanc e to Georgia State heal th pl anning efforts. H. To origin ate health action project plans where n e ed e d. I . To provide c ontin uin g li aison a nd information a l s e rvices to ensure communication of planning p r og r e ss to the general public and the appr op ria t e a ge ncies and organizations involved in carry in g out the int e nt of Congress a s s e t forth in Public L aw 89 - 7 49 r e latin g to compre hensi ve areaw id e hea lth p l a n ning . - 100 - l �ARTICLE III - MEilIBERSHIP 1. The Council shall be composed of not l ess than thirty-five(35), nor more than fifty-five (55) members. Members sha ll be drawn from the following organizations and conwunity g roups, broad ly reflecting ecohomic, ethnic, and geog raphip , backg round distribution of the area: A. Membe rs by virtue of office shal l serve f6r tte duration of their terms of elective office : 1) 2) 3) B. Chairmen of County Commission s Chairmen of major planning agencies Mayor of the City of Atlanta Memliers named by ~:.unity agencies and organ i.z ut ions 1) Organizations naming membe rs shall be 8asi g nated in the fo l lowing categories: a) b) c) d) 2) 3) Municipal governments Health providers Business and labor Poor and near-poor consumers At the first election, the term of office for one-third of these me mbe rs shall !:le fixed at three years; the term of a n addi tional one -:-third of these members shall be fixed at two years; and the term o f the fina l one-third of these members shall be fi x ed at one year . At the expiration of the initial term of office of each r espect ive me mbe r, his successor shall b e named to serve a term of three - years. Member s sha ll serve until their successor s have b een e l e c ted and qual ified. No member shall ser\(e more tha n two (2 ) conse cutive three-year terms. The selection process for these memb ers shall b e determine d by a Nominating Committee of Council members. In ~e l ecting o rganizations and groups who will n ame members to the Council, the Nominating Committee shall achieve rotation among elig ible groups and organiz ations. C. A major i ty of t he Council members shall b e non-providers o f h ealth service s. D. Approx imat e ly one-third of Council members shall b e poor and n ear-poor consumers. E. Each organizati on sha ll b e authori zed to file wi t h the S ecretary of the Council the name s of alternat e me mbers , not to exceed the numbe r of r e pre sentatives to which it is entit l e d. Any regul ar me mbe r of the Council may call upon alterna te ( s ) from his organizat ion to attend and - 101- J I' t ! �to vote in hi s s tead at any meet ing which the regular member is un a bl e to attend. F •· Organ iza tion s othe r t han t h ose con st ituting the Council at the time thes ~ rul es and r egul at ions are adopted may be invited ~o n~me r e ~Tesentatives in a sta t e d number to the Council up cr1 r e commend at ion by the Nominating Committee and approval by t l-,0 Council at any me eting of thP. Council, provid e d that ten (10) days advan~ ~ notice 0f such propose d action is mail 8 d to each me1.1b er at h ls l ast known post office addres~. ARTICLE IV - DUTIES AND I\,\\'ERS OF THE COUNCIL 1. The Council shall be the final authority for approval of activiti es pr oposed in plann i n g actions, and on all matters o f p olicy related to comprehe nsive areawide health pl a nning. 2. The Council shall consid e r the annu2l Lud get rrres c:1t. c d by the Budget and Finance Commi ttee , and after any r ev isi on , it may det erm in e to be advis abl e , i t shall adopt the s ame . I t shall ma: .c suci.i subs~ quent revision on the bud get as it may d eem advisabl a after c onsult ation with the Budg et and Fina.nee Cornn:iit tee and t h e Dir8ctor of Comprehe nsive Are aw id e He a l th Planning. 3 . It shall have the powe r of a pproval of the Presiden t_ ' s appointme nts of committee cha_irmen and l ega l counsel. 1. It sha ll app oint the Dire c tor of . Comprehe nsive Areawide Hea l th Planning , and fix the terms of his c ompe nsati on, tenur~ , and responsibilities, givin g due con sid e:r; at ion t o the recomme nda ti ons of the President and the Personnel Cammi ttee. ' 5. It sha ll appoin t t.he auditor as provided in Article IX of the se BY-LAWS . . 6. I t shall r e quire p e riodic r e ports on ope r ations from the variou s commi ttees and_ from ._the Dire ctor of Comprehensive Areawide Heal th Planning. 7. It sh a ll fix t h e time and place of the Annual Mee t ing of the Counci l. · 8. It shall pass on appli c a~ions for admission to the Council of addition a l a dj a c e n t are a s d e~ iring to p a rticip a t e in c ompre h e nsive h e al t h planning with the metropolitan Atlanta a r ea . ARTICLE V MEETINGS 1. The Counci l shall hold at l east si x ( 6 ) r egul ar meet i n gs p e r y e ar , to b e c a ll e d for t h e f i rst Thur s d ay i n the s chedul e d mon t h, o r on s uch o t h er con ve ni e n t d ay as may b e d e cid e d fr om t im e to time by ma j ority v ote. 2 . Spe ci a l mee tings may b e c i ll e d by the Pres ident a nd shall be c a ll e d by t h ~ Se c r e t ary a t t h e r e que st o f . f if teen (1 5 ) memb e rs of the Counci l . - · 102 / �3. Notice of each meeting shall be mailed to each member of the Council at his last known post office addre ss at leas t ten (10) d a ys in advance of~ the meeting. 4. Twenty {20) member~_of the Council shall constitute .a quorum for the tiansaction of business at a~y meetin g of the Council; the presence of less than a quorum P.18}' adjourn a meeting until such time as a quorum is' pre .sent. 5. A majority in number of members present and voting at n meeting at which a quorum is present shall be . required for approval of any ar. t io:1 by the Counc j l . f, , Each ;,1ember of the Council is entitled to one (1) vote at any meeting at which he is pre s~nt. 7. lfo proxy votes shall be allowed. A duly appointed al t e~-,1~ te member, however, may vote in the absence of a regular member representin~ the organization for which h e is designated alternate. In such case, the alternate me mber shall be considered a member for the purpose of determining a quormn. 8. The Council may act by mail, wire, or telephone between regular ms etings, but in such case the concurrence of a majority in nmnber of membe rs shall be necess a r y and shall be subject to conf irmation a t t h e nex t meet i n g of the Council so tha t such action shall b e r e cord e d in the minutes. 9. The first meeting of the Council, after Janua ry leach year, shall be considered the Annual Meeting for the seating of new members named by organizations,and election of office rs and nominating committee me mbers. 10. The Administrative Year of the Cotmcil sha ll e xt e nd from Annual Mee ting to Annual Mee ting . ' ARTICLE VI - OFFICERS AND EXECUTIVE COMMITTEE 1. 2. Office rs A. Of f ice rs of the Coun cil sha ll b e a Pres id e nt, five (5) Vice -- P_r e side n ts , a nd a S e cre tary , who sha ll b e e l e ct e d annually from among memb e rs of the Council by a majority _ vote of memb e rs pre s e nt and voting a t the Annual Meetin g . B. Of f ice r s so el e cte d s hall s e rve f or on e y e ar, or un t il t h e ir succe ssors have b een e l e ct e d. No o ffi c e r s h a ll hold t h e s a me o ff ice f or more than thr ee ( 3 ) c on s e c utive terms . C. Vacanci e s in office s occuring b etween Annu a l Meet ing s o f the Council ma y b e fill e d by el e c t ion b y a ma j or i ty vote of me mb e rs p r e s e n t and vot ing at a n y mee ti n g of the Co un c il . Of ficers sfo e l e 8 t e d ~h a ll s e rve u nti l t h e n ext Ann ual Me e tin g o t h e o un c i l. Pres i d e n t A. The P res i d e n t of the Coun c i l s hall b e t h e c hief o ffi c e r - 103 - �of the orga11izat i on a nd sha ll pre s id e at all me e t ing s of the Council a nd Exe cutive Conuni t t ee. The Preside nt shall, subject to the approval of the Council, appoint the chairme n of all conunittees, except the Nomir.ating Committe e , and shall b e a me mbe r, ex-officio, of all conuni tt ees ; and shall, with the Secre tary, sign all obligations authorized by the Council which may be beyond the authority of the Director of Comprehe nsive Areawide Health Planning ; and shall, with the approval of the Council, a~point legal counsel. 3. Vice Presidents A. 4. There shall be five or more vice -r,resi<lents, ·wi10 shall assist the Presid e nt , and shall c0ordinat~ the activities of groups of conuni ttees of the C0uncil. These oli' cers snall be designat e d Vic e -i)resident for Council F'unct:l.0n, Vice President for Liaison and Public Relations, Vice President for Special Needs, Vice P~esident for Project Revi~w, Vice President for Administration, and such othe rs a-s the Council may designat e . Vice Presidents may preside A~ B. 5. A Vice President shall pres1J0 at any fue eting of the Council or Exe cu ti ve Comm i ·~ tee in the a.bsence of the President, and in such case sha ll h a ve all the r e sponsibilitie s and perform all the du t i e s of thq P re sid e nt. The ord e r of pre c e d e nce for th ' s . func t ion sha ll b e : Vice Presid e nt for Council Fun~tion, Vice Presid e nt for Liaison and Public Relations, Vice President for Special Needs, Vice Presid e nt for Proje ct Re view, and Vic e President for Administration. The Vic e P re sid e nt s shall have and p e rform s uch oth~r duti~s as may be assign e d b y the President or by the -Council ; Secretary A. The S e cre tary of the Council sha ll handl e the gen e r a l corres pond e nce o f the Council a nd sha ll c a u se not ice s to be sent of all regular or special meetings of the Council. B. He sH~l~ cause minute s t o b e k e p t of all meet ing s 6 f the Council",,_ and f sha llcsee t ha t . these min u tes 2.re d ist ribut e d to me m5~rs o t h e o uncir w1tn1n a r ea sonable p eriod OL time a fte r e ach meet ing . ! C. He · shall pre side at me etings of the Council in the absence of t h e Pre side nt and the Vic e P re side nts and in such c ase s h a ll h a v e all the r e spons ibili t i e s and pe rfor m . all the duti e s of the Pres id e nt. 10 4 �D. 5. The Secret ary sh a ll h a v e and p e rform such other duties as · may be a s s .i g ncd by the Pres ident or the Council. Executive Committee A. The Execui;.tve Committee shall consist of the President, Vice Presidents and S~cretary of the Council. B. Duties of the Exe cut ive Committee shall be to handle matters pertinent to Co1mcil business during intervals between meetings of the Cou~~il . C. Act:i.c,ns and r c conunendations of the Executive Conuni ttee ,. shall be subject tr Council review and , approval at the riext .meeting of thC:; Council . ARTICLE VII - COMMITTEES 1. Statutory Conunittees A. B. A iiominat i n : C.>m; , :, -:i..t:e shall be elected from members of the c~:mnci ... , with due regard to the makeup of the Cotmcil. The duties of the Nominating Committee sh a ll inc,ucle : 1. Nominating a slate of officers prior to the Annual Meeting. 2. Nominat _ing a new Nominating Cammi ttee prior to the Annual Meeting . 3. Nominating ·organizations, on a rotating basis, which will name members of the Council to take office at the ne~~ Annual Meeting. 4. Nominating replacements for vacancies as they occur. A Personnel Cmnmittee shall be elected from Council membership and the. community at large. The duties of the Pe rsonnel Committee shall include: 1. Recommending selection and salary of Director for Council aciion. 2. Formulating personnel policies, including salary ranges. The Chairman of the Personnel Conunittee shall b e a member <;>f the Council. 2. Other Comm ittees _A. Other standing and ad hoc committees may b e d e sig na te d, elected or appointecf:- 'iis""ne e ded . Ch a irmen of all s t a n din g committ ee s sh a ll be me mbe rs of the Council. - 105 - �ARTICLE VIII- LEGAL COUNSEL 1. Legal counsel shall be appoin t ed by the President with the approval of the Council . All matt ers involving interpre tation of State and Federal law, loc a l ordinances, and tax questions shall be promptly referred to such counsel for opinion and ~dvice. ARTICLE D~ - AUDIT J.. The fiscal records of the ccrnprehe nsive areawide health planning activities shall be audited Annually ~Ya certified public accountant, appointed by the Council. The auditor's r e port sha ll be filed with the records of the " organization. ARTICLE X - GENERAL 1 0 Waiver A. 2. Any notice require d to be given by these By-Laws may be waived by the person entitled thereto. Contravention P.. 3. Notlii.ng :in these By-Laws shall contravene applic a ble rules and r e gulRtions, proce dures, or policie s of th~ U.S. Public Health Service, or of the Georgia Office er£ Comprehensive Heal th Planning. Parliame ntary Procedure A. 4. Publicity A. 5. The latest revision of Robe rt's Rules of Order shall cove r the parliam~ntary proce dure at all mee t i ngs of the Council and of the Committees, where not in conflict with these By-.J.,aws. No publici t y r e l e a se s to the me dia shall b e mad e or authoriz e d by any organiz ation r e present e d on t h e Council, or by any member of the Council without prior clearance by the Director of Comprehe nsive Areawide Health Planning. Acc e ptance of By-La ws A. Any org ani za tion acc e p t ing invit a tion to d esign ate me mbe r s hip on the Council sh a ll by the ir a c ce p tanc e attes t to their active participation and to their agreeme nt to abid e by the se By-Laws. ARTICLE XI · - ADOPT ION 1. E ffe c t ive d ate A. The s e By - Laws s h a ll b ecome e f fe cti ve imme di ate ly u pon adop t ion by the Coun cil. - 106 - �ARTICLE XII 1. 2. - ASSOCIATE AND AFFILIATE MEIIIBERSHIPS Associate Membership A. At the d_i._scretion of the Council, sub-areal compreh ensive ' hea lth councils may be admitted to associate membership in the Council. The Council shall fix general qu a lifications for such associate membership. B. As a condition of associate membership, sub-areal comprehensiv e health councils shall admit to membership all members of the Council residing in the area of the s4bo.real coun c'i l. C. Each associate member council is entitled to send an observer to meeting ."' o · the Counci-1. Affiliate Membersh ip A. At the discretion of the Council, organizations other than sub-ar.cal. comprehens i.ve h ea l th councils may be admitt ed tu 9ffiliate membership in the Council. These may include such organizations as voluntary health agencies, p rofes sional socie ties, citizens' associations for h ealth concerns , etc. The Council shall fix general qualifications fo£ su ch affiliate membership. B. Each affiliate member organization is entitled to send an observer to meetings of the Council. ARTICLE l. XIII - AMENDMENTS ·Method A. These ,By-Laws may be amended or r epe::i led by a majority vot e of the members of the Council present, and voting at any meeting of the Counci l at which a quorum is present, provid e d tha~ written notice of such proposed changes shall have been sent to all members not less than ten (10) days prior to the d ate of such meeting . - 107 - �I' I STEERI NG COMM ITTEE Mrs. Thelma Abbott 521 W. Columbia Avenue College Park, Georgia Dr. Napier Burson, Jr. Baptist Professional Building 340 Boulevard, N. E. Atlanta, Georgia 30312

s.

Hon . S. Abercrombie, Chairmai1 Clayton County Commission Clayton County Courthous e Jon esboro, Ge orgia 30236 Hon. L. H . Atherton, Jr. "Mayor of Marietta P.O. Box 609 Marietta, Ge orgia 30060 Mrs. Mary Jpne Coft'l' 443 Oakl~nd Avenue Atlanta, Georgia 30312 Miss Dorothy Barf i e ld, R. N. Chief Coordinator of Nursing Services Geor gia Department of Public Health 47 Trini ty Avenue Atlanta, Georgia 30334 -~ Mr. G. x.·Barker, Ex. V. P. Interna tional Brotherhood of Electrical Workers Fifth Dis trict Office 1421 Peachtree Street, N. E. Atlanta, Ge~rgia 30309 Hon. Ernest Barrett, Chairman Cobb Coun ty Comfuiis ion P. 0. Box 649 Marietta, Georgia 30060 ' Dr. J. Gordon Bariow, Director Georgia Regional Medic~l Program 938 Peachtfee Stre~t, N. E. Atlanta, Georgia 30309 Mr. M. L_inwood Beck,_ Executive Director Georgia Hea rt Association 2581 Piedmont Road, N. E. Atlan ta, Ge orgia 30324 Mr. Herschel ·T. Bomar, Chafrman Douglas County Commission Doug las County Courthous e l Douglasville, Georgia 3ql34 . Hon. William H. Breen, Jr. Mayor of Decat ur c/o First National Bank Building Decatur, Ge orgia 30030 Appendix E-1 ---~ ., Hon. T. M. Callaway , ~r. DeKalb County Commission c / o Callaway Motors 231 West Ponce de Leon Avenue Decatur, Georgia 30030 Mr . Gary Cu tini, Regional Rep. Health Insurance Council Life uf Georgia Building 600 W. Peachtree Atlanta, ~corgia 30308 Dr. F. William Oowda 490 Pe achtree Stre et , N. E. Atlan ta , Gecrg{a 20308 Mr. J . Wm. · Fortune Mayor oi Lawrencevill e 290 Old Timber Road, S. W. Lawr encevi lle, Georgia 30245 Mr. Drew Fuller Fuller & Deloach 1726 Fulton National Bank Bldg. Atlanta, Georg ia 30303 Miss Jo Ann Goodson, R. N. Wesley Woods 1825 Clifton Road, N. E. Atlanta, Georgia 30333 "Mr. Fted J. Gun ter, Administ~ator Sou th Fulton Hospital 1170 Cleve land Avenue East Point, n eorgia 30344 Dean Rhodes Haverty Ge orgia Stat e Coll ege School of Allied Sciences 33 Gilmer St., S. E. Atlanta, Ge orgia 30303 �Pag e 2 - St ee ring Committ ee Mr. Lyndon A. Wa d e , Fxecutive Dir. Ai lanta Urban Leagu e 239 Auburn Avenu e , N. E. Room 400 Atlanta, Ge orgia 30303 Mr. Maynard Jackson Emory Community Law Firm 551 Forr e st Ro a d, N. E. Atlanta, Ge orgia 30312 Mr. Purch L. Jarrell Route # 1 Box 24 Duluth, Ge orgia 30136 Dr. Robert E. Wells, 1938 Peachtree Road, N. W. Atlanta, Ge orgia 30309 . Hon. Walter M. Mitchell, Chairman Fulton County Commission 409 Administration Building 165 Central Ave nue, S. W. . Atlanta, Georgia 30303 Mr. John L. Moore, Jr. Attorney-at-Law C & S National Bank Building Room 1220 Marietta and Broad Streets Atlanta, Ge orgia 30303 Dr. William W. Moore, Jr. Suite 616 1293 Peachtre e Street; N. E. Atlant~, Ge orgia 30309 Mr. A. B . Pad g ett, Trust Officer Trust Company of Ge orgia P . 0. Drawe r 4655 Atlanta, Ge org ia 30302 ' Mr. Dan Swe at Assistant ~o Mayor City of Atlanta City Hall Atlanta, Ge orgia 30303 Dr. Charl e s B. T ~al, Jr. Gwinnett Co~nty He alth De partment 300 South Clayton St. Lawrenceville, Ge orgia· 30245 Mr: Bil~ Traylor _ 1397 Ox ford Road, N. E. Atlanta, G~orgia 30307 Dr. T. 0. Vinson, Dir e ctor DeKalb Coun t y He aith De partm e nt 4 4 0 Winn Way De catur , Ge or gia 30033 Appe ndi x E-2 . Joseph A. Wilbur, M. D . 615 Peachtre e Stre et , N. E. Atlanta, Ge orgia 30308 Mrs. Dal by Bigsby 585 dibbons Drive Scottdale, Ge orgia �MEMBERS OF EXECUTIVE COiV!MITTEE OF COMMUNITY INVOLVEMENT STEERING COMMITTEE ., FOR AREAWIDE COMPREHENSIVE HEALTH PLANNING:. NA.ME Hon. Howard Atherton · Mr. Linwood Beck Hon. Thomas Callaway AFFILIA'l 'ION Mayor of Marietta Director, Georgia Heart Ass::, c. Commissioner, DeKalb Ccutlty Mr. Drew Fuller Chmn. Health Committee, A.tl. C. of C. Mr. Fred Gunter Administrator, So. Fulton Hospital Hon. Walter Mitchell Chmn., Fulton County Com..111is 1:: iu'c Mr. A. B. Padgett Chmn, CHP Steering Committee Dr. Osbar Vinson · Director, DeKalb Boa rd of Health Mr. Lyndon Wade Director, Atlanta Urban League Dr. Robe rt Wells Chmn. Fulton County Me d. Soc. Board "\ ~ppendi x E-3 VIEi','.POEiT municipalitles voluntary agencies Maclog commerce hcispit a ls COlli"l"t.Y govts. Commun:;ty Council Public Health conswne rs medical professions �