Box 3, Folder 15, Complete Folder

Text Item Type Metadata

Text





Community
Council of the

Atlanta.

Area inc;

Eugene T. Branch. Chairman of the Board
Duane W. Beck. Executive Director

1000 Glenn Buildin .Atlanla. Georgia 30303
Telephone [404] Sig-2250

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Raphael B. Levine. PILD. Director

VOLUME 1

IN THE BEGINNING—THE LAW

Public Law 89-749 is cited as the "Comprehensive Health Planning
and Public Health Services Amendments of 1966", and declares the
following to be its findings and declaration of purpose.
Sec. 2 (a) The Congress declares that fulfillment of our national
purpose depends on promoting 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 depends on an effective partnership,
involving close intergovernmental collaboration, official and
voluntary efforts, and participation of individuals and organiza-
tions; that 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
professional practice of medicine, dentistry, and related healing
arts. (b) To carry out such purpose, and recognizing the changing
character of health problems, the Congress finds that com-
prehensive planning for health services, health manpower, and
health facilities is essential at every level of government; that
desirable administration requires strengthening the leadership and
capacities of state health agencies; and that support of health
services provided people in their communities should be broadened
and made more flexible.

THE SALUBRIOUS WIND
STOCKING OF CHANGE



Vision of social and health planners of the Community Council of
the Atlanta Area, Inc. (CCAA), made it possible for the Atlanta
metropolitan area to be the first area in Georgia to receive an
“organizational grant”'for the purpose of defining and developing
an agency which will be capable of doing comprehensive health
planning and obtaining broad community support and
participation in the planning effort. This grant, from the United
States Public Health Service, through the Georgia Office of
Comprehensive Health Planning, supports the CCAA in the pro-
fessional and organizational effort necessary to instigate such an

organization.

The term “comprehensive” means that every aspect of the health
landscape in the six-county metropolitan area must be taken into
account in the planning process. This includes not only the
treatment of illness and injury but the prevention of same as well
as compensation for any lasting effects received. In addition to the
manifold activities of medical and paramedics] personnel in the
variety of health treatment facilities, planning must consider
environmental controls of air, water, soil, food. disease vectors,
housing codes and construction, and waste disposal. Needs for
training of health personnel. for improvement of manpower and
facilities utilization, and for access to health care must be
considered. The fields of mental health. dental health. and

rnimhililalirsn cl-u'nllr'i Inn inrslnrlnri ’T‘lnnm mun Lin unmannt "kind tlm

alloys F. Brenton. MBA. associate Director

June , 1969



Cynthia R. Montague. Editor

NUMBER |

The Partnership for Health Law requires that Such planning be
done with people rather than E people. Therefore, maximum
participation of health “consumers", health professionals.
governmental units and agencies, and other community organiza-
tions is a necessity. The law is telling the states and communities
that they will be given increasing responsibility and power to
determine their own best health interests, and that the current
Federal practice of funding health-related projects through specific
project-type grants will phase into a system of “block" grants to
the states for use as local emphasis requires. Eventually, only
communities which have organized themselves for comprehensive
health planning may be eligible to receive Federal support.



Ideas of excellence need corresponding institutions; the
Comprehensive Areawide Health Planning Project is an example of
such an idea. Such ideas need feet and so the pioneering march has
begun towards healthful social change of a magnitude never before
undertaken.

, THE CONVENORS





Eugene T. Branch. Chairman,

Board of Directors, Community Area Joint Health Professionals

Council of the Atlanta Area. lne. Committee on Comprehensive
Health Planning

Dr. Robert E. Wells. Chairman,

Gilbert Ft. Campbell..lr..
Chairman. Metropolitan
AreaCounciI of Chambers
of Commerce

A necessary step in the organizational development of the
Comprehensive Areawide Health Planning Project was the
convening of a large “Community Involvement Panel". to which
approximately 170 representatives of agencies, organizations. and
governmental units were invited: In order to indicate the breadth
of concern for health planning in this community. three major
groups collaborated in issuing the invitation. and hence. became
the “convenors” of the Panel. Shown are the chiefofficcrs (left to
right) of the three groups: Eugene T. Branch, Chairman of Hit“
Board of Directors. Conununity Council of the Atlanta Area. Ines.
Dr. Robert E. Wells. Chairman of the Arcs Joint Health; Pro-

fessionals Committee on Comprehensive Health Planning (iilhcrt
p P‘Jmnkn“ Ir

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DIRECTOR'S REPORT



Raphael B. Levine. PhD.

On Thursday, June 5th, the long process of “community
involvement" came to a successful climax, when the new
“Metropolitan Atlanta Council for Health" met for the first time,
and formally accepted the responsibility for guiding the destinies

of comprehensive health planning in this six-county metropolitan
area. The membership of the Council represents in the truest sense

the “partnership for health” concept which is the basis of Federal
support of comprehensive health planning. Local governments,
major planning agencies, health providers, health consumers, public
and private medicine, voluntary health agencies, poor and middle
class, black and white, are all present on the Council. Moreover,
they were selected for Council membership in the spirit of today’s
participatory democracy, rather than being appointed by a select
body. I am enormously pleased with the caliber of this body of
citizens, who will be making policy decisions on health matters for
this community. I am convinced that, although they come from
many different walks of life, they will function as the 18th
Century Statesman, Edmund Burke, expected of the British
Parliament:

“Parliament is not a congress of ambassadors from different and
hostile interests, which interests each must maintain, as an agent and
an advocate, against other agents and advocates: but Parliament is a
deliberative assembly of one nation, with one interest, that of the
whole—where not local purposes, not local prejudices, ought to
guide, but the general good, resulting from the general reason of
the whole. You choose a member, indeed; but when you have
chosen him, he is not a member of Bristol, but he is a member of
Parliament.”

ORGANIZATIONAL EFFORT

The work during this organizational year has fallen into two major
fields: (A) identification of the technical aspects of community
health planning, and (B) development of an organization gagency
capable of carrying out comprehensive health planning on a
permanent basis.

A. Technical Asgects

The principal technical objectives of this project are (1) to identify
the community‘s principal health 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 numbers and qualifications of the technical
staff who will be needed to carry out such planning. Two of the
numerous activities undertaken by the staff and volunteers which
bear on these objectives are (a) developing a “systems approach" in
planning for the health field, involving cost-benefit analyses, and
the building of community health “systems models”, etc.; and
(b) the use of volunteer “task forces" to identify and scope health
problems through descriptions of problem areas,trends,resources,
obstacles, and suggested solutions to the problems. A great deal of
thanks is due to these hundreds of volunteers, both health
professionals and other concerned citizens, for their efforts,
expertise, and insights into the health picture of this community.

B. Organizational Development

The principal organimtional objectives of the project are tl)to
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organization, and (2) to devise an organizational structure for such
operation, including corporate identity. policy Council, and the
means of selecting the Council and writing its by-laws. Two of the
activities undertaken in this field are (a) identification of
community interest and decision groups involved in health
activities, and holding literally scores of meetings with them; and
(b) working out the detailed plans for permanent agency and
obtaining acceptance and endorsement of them by important
groups in the community: governments, health officials and
consumers‘ groups.

COBB COUNTY HEALTH
ADVISORY COUNCIL ESTABLISHED

In tune with the Comprehensive Areawide Health Planning
concept, the Cobb County Health Advisory Council was recently
born. The infant Council has the charge of determining the
county’s health needs in order of priority and how such needs
should be met. Mr. William Thompson, Administrator for the Cobb
Health Department, and Chairman of the newly formed Council
has cited four areas of concern: service, manpower, financesand
facilities. The idea of such Health Advisory Councils grew out of
the Partnership for Health Legislation of 1966 which established a
program of providing matching funds to help communities obtain
needed health services and facilities. Says Dr. Raphael B. Levine,
Director of the Metropolitan Atlanta Comprehensive Areawide
Health Planning Project, “Citizen participation in health planning
at the local level as well as the metropolitan level is essential to a
successful community-wide effort. It is most encouraging that the
Cobb County Health Advisory Council has been formed", he
concluded.

BACKGROUND—Dr. Raphael B. Levine

Dr. Raphael B. Levine was educated at the University of
Minnesota. There he received a Bachelors and Masters degree in
Physics and a doctorate in biophysics. His recent professional work
has consisted of developing “intelligent“ computors which can
learn to recognize patterns of behavior in complex systems
(biological or physical). Some of his previous research activities
concerned man‘s reaction to physical and emotional stresses of
atmospheric and space flight, as well as the electricalaetivity ofthe
heart and brain. He has taught and done research at the University
of Minnesota, the University of Illinois, and Ohio State University.
Since 1958, he has been managing and performing research in the
Human Factors laboratory and the Systems Sciences Research
Laboratory of the Lockheed-Georgia Company. In I968, he
became the consultant to and then the Director of the Compre-
hensive Areawide Health Planning Project for Metropolitan Atlanta
under the Community Council of the Atlanta Area, Inc. He is

currently serving as President of the Planned Parenthood Associa-
tion of the Atlanta Area.

BACKGROUND—Alloys F. BrantonI Jr.

Alloys F. Brenton, Jr., was educated at the University of Minnesota
where he received a Bachelor of Arts Degree, and at the University
of Chicago where he received a Masters Degree in Hospital
Administration. He was Health Division Secretary of the Council of
social Agencies of Greater New Haven, Inc., New Haven.
Connecticut. Next. he served as a Health Consultant to the
Community Health and Welfare Council of Hennepin County. Inc.
Minneapolis, Minnesota. He came to Atlanta as Assistant Director
of the Hospital and Health Planning Department Community
Council of the Atlanta Area, Inc. He is now Associate Director ot
the Comprehensive Arcawitle Health Planning Project. He also has

an appointment as adjunct faculty member Course in Hospital
Mmirm‘hvm Q. 1-1- \..1.I .J- D I.





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Altoys F. Brenton. MBA. Associate Director

Raphael B. Levine. Ph.D. Director

VOLUME l

MACHEALTH NOMINATING AND
PERSONNEL COMMITTEES

Two very important committees were selected at the October
meeting of MACHealth by nomination and vote of the member-
ship. The Nominating Committee will propose a slate of officers
for the first Annual Meeting and election in January. The work of
those officers will, to a great extent, determine the success of
MACHealth in its first full year. Another duty ofthe Nominating
Committee will be that of selecting organizations who will name
members to MACHealth in subsequent years. This will be done by
collecting and evaluating a list of eligible groups in categories to
be represented. A fair rotation and equal representation will be
achieved in this way.

The Personnel Committee will select and recommend to the
Council a candidate for Director of the Agency. It will also set
personnel policies for the MACHealth staff.

Members newly elected are:

Nominating Committee

Hon. L. Howard Atherton, Mayor of Marietta. He is also Presi-
dent, Georgia Municipal ASSociation. member of the Georgia
House of Representatives, Chairman of Metropolitan Atlanta
Council of Local Governments. He has been a tireless supporter
of MACHealth since its early inception.

Mr. A. B. Padgett, Chairman Pro Tem of MACHealth. A Trust

Officer of the Trust Company of Georgia, Mr. Padgett is on the
Executive Board of the Community Council and was Chairman of
the Steering Committee for the Comprehensive Health Planning

Project.

Dr. Robert E. Wells, Chairman of the Board, Fulton County
Medical Society. He is an orth0pedic surgeon, and directed the
Joint Health Professionals Committee for Comprehensive Health
Planning, as well as participating on the Executive Committee of
the early Steering Committee.

The Rev. Ervin B. Broughton, member of the Governing Board,
Gwinnett County E.O.A. A retired Baptist minister, Rev.
Broughton still pastors two churches, is a Mason and President of
his Lodge, and works in his community for improved social

conditions. He is a lifelong resident of Lawrenceville.

Personnel Committee

Hon. Walter M. Mitchell, Chairman, Fulton County Board of
Commissioners and Executive Committee member of the Steering
Committee.

Mr. Drew R. Fuller, Chairman. Health and Health Services Com-
mittee, Atlanta Chamber of Commerce. He was also on the
Steering Committee’s Executive Corrunittee and has devoted
much time and effort to the organization and success of

MACHealrh.

Mr. J. William Pinkston, Jr., Administrator, Grady Hospital. He
has given many hours in service to the concept oi Comprehensrve
l-Icallh Planning and in furthering its support.

Mrs. Loretta Barnes. Secretary Pro Tem of MACHealtli. Her
yemnan service to the Council has been evident front the start.
and is unselfishly given in addition to her work for the Inter-
tleIIominanonal Theological Seminary and as a busy mother.

MI. Paul (adenhead. iiwyer Ill private practice. PFLSIl-lL‘HI clccl
Allnula Btu AssoeiaIIoII past pIesrdcnl oi Loth Atlanta Mental
ilc: lllll Asmaeialion and (Jcoigin Asswi; moo Ioi Mtnl; Ii Health.

November,

C ommunity

Council of the
Atlanta

Area. inc.

Eugene T. Branch. Chairman of the Board
Duane W. Bee it. Executive Director

1000 Glenn Building Atlanta. Georgia 30303
Telephone (404} 57'!- 2250

[III l'lllNllIllll I'lllllllll

Cynthia R. Montague, Editor

1969 NUMBER VI

MRS. ELIZABETH C. MOONEY

Vivacious Mrs. Elizabeth C. Mooney is a member of MACI-Iealth.

She was appointed to the MACHealth Board by Economic Oppor-
tunity Atlanta to represent the poor and
near-poor. She resides in the Antoine
Graves Homes, is secretary of the local
Citizens Neighborhood Advisory Council
(CNAC), and a member of the Atlanta
EOA Health Committee.

., _ Despite the absence of her larynx she
3 manages to Speak quite audibly and

“‘i- eloquently whether she 15 conversing with
Senator Russell in Washington about the
" welfare freeze or passing the time of day
- with someone on the street in Atlanta.

- - Mrs. Mooney, a retired nurse has stood
the test of survival for 64 years and is still going strong. She has
battled a heart condition, cancer, diabetes and low blood pres-
sure; she triumphs almost weekly over debilitative conditions ofa
more ephemeral nature such as eye trouble and toe infections.

Mrs. Mooney’s hobby is working with people. She is always
there, giving of herself; sometimes in the form of a flower
arrangement which she has designed with herpwn hands, at other

times, simply uttering comforting words from the heart.

Mrs. Elizabeth C. Mooney—humanitarian, friend of Grady
Memorial Hospital, valuable member of MACHealth.

J

CONTRIBUTIONS FOR 1969 EFFORTS RECEIVED

We acknowledge with thanks the recent contribution of the
Clayton County Commission of $2280 toward the current year’s
operations of the Comprehensive HealthPlanning Project. We are
also pleased to report that the Gwinnett County Commission has
appropriated $i'r'48 for the same purpose. These amounts, added
to previous receipts from Fulton, DeKalb, and Douglas counties.
plus gifts from private sources. have made pOssible the work of
the project to date. Such local funds have served to “match“
equal dollar amounts from the U. S. Department of Health,
Education, and Welfare.

MENTAL HEALTH HOUSE BILL NO. 1
Frank Adams Smith

In 1958, the General Assembly made a major revision in the law
relating to hospitalizing the mentally ill. according to recom-
mendations of the Joint Senate~House Mental Health Committee.
chaired by Peyton Hawes.

Other minor revisions were made in Who and 1964. In [969.
another major revision. House Bill | . was enacted.

In the 1969 Act, the procedure for Voluntary Admission and the
judicial procedures for [nvoluntary Admission are substantially
[he same as in the current law.

While the protection of "rights of the patient“ was a predominant
characteristic of the W58 Act and Lil succeeding Acts. the late)
Law extends and broadens this protection.

The 1950 Act provides for emergency care up to 34 hours. and
for evaluation and lillL‘ilStVL‘ treatment up In 5 days; and liinlls‘
further lIosrntulIqu-n to an Initial s1\' niuIIIlIx Arltlitmnal
huspilulimllon can he wnI'ILIIIIeIi iI|1l\ in thorough L'\i!IlIl|llIItIIrI



of the patient indicating such need and by the authorization of
the Court of Ordinary. The patient, his attorney, guardian or
representatives, if they desire, can request a hearing.

Emergency care, evaluation and treatment for a period ofS days,
and limitation of hospitalization, have not been provided in any
prior law. Emergency care and evaluation plus short-term in-
tensive treatment should prevent at least 50% ofthe patients now
going to Central State Hospital from having to go there.

The limitation to six months of the initial order for hospital-
ization forevermore bans the “putting away for life" of any
mentally ill person.

The philosophy of the 1969 law, simply stated, is that the men-
tally ill are in fact “ill” and should be treated as sick people and
should have immediate and intensive care and treatment. This
philosophy is identical with the philosophy of comprehensive
mental health services enunciated by Congress in 1963.

The metrOpolitan Atlanta area is fortunate in having a Regional
Hospital which will be both an Emergency Facility and an Evalua-
tion Facility. Also Grady Memorial Hospital is now performing
the functions of an Emergency and Evaluation Facility.

The governing authority of each county can choose between the
“medical procedure," which is outlined in the new law, and the
“judicial procedure" which is essentially the same as in the cur-
rent law. No formal action is necessary for a county to operate
under the “medical procedure" of H.B. l,but formal resolution
by the governing authority is necessary to function under the
”judicial procedure.” Such action can be taken only once a year.

In every step of the “medical procedure,” the patient and repre-
sentatives are notified of his right to an attorney, which the
county must provide, if the patient is unable to pay for such
services. The patient, his representatives and attorney are notified
of patient’s right to judicial intervention at any time they think
his rights are abrogated.

The sections of the law relating to “rights of patient” became
effective June 1, 1969. The remainder of the law becomes
effective January l, 1970.

Quote

How can we get more participation in solving environmental
health problems? By encouraging community leaders to come to
the Health Department and other agencies to learn all they can
about the environmental health needs and then to approach the
governmental officials in quest of meeting these needs.

Clifford Alexander,
Environmental Health Planner

DI RECTOR'S REPORT

Raphael B. Levine, PhD.

At the October meeting ofMACHealth, the Council voted,after a
spirited discussion, to approve the changes in language dealing
with the responsibilities and influence of the new agency. A large
majority of the members agreed with the committee appointed to
negotiate the wording, that the new language fairly states the role
of MACHealth in the health affairs of the six-county area. Several
of the members felt, however, that MACHealth should play an
even more influential role than indicated. lbelieve that all ofthe
MACHealth staff and Council members want this new agency to
he just as effcclivc as possible, since the needs for comprehensive
planning were never greater than at present. in fact. MAClvlealth
has already been able to influence rather strongly some very
important issues in the hospital and nursing Ironic field, and the
Council‘s power of review of all locally-originated action projects
in the health field will continue to work toward a truly compre—
hensive. truly arcawidc kind of health planning.

With the new wording approved. the staff was able to enter the
final stage of revising our proposal for funding hy the Federal
Department of Health. Education. and Well—arc. When completed.
flit." proposal will he published ill :I single hintling. although the
division into Ilu'cc volumes lpr'ojccl summary. budget and stall.
and tasl. ionic rcporlsl will continue. We expect to print about a

l
thousand of these volumes, at d hrill be surprised if the demand

for copies is any less than this number.

MACHealth is continuing to receive recognition from additional
important agencies: governments, medical professional associa-
tions, hospitals, voluntary organizatiOns, and the like. Since June,
some 13 such agencies have added their recognition to the 45
who had done so by that date. The list now covers nearly all of
the important health action agencies, as well as many of those
concerned with matters closely related to health.

MORE AIR CURRENTS

Four people active in MACHealth affairs have recently been seen
on the area television media: Mr. A. B. Padgett and Dr. Raphael
B. Levine were seen on separate programs on Channel I] in the
series produced by the Urban Life Center of the Georgia State
University. Mr. Duane W. Beck was a recent guest on the Ruth
Kent “Today in Georgia" show, speaking about the Conununity
Council of the Atlanta Area. Mr. Louis Newmark was interviewed
by Linda Faye on Channel 11 in connection with a session of the
State Conference on Aging of which he was chairman entitled
“Involvement of Older People in the Community.” The ap-
pearances of Dr. Levine on Pat Wilson’s “Tempo Atlanta” show
(Channel 36) began, and are scheduled to continue with a
monthly appearance at 11:30 AM. on the fourth Thursday of
each month hereafter.

ENVIRONMENTAL H EALTH TOU R

The Environmental Health Tour as presented in the August,
1969, Newsletter will be held on Thursday, November 13, 1969.
Notices with further details will be sent to all MACHealth
members before that time.

MACHEALTH MEETING DAY CHANGED

The MACHealth meeting day has been changed by action of the
Council to the second Thursday of each month. This was done in
order to avoid a conflict with the Executive Committee of the
Community Council of the Atlanta Area, Inc., which meets the
first and third Thursday of each month.

MRS. KATHARINE B. CRAWFORD—Trothplighted

.1

Comprehensive Areawide Health
Planning’s Organization Liaison, Miss
Katharine B. Crawford, has left the
organization to become the bride of Dr.
Marvin D. Smith. The bride and groom
will reside in Gadsden, Alabama where he
has established a practice in
Ophthalmology.

Miss Crawford has made a tremendous
contribution to the efforts of
Comprehensive Health Planning and her
presence will be missed by her friends and
co-w0rkers. The best life has to offer is
wished for her and Dr. Smith.

BACKGROUND—William F. Thompson—Consultant

A hardworking member for MACHealth is William F. Thompson.
Administrative Officer of the Cobb County Health Department.
He finished secondary school at Young

Harris Academy. going on to Piedmont

College for a Bachelor of Arts Degree in

malhernatics and education, He was

awarded a National Science Foundation

Scholarship in Washington University and

received his Master's Degree in Public.

Health Administration front the Univer-

". sn), ol‘ North Carolina. He has been :1

.‘ '. tuhcrculr'usis investigator; Director.
r 'uh‘zg' Medical Self Help Program; and :In
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June 2, 1969

Hon. Ivan Allen, Jr.
Mayor of Atlanta

City Hall

Atlanta, Georgia 30303'

Dear Mayor Allen:

This is to inform you of activity taking place since my earlier letter to
you on the subject of your membership on the new Metropolitan Atlanta
Council for Health. There has been a slight change in the meeting time
of the Council because of room assignment confliCt. The £3.11 m sting

of the Council will be this Thursday at 11:90 5. M., in'room 519 of the
Glenn Building, 120 Marietta Street, N. W., Atlanta, Georgia.

The principal business of this Council meeting will be to discuss and
-approve the proposal to be submitted to the U. S. Public Health Service,

and to certify that the-Council accepts responsibility for the policy aspects
of comprehensive areawide health planning in this metropolitan community,
beginning in January 1970. Additional business will be to discuss and approve
Council By—Laws, and to approve a program of activities for the balance of
1969. These are recommended to include (1) meetings, seminars, and field
trips for familiarization of Council members with health problems of the
community and the types of action the Council can take; (2) the naming of

a Personnel Committee for the purpose of selection of a Director of
Comprehensive areawide Health Planning and the recruiting of staff prior

to the beginning of operations in January 1970; and (3) the naming of a
Nominating Committee for presenting a Slate of permanent officers to the
first Annual meeting in January, 1970.

Enclosed with this letter are Volumes I and IIIJof the Proposal, as they

now exist. Additional material is still-coming in, but the pages you have
before you include all of.the vital material.on which your approval is

being asked. Volume II of the Proposal contains detailed budgetary material,
and will be covered at the meeting. I would like to-invite your attention
'eSpecially to_the following pages in Volume I: i - ii, 2-3, 8—9, 16-l7,
48-49, 54-55, 64—65, 88—89, 90—91, 92-93, 96~97,.98—99, and the By—Laws
100"107'- Please read as much of_the other material as you may have time for.







ATLANTA METROPOLITAN AREA

COMPREHENSIVE HEALTH PLANNING

PROPOSAL

VOLUME III

TASK FORCE REPORTS
hi

Submitted by

METROPOLITAN ATLANTA COUNCIL OF LOCAL GOVERNMENTS

20 June 1969



This is an incomplete edition of VOLUME III,

PROPOSAL FOR COMPREHENSIVE
HEALTH PLANNING

Other work is in process of completion.



TABLE OF CONTENTS

Responsible
Task Force Staff Member

Manpower Branton
Mrs. Frances Curtiss, Chairman

Manpower Shortages in Allied Health Professions

Home Health Care Roberts
Edwin C. Evans, M. D., Chairman
Health Problems Compounded with Socio—Economic Bush

Problems
Mrs. Ella Mae Brayboy, Dr. P. w. Dowda, Chm.

Maternal and Child Health, Family Planning Levine
Dr. Conrad, Chairman

Better Mental Health for the Atlanta Area Smith
James A. Alford, M. D., Chairman

Control of Air, Water Pollution_and Waste Disposal Alexander
Bernard H. Paley, M. D., Chairman

Proctor Creek — Case Study of Multiple—Impact Alexander

Health Hazards .
Otis W. Smith, M. D., Chairman

Public Health - Budgets, Boundaries and Personnel Thompson
Wm. F. Thompson, Chairman

Vector Control Alexander
Mrs. Helen Tate, Chairman

Emergency Health Services — The Systems Approach Alexander
Dr. George Wren, Chairman

Prevention of Accidents Alexander
Mr. Max Ulrich, Chairman

Medical and Dental Service/Information and Referral Bush
Dr. Robert Wells, Chairman .

Alcohol and Drug Abuse Smith
Mr. Bruce Herrin, Chairman

Balancing the Costs of Health Care Bush
Mrs. Harriet Bush, Chairman

Coordination of Planners Bush
Mrs. Harriet Bush, Chairman

Suicide Prevention - Crisis Intervention Smith
W. J. Powell, Ph. D., Chairman .

Mental Retardation Program Needs Smith
Mr. G. Thomas Graf, Chairman

Parks and Recreation Alexander

Rehabilitation Branton
Mieczyslaw Peszczynski, M. D., Chairman
Environmental Effects on Social and Economic

Processes Alexander
Mr. Clifton Bailey, Chairman

Environmental Effects on Mental Health Alexander
Mrs. Faye Goldberg, Chairman





Table of Contents, Cont'd.

Task Force

Home Sanitation
Mrs. Helen Tate, Chairman
Food Service Program

Mr.

G. DeHart,

Chairman

Responsible
Staff Member

._I_,_._.———

Alexander

Alexander

Page



46

48

FOREWORD TO VOLUME III

The descriptive reports in this volume represent the efforts of some 27
"task forces" organized to assist the comprehensive health planning staff
in identifying the Atlanta area's health problems in sufficient detail

to project the scepe of the first year of effort by the permanent planning
staff. Several hundreds of area citizens, both health providers and
health consumers contibuted their time, expertise, and insights in the
preparation of these reports. Although in many cases, the task force
reports were quite detailed and voluminous, all have been condensed for
inclusion in this volume. The points of view expressed in these reports
are those of the task forces themselves, and their recommendations deal
with the specific problem areas, rather than with the total community
health situation. As input to the total planning process, these are valuable
documents, and the staff expresses great appreciation to the task force
chairmen and members.



Manpower Shortage in Allied Health Professions

SUMMARY:

EXISTING VACANCIES WILL INCREASE ALARMINGLY WITH POPULATION GROWTH UNLESS
MORE INDIVIDUALS ARE ATTRACTED AND RETAINED. THESE PROFESSIONS SHOULD BE
UPGRADED AND PUBLICIZED: EDUCATIONAL OPPORTUNITIES SHOULD BE DEVELOPED,
AND TRAINING PROGRAMS COULD USE FINANCIAL SUPPORT. SYSTEMATIC EVALUATION
OF EXISTING AND FUTURE NEEDS AND RESOURCES SHOULD BE DETERMINED AND UTILIF
ZED AS THE BASIS FOR A COMPREHENSIVE EFFORT TO CORRECT THESE DEFICIENCIES.

Problem:
Demand grows faster than supply. Why?
—-While existing vacancies are distressing,
—-Popu1ation increases create new needs;
——Public and professional awareness of these professions
is minimum;
——Required education (B.A. or corresponding degree) is not
within the financial reach of many;
--Professiona1 dedication is exacting;
Y E T
VOCATIONAL BENEFITS,
CAREER OPPORTUNITIES AND
PRESTIGE are inadequate.
-4Training programs are still in the development stage in Georgia;
——Communication and coordination needed to unite all related
health care groups behind a study and solution of this problem
is lacking;
——Funds to deve10p programs, Sponsor students; for research and
patient care are not available.
——Accurate assessment of all needs - present and future, has not
been made.

Resources:

There are clinical, medical, rehabilitation facilities which provide
practical training, and while the number is increasing, further expansiOn
will be necessary.

One graduate and two undergraduate programs in Allied Health Profess—
ions are presently under development, but these will require time to grow
and graduate trained individuals. Even these, however, cannot fulfill
the number or variety of available positions. 2
Solutions:

Undertake systematic analysis of the entire problem to serve as a
realistic basis for planning and corrective action.

Provide financial support, develop career incentives, arouse public/
professional interest in and for these professions.

Develop transportation and communication networks in all areas:
patients, employers, health professionals, institutional, organizations
and associations, public and private agencies.

Empahsize broad health service rather than: crisis oriented care.

Improve and expand hospital and rehabilitation facilities to assist in
training and improve use of present personnel.

Mount an aggressive campaign to recruit and retain — even recall —

existing personnel.







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NUMBER OF REGISTERED ALLIED PROFESSIONAL PERSONNEL IN GEORGIA AND IN T1115:
I I ATLANTA METROPOLITAN AREA

Georgia Metropolitan Area
4,000, 000¢——- population —.p 1,300,000
135_ Physical Therapists—75
9,092 (3,267}i'—Nurses—-—-fi3,865 (1,477)
40"“— Oceupational Therapists—#19
1,000—— Social Service—+500

(100 students included)

175; Speech Pathologists flTS¥

{i (inactive)

4(pub1ic schools included)

Ml



Home Health Care

SUMMARY:

THE PAUCITY OF HOME HEALTH SERVICES IN THE ATLANTA AREA LEAVES MANY
PATIENTS WITHOUT NEEDED CARE, CREATES SERIOUS BOTTLENECKS IN INSTI-
TUTIONS, AND LIMITS PHYSICIANS IN THEIR CHOICES OF SETTINGS WHERE

PATIENTS CAN RECEIVE ADEQUATE CARE. THE ANSWER LIES IN THE AMAL~
GAMATION OF ALL PROVIDER AGENCIES.

Text Outline:
* We DO have:

i duplication, fragmentation, and threats of further
proliferation;

i increasing service needs due to upward trends in popu—
lation growth, longevity, institutional costs and man-
power shortages;

seven agencies serving fewer than half of the patients
who need services;

obvious gaps in services to the sick and disabled at
home,

fairly adequate services for protecting the general
community health, and

interest and concern for better coordination, primarily
due to activity under-special projects over the past
three years.

DO NOT have:
a a central coordinating and research unit;
I the most efficient, economical, and effective utili-
zation of our limited supply of personnel;
a whole-hearted cooperation and trust among agencies,
institutions, other providers, and consumers;
i insurance exchange to provide payment for home care in
lieu of hospital care;
i a structure to provide central information, liaison, and
easy access to care;
i designated responsibility for the expansion and develop-
ment of comprehensive personal care services at home; and
a a well balanced range of services.
-K Specific charge to comprehensive health planning:
* Long Range: agressive action to amalgamate s11 agency
previders of home health services; and
i Immediate: central coordination and establishment of
research and education programs in home
health services.







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Meeting Health Problems Compounded with Socio—Economic Problems

S UTu‘HithY :

THE POOR AND DISADVANTAGED SUFFER INEQUITIES IN HEALTH LEVELS AND CARE
EiUND‘rIR EXISTING INSUFFICIENT, INCONSISTENT AND UNCOORDINATED ARRANGEMENTS
EWUICH ALSO'DO NOT CONSIDER THE ALMOST INSEPARABLE SOCIAL, ECONOMIC AND

CULTURAL PROBLEMS. A SYSTEM BASED ON IMPROVING LIVING CONDITIONS, HEALTH

EDUCATION, AND CITIZEN PARTICIPATION WOULD PRODUCE MORE PERMANENT RESULTS
WHILE MORE EFFECTIVELY UTILIZING PUBLIC FUNDS.

Problem:

Poor sanitation, inadequate and improper diet invite and perpetuate
health problems.

The under and improper use of health services and resources lend to the
seriousness and aggravation of health services and problems.

Quality of housing and overcrowding are related to certain diseases,
accidents, and mental disorders.

All of these primary social and physical conditions are character-
istic of the economic poor.

Health care tends to be piecemeal, poorly supervised, and uncoordinated.

Current Resources:

Public Health Department programs, services, facilities

Federal outlays of $465,453,901 in 1968 (HEW, HUD, 0E0)
' Charity hospital with more than one thousand beds

Local and State Government contributions

Over twenty health-centered voluntary agencies

Solution:
A health centered approach to these problems should:

nplan together with other social institutions, programs, and movements
to develop adequate and safe living conditions in the areas of homelife,
housing and neighborhood, transportation, health and general education,
business and industry, legal arrangements, health resources, etc.; and

nencourage the development and improvement of medical resources and

programs to meet technological, organizational, cultural, geographical,
numerical considerations of what our society needs.

Trends:

Indications are that as things go, "the sick get poorer and the poor
get sicker." In turn, it is their voice which is seldom heard and
frequently not interpreted into programs designed for them.



PROBLEMS IDENTIFIED FDR COMPREHENSIVE HEALTH
PLANNING BY A SAMPLE OF LOW—INCOME RESIDENTS

Meeting 1 2 3

6 7
Problem County G F G F F
8 1

Present 24 15 10 8

HEAUTH

Knowledge of Services

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Trash, litter, refuse

Emer1enc Care
Discrimination at Hospital

Insufficient Personnel
Inadequate Services

Sewage
Garbage and Hats

Limitation of Charit Care

Special Envioronmental Heed

Health Problems Total

HEALTH RELATED

Finances
Transportation

{Garbage Service
Code Enforcement
Housing

Street Lightin:
Fire Hydrants

Housekee in
Mental Releasee Employment

Health Related Problems Total
All Problems Total

G=Gwinnett County =mild concern
F=Fu1ton County =high concern

Problem Indicators:

ATLANTA (SMSA) , 1960:

Overall:
Families with income under $3,001
Unsound housing units
In Depressed areas:
Families with income under $3,001
Persons per residential acre
Non-white:
Percent of total population
Median income
Median years of education



Title: Better Mental Health for the Atlanta Area

SUMMARY:

MENTAL HEALTH PROBLEMS GENERALLY ARE CAUSED BY STRESSES AND STRAINS ON PERSONS AND ARE DUE TO ENVIRONMENTAL,.
PHYSICAL, SOCIAL, ECONOMEC, EDUCATIONAL AND OTHER FACTORS. ONE OUT OF TEN PERSONS COULD BENEFIT BY RECEIV-
ING SOME FORM OF MENTAL HEALTH SERVICES. BUSINESS AND INDUSTRY BUFFER HEAVY LOSSES FROM THE IMPACT OF

MENTAL ILLNESS ON EMPLOYEES AND THEIR FAMILIES. SURVIVAL OF OUR DEMOCRATIC INSTITUTIONS IN THIS HIGH ENERGY
NUCLEAR AGE MAY WELL DEFEND ON MOBILIZING THE RESOURCES OF EVERY COMMUNITY TO FIGHT AND PREVENT MENTAL DIS- '

ORDERS AND TO PROMOTE POSITIVE MENTAL HEALTH.

Problem:
130,000 inhabitants of the metropolitan area (10% of population) could lead happier more effective lives
if they had the benefit of modern mental health services.

Ten percent-of school children have handicapping emotional and psychological problems. These children
need help towards self-realization.

Heavy loss by business and industry in the metropolitan area due to impact of emotional and psychological
disturbance on worker and family, can be drastically reduced by a comprehensive system of modern mental health
services.

Greater involvement of general hospitals, physicians, and psychiatrists is essential to proper develop-
ment of mental health programs.

Insurance coverage not yet adequate.

More MANPOWER must be made available; better use should be made of present personnel and new sources of
manpower explored.

Mental health services must be brought to the people rather than administered for the convenience of the
"establishment".

Full development of comprehensive community mental health centers in the ATLANTA AREA is 3 TOP PRIORITY.

Total resources of every community should be mobilized to treat and rehabilitate victims of mental
illness, to PREVENT mental disorders, and to produce a climate conducive to better mental health for all.

a

Physicians could and should be first line of defense against mental illness, but their medical train-
ing has not prepared them for this role. The outpatient clinics, as a rule, are severely understaffed.

A crucial barrier to the developing mental health program is lack of trained personnel.

Current Status:
No general hospital in the Atlanta Area accepts patients who are mentally ill. Exceptions: Emory

University operates a psychiatric unit of twenty beds for patients selected for teaching purposes; and
Grady Memorial Hospital has a psychiatric unit of thirty-six beds for emergency short-term patients.

The public schools' staff, while improving in number and qualifications, is still inadequate.

The State Retardation Center is under construction.

Psychiatric units as components of comprehensive community mental health centers are under construc—
tion, as follows: Clayton County Hospital (25 beds); DeKalb General Hospital (d4 beds); and Northside

Hospital, Fulton County (25 beds).
There are four private psychiatric hospitals in the Atlanta Area (SHEA).

The State Regional Hospital (Atlanta) has been constructed and is being activated to serve fourteen
counties.

The State of Georgia has built the Georgia Mental Health Institute for the primary purpose of
”training and research".

Possible Solutions:
The full development of at least ten proposed comprehensive community mental health centers in the

Atlanta Area will alleviate for the present many of the problems when they become operational.

More MANPOWER must be made available, better use should be made of present personnel and new
sources of manpower should be explored.

Total reliance must not be placed on hospitals, clinics, or mental health professionals to do the
"job" of dealing with mental health problems; but rather every resource in the community, such as the
schools, the churches, the courts, the health and welfare agencies, etc., should be fused with and
oriented in basic principles of mental health, that each will be a positive force that will help create

a climate conducive to better mental health for all.

COMPREHENSIVE
COMMUNITY MENTAL HEALTH PROGRAM

COMMUNITY
HEALTH SERVICES

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Control of air, water pollution and waste disposal vital to Atlanta
Area future.

SUMMARY:
THE CONSERVATION OF ENVIRONMENTAL RESOURCES OF AIR AND WATER AND THE RELATED
CONTROL OF WASTE DISPOSAL ARE FUNDAMENTAL CONTRIBUTORS TO HEALTHFUL LIVING.

IN THE ATLANTA METROPOLITAN AREA THE CRITICAL PROBLEM IS ONE OF AREAWIDE PLANNING
AND IMPLEMENTATION IN TERMS OF PRESENT AND PROJECTED POPULATION NEEDS.

Problem:

Present water resources will be adequate for future needs only if handled
properly on a planned basis. Waste water, solid waste, and air pollution are
compounding problems as a result of lack of overall planning and coordination

among governmental bodies. Pollution of rivers and streams threatens health,
recreation and wildlife. Automobile graveyards, rodent-infested litter and
dump areas illustrate to the observer an increasing solid waste problem, Air
quality control is insufficient for future needs as projected.

Resources:

Local governments and governmental agencies, collaborating organizations,
University projects (capacially the Comprehensive Urban Studies Program of Georgia
State College), and planning agencies have Sufficient resources to creatively
deal with the problem, given funds and responsibility.

Solutions:

Dissemination to governments and others of the exhaustive study prepared for
Atlanta Region Metropolitan Planning Commission, and implementation of its
recommendations.

Increased coordination of those concerned with the problem and able to
enforce recommendations.

Conscious, deliberate effort at communicating extent and import of the
problem to the public. Recruitment of volunteers for active support.

Regulations for usage and control developed and enforced.



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Proctor Creek - Case Study of a Multipleulmpact Health Hazard

SUMMARY: -
PERIODIC FLOODING OF PROCTOR CREEK, A HIGHLY POLLUTED WATERWAY IN SUBURBAN

ATLANTA, RESULTS IN CONTAMINATION, DROWNINGS, INCREASE IN NUMBER OF PESTS,
DESTRUCTION AND LOSS OF PROPERTY. REDUCTION IN POLLUTION AND FLOOD LEVELS
MUST BE SOUGHT TO IMPROVE OVERALL CONDITIONS IN THE NEIGHBORHOOD.

Problem: _
An area involving 1200 residences and 6000 families encounters the
following problems as direct result of pollution and flooding of the creek:
Seven drownings in six years.

Illnesses directly related to pollution.

Sewage backup and overflow conditions in homes.

Uninhabitable basements resulting from constant sewage backup.

Severe, oppressive odors.
Proliferation of pests, insects, rats.

PrOperty erosion, damaged building foundations, loss of large articles
in floods.

Fire hazard from oil and other flammable materials in creek.

Current Resources:
Georgia Water Quality Control Board, Public Works Department of Atlanta,
the Corps of Engineers, and area industrial plants.

Solutions:

Alternative plans and detailed study of cost alternatives and benefits
will be necessary for improvements of the creek and adjacent areas. Possi-
bilities include:

Channel improvements, floodwalls, enclosure, zoning restrictions.

Controlled access to prevent drownings.

Clean stream beds and banks of unsightly and hazardous objects that block
stream flow.

Separation of sanitary and storm sewers.

Make area adjoining stream part Of a lineroe regional park.

Evacuate residents and fill creek.

Indict companies contributing to pollution.







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Public Health, Budgets, Boundaries and Personnel
___I.__I_a________.__i____.________i___________

SUMMARY: .
THE NUMBER OF PERSONS TREATED WITHIN PUBLIC HEALTH SERVICES, ALMOST

WITHOUT EXCEPTION, IS DIRECTLY RELATED TO THE COUNT OF MANPOWER,
FACILITIES, AND POPULATION OF A GEOGRAPHICAL AREA RATHER THAN TO
COMMUNITY HEALTH. OF COURSE, THIS IS A CONVENIENT ARRANGEMENT OF

OUR MARKET ECONOMY AND JURISDICTIONAL SUBDIVISIONS. IF SERVICES WERE
BASED ON MORE EXTENSIVE INVESTIGATION AND DOCUMENTATION OF HEALTH
NEEDS RATHER THAN A CAPACITY TO PROVIDE SERVICES, PRESENT RESOURCES
AND EFFORTS COULD BE MORE EFFECTIVE.

Problem:
Programs in Public Health are dependent upon both county and

state funds and budgeting policies.

While these policies do take into account health needs and demands,
they are directly affected by grant-in-aid formula.

As grant-in-aid monies are received on a local level, local dir-
ectors are required to decide on where local Onatching) money, furn-
ished by the county governments, will be spent.

A thorough analysis of cammunity consumer needs has not been
developed.

It is patently impossible for the same individual to both operate
and objectively evaluate program areas.

Confining program Operations along county lines has adversely
affected certain state health programs.

Reciprocity is provided for and_is even discouraged by budgets.

A planning agency could:

Broaden the voice of decision in programs to include lay, govern-
mental, and professional consumers as well as providers.

Share the burden of public health officials in allocation decisions.

Extend planning and establish communication across county lines in
such programs as water and air control, industrial hygiene, sanitation,

etc.





Title: Emergency Health Services - The Systems Approach



SUMMARY:
PRESENT EMERGENCY HEALTH SERVICES DEFEND UPON DECISIONS OF MANY INDEPEND-
ENT LOCAL AUTHORITIES. LACK OF COORDINATION AND COMMUNICATION, AS WELL

- A3 LACK OF INFORMATION ON WHAT CARE IS AVAILABLE AND HOW TO UTILIZE IT
RESULT IN OMISSIONS, DUPLICATIONS AND DISSERVICE TO THE PUBLIC.



Problem:
There is much adequate emergency health care being planned and
provided (especially for disaster and mass casualty) but uncoordinated

efforts are resulting in dynamic deficiencies:

NEEDS Unfulfilled in some vital areas
STAFFING numbers
‘ Inadequate quality
FACILITIES distribution
SERVICES Incomplete and often tardy
Restricted to some classes
Part—time death follows no clock
INFORMATION Fragmented in—service and to the
public who often most need to know
TRAINING Insufficient for public self-help or
service personnel needs
TRANSPORTATION Dangerous clogged urban corridors
delay help/cause accidents
FINANCING Marginal and less in urban areas
COMMUNICATION Infrequent between the private and

public power structures most involved
in health services

PLANNING Duplications & uncoordinated efforts of all
Omissions 6—county area groups;
emergency health programs;
Unimaginative reluctant public and pro~

fessional acceptance of new methods

Needed:

One comprehensive system administered by one community—wide
representative agency.

.1

Solution:

The Systems Approach: The involvement of all health-concerned institutions,
organizations -- including governmental units and officials, both 1egisla~
tive and executive under the experienced guidance of health professionals.

The Goal: One central agency, one overall plan, to provide total, ade-
quate emergency health services and care throughout the community.

Objectives:
* Increase staffing and facilities
tFTovide adequate ambulance service
iTrain the public in first~aid and medical self—help
lEstablish hospital affiliated neighborhood health care centers
#Initiate two—way radio communication between hospitals, fire,

police, hospitals, and other emergency care units
$Hold actual disaster and mass casualty exercises



EMERGENCY SERVICES

1960 1970 1980 1990 2000

4,000,000

3,000,000

2,000,000

Population

,1

1,000,000



Total Population; Atlanta Five-County Source:
Atlanta Region Metropolitan Planning Commission



Emergency Health Services in the Atlanta Area???



Health care is divided into a number of-categories. One of the most
important of these is emergency health care. The following:

Hospital emergency room care

Emergency care in physicians' offices
Emergency care in_neighborhood health centers
Emergency care in industrial situations

First aid training of the public

Accident prevention

Ambulance services

Marking of evacuation routes

Helicopter evacuation and landing facilities
Emergency psychiatric and acute alcoholic care
Poison control and poison control centers

Blood banks
Communications between institutions and organizations

providing emergency health care
Public information on sources of emergency health care
Education and continuing education of personnel providing
emergency health care
Disaster and mass casualty reception

are not emphasized and organized in the Atlanta area.











Prevention of Accidents Can Significantly Reduce Area Toll of Deaths
and Injuries

fiflNNAEZi
ACCIDENTS CONSTITUTE A MAJOR HEALTH PROBLEM, RESULTING IN STAGGERING ECONOMIC
AND MANPOWER LOSSES. PUBLIC APATHY, THE MOST IMTORTANT OBSTACLE T0 PREVENTION,

MAY BE OVERCOME BY WELL PLANNED USE OF RESOURCES AVAILABLE IN VOLUNTARY SAFETY

CONTROL, LEGISLATION, IMTROVED COMMUNICATION FOR EDUCATIONAL PURPOSES, AND
PLANNING FOR BETTER SAFETY PHYSICAL FEATURES IN THE MOVEMENT 0F PEDESTRIANS
AND VEHICLES.



Problem:

An ever-increasing flow of traffic has led to more and more collisions,
injuries, and deaths. Nearly 50% of hospital beds are occupied by accident
victims. National figures indicate annual economic losses in 132 million days
bed-disability, 94 million days work less, 11 million days school loss, 22
million hospital bed days, and a total estimated cost of 12 billion dollars.
Home, traffic, and other accidents are most often incurred by those least able
financially and socially to bear the burden. This may chiefly be the result
of compounded difficulties ~- poor education, hazardous environment, low income.

Current Status:
Mortality statistics indicate the problem has reached epidemic proportions.

Accidents are the leading cause of death to persons under the age of 44, and
rank fourth as cause of death in all ages, following heart disease, cancer,
and stroke.

Obstacles:

A major challenge is that of changing the viewpoint of those who still
think of accidents as uncontrollable events. Public apathy exists, in this
more than any major area, largely as a result of ineffective communication
between experts and lay people. Indicative of this is fear of loss of per-
sonal freedom when strict preventive legislation is proposed.

Solutions:
1. Increased cooperation between safety councils, legislators, and mass
media for planning and communication.

2. Increased nae and standardization of drivers education in schools and
defensive drivers courses in adult organization.

3. Increased financial support for safety-involved organizations.
4. Research into human behavior aspects of safety/accident problems.
5. Better street and highway design in the Atlanta Area.

6. Elimination of unnecessary roads and streets in order to provide for
better pedestrian and vehicle movement.

7. Planned program of railroad, street and pedestrian "grade separation" in
the Atlanta area.

8. Institution of a streetlighting program.

_ 24 -

MAJOR FACTS ABOUT ACCIDENTAL INJURIES AND DEATHS-1968
(Statistics provided by: Epidemiology and
Surveillance Branch Division of Accident

Prevention,State of Georgia)

Following are estimates of the annual toll of accidents for the United
States:

Persons killed 112 thousand
Persons killed motor vehicle 53 thousand
Persons injured 52 million
Persons injured,moving motor vehicle over 3 million
Persons bed—disabled by injury 11 million
Persons receiving medical care for injuries 45 million
Persons hosPitalized by injuries 2 million
Days of restricted activity 512 million
Days of bed-disability 132 million
Days of work loss 90 million
Days of school loss 11 million
Hospital bed-days 22 million
Hospital beds required for treatment 65 thousand
Hospital personnel required for treatment 88 thousand
Annual cost of accidents $16 billion
Annual cost of accidental injuries $10 billion

It is estimated that the prevalence of physical impairments caused

by injuries in the non—institutionalized population of the United
States is over 11 million.





Medical and Dental Service/Information and Referral

SUMMARY:

INFORMATION ON THE HEALTH SERVICE NETWORK IN THIS AREA IS FRAGMENTED
AND UNCOORDINATED. REFERRAL PROCEDURES LACK STANDARDIZATION. CHANGING
POPULATION AND INDUSTRIAL CHARACTERISTICS SUGGEST RE-APPRAISAL OF CUR-
RENT AREAS OF CARE CONCENTRATION AND COORDINATION. MANY OF THE CAUSAL
FACTORS ARE BEYOND THE CONTROL OR EVEN THE PURVIEW OF THE PRACTITIONER.

A CENTRAL PLANNING AGENCY COULD GATHER, MAINTAIN AND DISSEMINATE THE IN—
FORMATION BOTH CARE PROVIDERS AND USERS NEED.



Problem:

Direct health care involves doctors, dentists, other health workers,
hospitals, health centers, associations, programs and community organi-
zations. The patient enters the system at any point, in highly varied
states of health, wealth, intelligence and experience. Both parties
suffer strain and are inefficiently serviced due, in part, to incomplete,
haphazard information and referral systems.

Atlanta Has: Health characteristics that are frequently below
National par, consistently below those of Northeast
metropolitan areas, but that rate favorably with other
parts of the South.

Population increases and related rising health service
demands that are offsetting past numerical gains in
medical personnel, facilities and agencies.

Aggravated problems of age, youth and working women
arising from rapid urbanization and industrial growth.

Complex administrative, educational and personnel

procedures resulting from complicated Federal pro—
grams and financing.

One large hospital supplying_quality care to a vast

but limited number of indigent sick of two counties.
Patients needing some types of care cannot be adequate-
ly treated, and even nonmal sicknesses exceed the
plant's capacity.

Medical societies and voluntary agencies making out-
standing efforts in community health planning and
implementation for several but incomplete areas.

Atlanta Needs:

Formal communication between demands and provisions of
services. Increased and more efficient use of existing

personnel and facilities.

Broader and more intense coverage of community health
problems.
26





SELECTED CHARACTERISTICS OF METRO ATLANTA WHICH AFFECT MEDICAL SERVICES

More older persons Domiciliary and extended care, treat-
ment for special diseases and impair-
ments. third-party payment

More younger persons Treatment for infectious diseases. in—
cluding venereal disease. accidents.
impairments, handicaps, maternal and
child care.

*Urbanization and industriali-
cation

Special groups Special deliveries of care (migrants.
veterans, etc.)

Affluence Greater quantity and quality of care.

Poverty Public provision of care.

Congestion Epidemiological control.

Suburbanization Geographical redistribution.

Formal groups Special interests.

Mobility Fragmented care.

Work shifts Full time availability.

Working females Convenience. special diseases.

Organization and Bureaucrati- Third-party payment, insurance, pre—
zation payment
Federalization Public programs and financing
Medical centers, schools Personnel demands
special institutions

Technological advancement Development of medical science
Greater expectations from public
mediums of broader communication

III I FIIII I ”III I I II“ I I III | I I III | I IIII | I "II | I IIII II I III PI II I I III: I I [III I lII' | I III” I IIII | I III! | IIIIl | I III | IIII I [Illlll Fl IIIJ 'IIIIIIIIIIIlIIIII IIrIIITIIIIllIIIII llll I IIIII I llllll lIllIl lIIIIl | IIII1 IIIIIIIIIIIII IHII'I





Title: Alcohol and Drug Abuse — Causes Human Suffering

SUMMARY:
RECOGNIZED AS THIRD LARGEST HEALEH PROBLEM, BUT CHARACTERIZED BY NEGLECT, STIGMA AND REJECTION. PUNITIVE

REACTION TO PROBLEM MUST YIELD TO A CONSTRUCTIVE APPROACH OF ASSISTING THE PERSON T0 RECOUP AND REGROUP
HIS PSYCHOLOGICAL RESOURCES FOR A MORE ADEQUATE RESPONSE TO LIFE'S RESPONSIBILITIES AND OPPORTUNITIES.



Problem:
Atlanta area (SMSA) leads nation in rate of arrests for public intoxication.

Largest market in world for bootleg whiskey.

Area has estimated 50,000 victims of alcoholism.

$5 million expended annually for local care of victims of alcoholism and their families.

$12 million annual loss to local industry due to alcoholism; absenteeism, accidentsI lowered efficiency, etc.
Human suffering due to alcoholism cannot be estimated.

General Hospitals of area reluctant to accept victims of alcoholism as patients. Ditto doctors.

No facilities for treatment of drug addicts.

Current Resources:

Are limited in scope. The Georgian Clinic division of the Georgia Mental Health Institute and limited
private programs, serve the entire state population. This service is incidental to the institute‘s research
and training mission. The Emory University Vocational Rehabilitation Alcohol project which has served the
chronic court offender alcoholic will probably be discontinued due to expiration of a three—year federal grant
program. The Georgia Division of Vocational Rehabilitation provides limited rehabilitation services for alco-
holics. A start has been made in the Atlanta Region (SMSA) toward preventing alcohol drug abuses through inte—
grating services for individuals with the plans for comprehensive community mental health programs.

Treatment, care and rehabilitation of victims of alcoholism and persons addicted to drugs must be incorpor-
ated in the services of the proposed comprehensive mental health centers of the area. including some adjacent
counties.

Additional reliable data is needed on the extent, nature and Scope of the local problems of alcohol and
drug abuse on a basis upon which to plan effective and innovative programs for prevention. control, treatment
and rehabilitation of alcohol and drug abuse.

-‘K Changing attitudes and concerns of communities by information, education and consultation.
-’[ More effective enforcement of drug laws and regulation of drugs.

Trends:

Since most authorities and federal officials embrace the view that alcohol and drug addiction is a
problem of living and probably symptomatic of an emotional illness that should be treated (a non-criminal
circumstance) it logically appears that newly developing programs associated with community mental health
centers will evolve as well as a thrust toward improving conditions in deprived neighborhoods where ad-

diction is most common.

Goals and Objectives:

The Georgia Legislature has expressly recognized alcoholism as a disease and declared it to be a
public health problem with administrative responsibility for alcoholic rehabilitation given directly
to the Division of Mental Health of the State Department of Public Health and indirectly to the County
Boards of Health and Public Health Departments. Comprehensive programs for alcohol and drug abusers
can be developed in conjunction with or as an integral part of comprehensive mental health programs.
The range of services that will be provided by the community mental health programs are very nearly
the range of services required for dealing with alcohol and drug problems. The goals of these pro-
grams and services will be: (1) improved health and prevention of disease; (2) separation of the
alcohol and drug abuser from alcohol and drugs; (3) repairing the physical and emotional damage and
preventing further damage; (4) changing community institutions, programs and services to meet the
special needs of the alcohol and drug abuser. While federal funds will be helpful in launching pro—
grams, state and local governments cannot presently rely upon federal funds for long-range support,
although such continued federal support may well represent the only hepe for programs for the alco-
hol and drug abuser in Georgia.







Balancing the Costs of Health Care

SUMMARY:

THE COSTS OF MEDICAL CARE ARE RISING SHARPLY, EVEN MORE THAN THE COST OF
LIVING. ILLNESS, DISABILITY AND PREMATURE DEATHS CREATE DISPARATE COSTS -

BOTH DIRECT AND INDIRECT - TO FAMILIES ACCORDING TO CIRCUMSTANCES WHICH

THEY CANNOT APPRECIABLY CONTROL: INCOME AND OCCUPATION, TYPE OF DISEASE
AND TREATMENT.



Problem:

The costs of health make it prohibitive to some families and ultimately
contributes to poorer health and additional costs to the community.

Current Status:

1. Federal assistance is directed to special groups of persons: Aged,
maternal and infant, indigent, etc.

2. Federal programs are developed around certain diseases and disabilities:
Crippled children, tuberculosis, blindness, cancer, venereal disease,
etc.

3. Middle—income groups use physicians' services at a lower annual rate
than other income groups.

4( Certain businesses and industries promote health and coverage from
debilitating health expenses.

5. The costs of health insurance rises with the cost of medical care,
capecially hospital rates.

Possible Solutions:

The rising cost of health may be stabilized and the entire community
brought into its purview within an area plan which can:

1. Review the eligibility requirements of tax-supported health services.

2. Reduce the demand on rare skills by providing information and referral
services to providers and consumers.

3. Recommend the wider inclusion of extra-hospital services in insurance
policies.

4. Promote the assembling of complex equipment, professional skills and
services to provide for extensive, continuous, non—domicilary treat-
ment. . ’

5. Encourage architectural and organizational modernization in hospitals.

-30—

NUMBER OF DISABILITY DAYS" PER PERSON PER YEAR
BY FAMILY INCOME, TYPE OF DISABILITY AND AGE
In the Unlled sum. July teas-June 1001'







T
E COSTS All llnder $3.000- $5.0 00- 5?.000- $1 0.000
Incomes“ $3.000 4.000 0.000 0.000 and over
RESTRICTED ACTIVITY -
All ages . 15.4 27.5 15.3 13.7 12.3 11.9
OF BEING UNHEALTHY Under 17 yam 9.9 _ 9.2 9.1 9.9 9.7 10.1
_ 1? - 24 years 9.5 12.5 9.5 9.0 9.5 7.9
25 - 44 years 13.8 24.5 17.0 14.1 11.9 11.3
45 - 64 years 21.4 43.5 25.5 19.0 15.9 14.5
55 years and over 35.2 39.5 29.2 35.2 34.5 29.0
BED DISABILITY .
All age: 5.5 9.7 5.9 5.3 4.4 4.6
Under 17 yeare - 4.3 5.1 4.2 4.5 ' 4.0 - 4.2
17 - 24 years - 4.1 4.5 4.4 4.0 4.5 3.5
25 - 44 years 4.5 9.0 5.5 4.5 4.1 3.9
45 — 64 years 6.9 14.3 . 7.5 5.3 4.9 4.9
65 years and over 11.9 . 13.2 0.2 ' 12.9 10.? 12.5

WORK-LOSS DAYS AMONG
CURRENTLY EMPLOYED'“

All ages 5.4 7.9 5.7 5.9' 4.4 4.6
Under 1? yearn -- — — —- —~ —
17 - 24 years _ 3.9 4.7 4.5 4.3 4.2 2.7
25 - 44 years ' 4.5 9.1 5.5 5.3 3.7 4.2
45 - 54 years 5.6 10.3 7.9 7.3 5.5 5.7
65 years and over 6.3 7.0 7.9 5.0 ““ 5.?

'Retere Io disebllltv because of acute endlor chronic condlllone.

"Includes unknown Income.
“'Beeed on currently employed population 17+ years 01 age.

““F-Igure does not meet standards or relieblilty or preclelon.
Source: United State. Netlonet Health Survey. United States Department or Heeltl'l.

(deem end Welt-m.

INCREASES IN MEDICAL CARE AND OTHER MAJOR

GROUPS IN THE CONSUMER PRICE INDEX
In the United statue. 1051-59 — 1997

All Items _19%
Food _'5*

Apparel _ 14%
Housing — .... EFL COSTS

Transportation _ 15%

Medical c... —m

Personal Care — 18%

Readinzand _ 20*







Recreation 0]? BE ING HEALTHY
one: Goods _ 18*
and Services‘

°Gornprlm tobacco. alcoholic beverages. legal eervloee. burlel eervleoe. kinking 1m. etc.
Source: 0.8. Department or Labor, Burl-ll ol Lebor Stellellce.

-31-

Coordination of Planners

SUMMARY: -

A COMMUNITY-WIDE HEALTH PLAN CANNOT SUCCEED WITHOUT STRONG COORDINA-
TION OF ALL INTERNAL AND EXTERNAL SPECIALIZED PLANNERS. THE VARIETY
AND INTERDEPENDENCY OF MODERN PLANNING AGENCIES REQUIRE A CAREFULLY
CONSIDERED LONG-TERM BASIS FOR BENEFICIAL INTERACTION AND EXCHANGE
WITHOUT LOSS OF CREATIVE AUTONOMY. PRESENT SHORT-RANGE, INFORMAL,
INCOMPLETE COORDINATION, WHICH CAN RESULT IN DUPLICATIONS AND

OMISSIONS, SHOULD BE STRENGTHENED BY A COMPREHENSIVE, CONSENSUAL
LONG-RANGE PLANNING FRAMEWORK.

Text Outline:

; Reasons for coordination:

:}The informal, unstructured coordination among local
planners are inadequate to the pace of change in the
modern community.

l-Present planning coalitions are arranged around
limited groups and mainly for short range goals.

*While there are 60 agencies listed as serving
the physically disabled, the gaps and overlaps
are only suggested, the interrelationships are
not well established.

I}(fities are receiving increasing amounts of federal aid
and attention yet no projective framework for land—use,
transportation' services, health cars, etc., has been
adopted by relevant providers.

Physical and pOpulation rearrangements are widespread
and require accompanying service rearrangements.

fir How coordination could be achieved:
fl-Provision of channels of communication and programs of
active cooperation by:
n-exchanging of skills and controls (personnel, data,
funds, etc.);
n-use of computer based techniques; .
» interlocking decision-making arrangements;
I overlapping of common jurisdictions; J
l-organized contacts on multiple levels of staff; and
n-meetings, conferences, mailing lists.



PROFILE OF HEALTH AND HEALTH RELATED PIANNING AGENCIES

Agency (Coded)



10 ll 12 13 14 15 16

Characteristic (Yes =.)

EIEI
EII
II
El

EIIEIEIIIJEIEIIEI w

El
CID
IEI
II
EIEI
II
EIEI

.DDDD Permanent
EIIIII can,
EIEIEEIEI'. - .. ..
EEmE Directl related to health
I I iAdvisory function
Dunn Implementing function

mu Collects health data

m. Direct evaluation rocedure



m. Uses outside consultations

Reports on request



E]
El
El
I
El
El

EEIB





HEEIHIEE

"II | I IIIII I III" I "III I III" I | IIIIII IIIIII I I "III I I-Il II III" I | IIIII I II "II I I "III I III“ I IIIFI I I I'll I | IIII I I I I II II I I l-Itl I I till I | | IIIIII I IIIKI I I III. I ' 1.1!“ II I- II I II

I

I
I
E-n Reorts ublished (health

mediate future lans



Formal intera enc r a '

F



inance intcra enc cooni.



IDUDDIID-l Formal p1annin_ structure .

III: I IIIII I I II“ II II IIIII I IIIII I IIIII I I II

EXTENT AND DIRECTION OF INTERCHANGE AMONG A SELECTED GROUP OF PIANN'ERS

PLANS WI TH

EHHIEEHEEEEEHE

Note:



listing may be found in the Appendix.



Numbers and letters are coded for names of agencies.

CONS ULTS

HHEEHEEEEIEE

A decoded

Suicide Prevention — Crisis Intervention

SUMMARY:

THE MAGNITUDE, URGENCY AND COMPLEXITY OF SUICIDAL AND PSYCHIATRIC CRISES
MAKE THEM PUBLIC HEALTH PROBLEMS. THE TRAGEDY, CHRONIC RECURRENCE AND
OFTEN LENGTHY HOSPITALIZATION CONNECTED WITH THESE EMERGENCIES CAN BE
AVERTED OR ALLEVIATED BY CONSISTENT PREVENTIVE CARE. THE PROPOSED COMMUNITY
COMPREHENSIVE MENTAL HEALTH CENTERS COULD EFFICIENTLY PROVIDE THESE NEEDED
MULTI-DISCIPLINE SERVICES.

Problem:

- Past reluctance of the general lay and medical public to openly become
involved in the recognition, research, cooperation and sympathetic_treatment
these crises demand.

Suicide nationally, ranks among the top ten causes of death; is fourth
in cause for all male deaths between 20-45, and is second highest cause
among college fatalities.

In the Atlanta Metropolitan Area, the suicide rate exceeds the National
average by about 25%.

For each actual death by suicide, 8-10 serious attempts occur.

_Psychiatric crises--that often end in suicide or physical violence to
others, can often be foreseen by trained personnel in the complex web of
social, economic, cultural and health problems that aggravate mental insta-
bility.

IThe essence of time demands quick reaponsive help.
l-The desperate bewilderment requires easily available aid.
I-The constant danger needs constant service, on a 24 hour basis.

*Follow—up of all cases is basic.

Current Resources:

Only two Georgia counties, Fulton and DeKalb, are served by a suicide-
prevention, crisis'intervention center. Coordinated with Grady Memorial
Hospital psychiatric services and the respective County Health Departments,
the program has two multi—discipline crisis_teams available 24 hours a day.
A total of 4,375 patients were treated in 1968.

A unique telephone service, also manned 24 hours a day, 7 days a week,
was set up to cover ten counties, on a toll-free basis. The "staff" includes
a psychiatrict, a clinical psychologist, a psychiatric nurse, three public
health nurses, two sociologists, and six "lay counselors."

Solution:

The fastest possible implementation of the ten proposed Community Mental
Health Centers in the Metropolitan Atlanta Area, with the backup of Georgia
Regional HOSpital-Atlanta.

*To: Prevent crises before they occur.
Eradicate the social stigmas of the problems.
Enlist full support of all medical and political units.
Make effective use of current knowledge and resources.

- 34 -



FELToN—DeKALB EMERGENCY MENTAL HEALTH SERVICE
CASES BY COUNTY - FIRST 13 MONTHS

Fulton ......... 1530 44.1% Gwinnett ......... 45 1.3%
DeKalb... ...... 622 17.9% Douglas 10 .3%
Cobb ... 130 3.7% ... 57 1.6%

2.0% 1009 29.1%

PSYCHIATRIC SERVICES — GRADY MEMORIAL HOSPITAL
January - December, 1968
I Emergency Patients

II Inpatients

III Outpatients

IV Consultations:
A. Medical Inpatient Service 356
B. Pediatrics 166

C. Obstetrics 757

V. Drug Clinic
Opening July, 1968-December, 1968 303

VI. Crisis Service
Opening August 19, 1968—December, 1968 421

VII. Psychiatric Day Center
Opening November 4, 1968-December, 1968 36



MENTAL RETARDATION (MR) PROGRAM NEEDS: MORE, BETTER, EARLIER,
MORE ACCESSIBLE

SUMMARY:

MENTAL RETARDATION IS ONE OF THE FOREMOST HEALTHI SOCIAL AND ECONOMIC
PROBLEMS IN THE METRO ATLANTA AREA. PUBLIC SCHOOLS PROVIDE LESS THAN
50% OF THE SERVICE NEEDS OF THE EDUCABLE MR CHILD, AND APPROXIMATELY
50% OF THE SERVICE NEEDS OF THE TRAINABLE MR CHILD. MINIMAL SERVICES
ARE OFFERED THE PRE—SCHOOL AND POST SCHOOL RETARDATE. DIAGNOSTIC AND
EVALUATION CLINICS, EDUCATION AND TRAINING PROGRAMS AND ADULT SERVICES
MUST BE GIVEN PLANNING EMPHASIS. SERVICES ARE WASTED HOWEVER UNLESS
PLANS ARE MADE TO INSURE DELIVERY OF THESE SERVICES TO THE CONSUMER.

A TRANSPORTATION PLAN MUST THEREFORE BE A VITAL PART OF PROGRAM DESIGN.

The Problem: The MR person is one who, from childhood, experiences
unusual difficulty in learning, and is relatively ineffective in
applying what he has learned to the problems of life. He needs Special
training and guidance to make the most of his capacities.

Current Status: In Metro Atlanta, there are an estimated 42,647 re-
tarded persons. At the present time, only 6,804 individuals by our
survey are receiving education and training, residential services,
vocational rehabilitation or other adult services from apprOpriate
community agencies.

Needs: While all the metropolitan area school systems offer some
services for mentally retarded children, many are not served.

Private residential facilities serve only non-ambulatory neurologically
impaired children. Vocational Rehabilitation works with retardates en—
rolled in public school special education programs, and with a limited
number of MR frOm the community at large. Expansion of all these pro-
grams is needed. Day training facilities for the severe and moderate
pre-school, severe school age,-and severe find moderate adults should
be established.

Structure of Planning Organization: The responsibility for area wide
mental retardation planning should rest in a 6 county planning body
made up of representatives from the 6 local health districts. Each
district would appoint 6 representatives, drawn from vocational re—
habilitation, the health department, family and children's service,
public schools, assOCiations for retarded children, and recreation
departments. An ma specialist should be employed.



mmmm ' ADAPTATIONi WWW . .
‘eamqumuamn; rdmmuan
.. .. .- ._ ,\’o. _"-"I=



Estimated Number of MR Persons in the 5 County Area**

Level of Retardation Chronological Age Range
0 - 5 6 - 17 18+ Total
Mild 5409 9554 24506 39469
Moderate 305 537 1375 2217
Severe 108 191 493 792
Profound 22 42 105 169
Grand Total 42,647

Existing Services in the 5 County Area**

Public Schools Private Schools Residential Voc. Adult
EMR TMR EMR TMR Private-Public Rehab. Act.

5151 37? 40 225 106 120 703 82
Organizational Chart** -

Comprehensive Health Planning
Metro Atlanta MR Planning Committee

FULTON GWINNETT ' CLAYTON

One Re-resentative from each field
Voc. Rehab. Voc. Rehab. Voc. Rehab.
Health Dept. Health Dept. Health Dept.
FACS FACS FACS
Schools Schools Schools
ARC ARC ARC
Recreation Recreation Recreation

MR Specialist
Secretarial Staff

* 1. Conceptual Visual Aid: Interaction of Multiple Factors.
(From Richmond, J. B., and Lustman, S. L., J Med Educ 29:23
GMay) 1954).

** Douglas County not included in the above 5 county tables and charts.
_ -37-






































Voc. Rehab.
Health Dept.
FACS
Schools
ARC
Recreation

Voc. Rehab.
Health Dept.
FACS
Schools

ARC
Recreation



Title: Parks' and Recreation‘s Lag in FacilitiesI Services and Manpower.

SUMMARY: _
GREATER RECOGNITION, FINANCIAL SUPPORT AND PARK/RECREATION PLANNING SHOULD BE GIVEN THE

GROWING DEMANDS FOR RECREATION AND PARK FACILITIES, PROGRAMS AND SERVICES THROUGHOUT THE



I ATLANTA AREA, (SMSA). IT BEHOOVES LEGISLATOR, RECREATION AND PARK EXECUTIVES TO OBSERVE
AND CORRECT THE PRESENT LAG OF FACILITIES SERVICES AND PROFESSIONAL MANPOWER NEEDS IN THE

-FASTEST GROWING CITY IN THE SOUTHEAST.



Problem:
Unfortunately, Atlanta does not have the park system and recreation program it needs

and deserves. There is:

lack of good public relations absence of public information
on parks and recreation

lack of public and city support
past segregation and apathy

inadequate local financing of current integration
rising cost of land lack of a comprehensive plan

to guide park and recreation
insufficient maintenance development
insufficient acreage lack of standards at the state

and local level.

staff personnel occupying position
without proper training

Possible Solution:
To provide recreation programs and facilities in all neighborhoods of the city.

\

To encourage housing project and apartment owners to include recreation facilities.

To insure close supervision of staff and a good in-service training program for staff
members that are not professionally trained.

To recruit professionally trained personnel for staff position.

To provide a well—balanced program for all ages, with a wide variety of interests.

To involve residents in planning and Operation of public recreation.
To provide minimum standards for all recreations programs.
Trends:

These are not theoretical standards. A survey done in 1965 showed that 49 out
of 189 cities met the acreage standards. As part of this study, comparisons were
attempted with other cities the same size as Atlanta. Overlapping governmental
jurisdiction made these comparisons difficult, but it appeared that out of 20 simi—
lar cities, 15 to 7 had more park acreage per pepulation than Atlanta. About one-
half met the acreage standards.

Inadequate open space. ;
Inadequate Planning.

Lack of interest at the Board of Aldermen level.

Diverted funds-

aosrm T..JoNES.JR. I‘ LAW 0 FFICES
FRANCIS M. BIRD

ARTHUR HOWELL
EuotNETfiaANcH JONES, BIRD 8: HOWELL
EDWARD R.KANE
EPMBAENRLLHIFLOLIQAERIBAN.JR. FOURTH FLOOR HAAS~HOWELL BUILDING
' ROBERT F'. JONES
FRA R R TT, .
5,ng 5?:55, J” ATLANTA, GEORGIA 30303 lave-less
TRAMME'.L ENICKERT’
RALPH WILLIAM5.JR. IQOS'lQEO
J. DONRLLY SMITH
WILLIAM B.WASSON
O‘DALE HARMAN February 28 3 19 69 TELEPHONE 522-2505
PEGRAM HARRISON AREA CODE 404

CHARLES W. SMITH
CHASE VAN UALHENBURG
RICHARD A.ALL|SON

F. M.BIRD,JR.

PETTON 5.HAWES.JR.
RAWSON FOHEMAN

MARY ANN ESEAHS

ARTHUR HOWELL III /

VANCE 0 RRNKIN III

cmus E.HOHNSBY m /

RICHARD M.ASBILL W
Honorable Ivan Allen @k/P7[ M “4

Mayor, City of Atlanta
City Hall '
Atlanta, Georgia

Re: Volunteer Citizens Services

Dear Mayor Allen: @-

I am writing to you as Chairman of the Board of the
Community Council of the Atlanta Area. I, and the others
who will be with me, appreciate and look forward to talking
with you on next Wednesday afternoon, March 5, regarding a
plan for the greater use of individual and group volunteers
in the Atlanta area.

Those with me on Wednesday will be Dede Hamilton,
who is the current President Of the Atlanta Junior League,
and John DeBorde, who is the representative of the Atlanta

RALPH WILLIAMS

Chamber of Commerce working with us on our volunteer project.
You perhaps know John. He is the general agent here for New

England Mutual Life Insurance Company.

Some months ago there was a meeting of representatives
of the Community Council, the Atlanta Chamber of Commerce, and

E.O.A. at which we discussed the possibilities of jointly

establishing a means of making a more effective use of volun-
teers. Dan Sweat was also present and is generally familiar
with what has taken place. Following this meeting there was
a larger luncheon meeting of about 16 or 17 organizations at

which there was a general discussion of the same subject.

Steering Committee was appointed to formulate a means of ef-

fectively recruiting, screening, training, and placing of



April 10, 1969

Mr. Eugene T. Branch

Chairman of the Board of Directors
Community Council of the Atlanta Area, Inc.
Clo Jones, Bird and Howell

Haas-Howell Building

Atlanta, Georgia 30303

Dear Mr. Branch:
The City of Atlanta has been fortunate in having many citizens and

groups volunteer their time and services to help resolve important
needs in our community.

As the City has grown and the interest and concern of our citizens
has increased, it has become more and more difficult to effectively
and efficiently utilise volunteers in meeting the needs of the city.

It is extremely encouraging to see the efforts being put Earth by

the Community Council. the Chamber of Commerce, the Community
Chest and the Atlanta J unlor League in developing a vehicle {or
providing orderly eeeignment and utilization of volunteer manpower.

It is essential that there be a. central point whereby community needs
cen be catalogued end coo-olideted and volunteers enlisted and trained
to help fulfill these needs. I believe only through each s coordinated
effort con the talents and skills of Atlanta's volunteer citlune be
rnenhelled and utilised to the best advantage of all the people of the

city.

Sincerely yours.

Ives Allen. J 1*.
Mayor



June 2, 1969

I am looking forward to meeting with you on June 5th, and to future meetings
and activities involving both the Council and the present staff.

Sinc rely,

/::L _/x/LCJ// /6f o-\ .9thth

Raplxael B. Levine, Ph. D. . Director
Comprehensive Areawide Health Planning

BBL/1a

enclosures



This is an incomplete edition of VOLUME 1,

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 to 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

The Community Council of the Atlanta Area, supported by organizational grant
No. 41008—01-69 from the U. S. Public Health Service, has been the agency
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 Area.

Consultation and Other Assistance

A number of persons gave continuing support to the Project on consultant basis,
and several hundred persons from governments, health professions, educational
institutions, commerce, and the population of health "consumers” gave invaluable
assistance in the compilation of information and in the formulation of
conclusions. The staff tenders its sincere thanks to all these individuals.

Funding

50% of the costs of this effort were borne by the Public Health Service grant
mentioned above. The remainder was contributed by local sources, including
county governments, foundations and the Community Chest, public, private, and
voluntary health organizations, and individuals. The community owes much
gratitude to these donors.

Organization of the Proposal

The proposal is divided into three volumes: project summary, budget and staff,
and task force reports. Each pair of facing pages makes up a self—contained
”story". The gist of each "story" may be gained from the bordered summary
material alone, with details added in the text and illustrative material.



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 Mary Lou Ashton, Senior Secretary
Clifford Alexander, Jr., Environmental Mildred W. Thorpe, Secretary
Planner

Katharine B. Crawford, Organization Liaison
OINSULTANTS ( 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 1. 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



.TABLE OF CONTENTS

Foreword to the Proposal . . . . . . . . . .
SECTION 1. INTRODUCTION AND SUPPORTIVE MATERIAL

A. Description of the Area

Planning for Planning: Technical and Community
Involvement Aspects . . . . . . . . . . .

The Atlanta Area, the Planning Area . . . . .

Atlanta Area Governmental Units, Current
Population . . . . . . . . . . . . . . .

Standard Metropolitan Statistical Areas Clean
to the Atlanta Area . . . . . . . . .

Atlanta Area, a Place of Growth and Variation

P0pulation Trends Require Review of Health
Needs 0 I I I I I Q I I I I I I I I I I

The Planning'Area Observes Other Programs
and Anticipated Expansion . . . . J . . .

Organizational and Procedural Arrangements for
Comprehensive Health Planning . . . . . .

Cooperative Arrangements.made for Funds, Per-
sonnel, Facilities and Services . . . . .

Planning is Based on Commonly Available Date . . .

s.

B. The Atlanta Area's Need for and Ability to Support
COmErehensive Health Planning

' Principal Teaching and.Service Facilities in _
the Atlanta Planning Area , . . . . . . . . .

Implications for Comprehensive Health Planning
"in Environmental Health Fields . . . . . . .

Atlantals Urban Redevelopment Project Program . .



Atlanta's Model Cities Program . . . . .

Relationships with thethorgia Regional
Medical Program .'. . . . . . . . . . . .-.

The Urban Life Center: A Solver of Urban Health
Problems for the Future . . . . . . . . . .

Local Health Departments in the Atlanta Area .

Major Voluntary Health Groups and Professional
Associations in the Atlanta Area . . . . .

Water and Sewer Districts. . . . . . . . . . . .

Facilities, including HOSpitals, Nursing Homes,
Outpatient Clinics and Neighborhood Health
Centers . . . . . . . . . . . . . . . . .

Existing Manpower Rescurces . . . . . . .

Economics of the Atlanta Area as Relates to
Health Services . . . . . . . . . . . . .

SECTION 2. NARRATIVE PROJECT SUMMARY

A. Project Outline

Goals and Objectives of Comprehensive_Health
Planning. . . . . . . . . . . . . . . . L

Community Council has Extensive Involvement in
Health and Planning . . .'. . . . . . . .

Organizational History of the Applicant . . .
_Scope of Program Health Concerns . . . . . . .

Cooperative Arrangements with Participating
Agencies . . . . . . . . . .‘3 . .'. . . .

Health Planning Process: Systems and Retrieval.
Information Gathering and Analysis Techniques .

The Need for Planning,Programming System for
' ZCOmprehensive Health Planning . . . . . . ,

Procedure for Policy Implementation . . . . . .

Example of Experience: Cobb County Comprehensive
Health Planning . . . . . . . . . . . . . .



Community Involvement in Comprehensive Health
Planning . . . . . . . . . . . . .

Atlanta Area Coordinatibh with the Office of
Comprehensive Health Planning, Georgia
Department of Public Health . . . . . .

_Faci1ities and Equipment Available for the

Page

Staff of the Applicant Agency a

B. figp orting Data

The Plan has Continuing Input from Existing

Rejources . . . . . . . . .

Personal Publications. . . . . .

C. Work Program

surrent Problems Carried Over. .
First Year Activities. . . . . .
Phasing into Systems Analysis .

Future Development . . . . . . .

D. Agency Organization

Staff Organization ... . . . . .

Council Organization . . . . . .
Council Membership . . . . . . .

Nominating Procedures. . . . . .

Training for Council Effectiveness

By-Laws of the Council . . . . .

?2

74

76

?8

80

84'

86

'88

90

92

94

96

98

Planning for Planning: 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 SOLU—
TIONS TO HEALTH PROBLEMS AND THE COMMUNITY INVOLVEMENT ASPECTS OF BRINGING
TOGETHER THE VARIED ELEMENTS OF THE COMMUNITY INTO A PARTNERSHIP FOR HEALTH
PLANNING AND POLICY-MAKING.

Technical Aspects

The technical objectives of this project have been (1) to identify the com-
munity's principal health 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 numbers and qualifi-
cations of the technical staff who.~ will be needed to carry out such planning.
Some of the activities bearing on these objectives have been:

identification and seeping 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 coor—
dinate 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 health problems and comprehensive health planning as possible;

Community Involvement Aspects

The organizational objectives of this project have been (1) to develop the
largest possible degree of cemmunity involvement in establishing and
operating a comprehensive health planning organization and (2) to formulate
an organizational structure for such operation, including corporate identity,
policy Council and its selection,and by—laws. Some of the activities bearing
on these objectives are:

identification of community interest and decision groups involved in
health activities; -

holding small and large meetings of such groups and selection 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 comprehensiva 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 community; writing by-laws;

obtaining acceptance and endorsement of these plans by the interest and
action groups in the community-—-governments, health agencies, consumers’
groups, other planning groups, etc.

selflEing and convening a council for action on this proposal.



ESTABLISHMENT OF METROPOLITAN COMPREHENSIVE

HEALTH PLANNING AGENCY

'III:IEIIIIIIII“IIIIIIIIIIIII'IIIIIIIIIIIIII| IIIIIII'I lIlIIIlI|II'II|IIIII'.IIII|IIIII|III‘IE'I lI|lI1lIllIIIIIII'llIIIIIII'IIIllllltll

Technical
ASpects

CHP
Permanent
Staff

'brganizational" funding

Community
Council’of the
Atlanta Area

20 Jun 69

IIIHHHHHHHIIII

METROPOLITAN CHP AGENCY
- 3 -

Community
Involvement
Aspects



The Atlanta Area

SlMflHAHY:
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: Atlanta Area: Douglas, Clayton, Cobb, DeKalb, Fulton and
Gwinnett counties.

Atlanta Area (SMSA): Clayton, Cobb, DeKalb, Fulton and
Gwinnett counties.

PRESENTLY:
ATLANTA AREA IS:

0 the "regional capital" of the Southeastern United States resulting from
continued growth and a central transportation network;

. the"major growth center" in the State of Georgia; and

. the central "regional city" for the ATLANTA AREA and contiguous
counties.

.the I'medical center" for the surrounding counties.

\

THE ATLANTA AREA COMPREHENSIVE HEALTH PLANNING DESIGN:

permits addition of contiguous counties or other planning areas
whenever feasibility or desirability are indicated. (Douglas
County, the newest member of the ATLANTA AREA has shown initia—
tive and set a precedent for non-SNEA‘S joining its sister
counties for health planning.)







Atlanta Area Governmental 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 Population (1968)

Fulton 605,400
DeKalb 353,500
Cobb 174,600
Clayton 78,700
Gwinnett 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
municipalities and population distribution.):

MUNICIPALITY COUNTY POPULATION (1968)

College Park Fulton 20,691
East Point Fulton 39,257
Hapeville Fulton 9,268
Decatur DeKalb 20,943
Forest Park Clayton 18,766
Marietta Cobb 28,003
Smyrna Cobb 16,365
Lawrenceville Gwinnett 4,561
Douglasville Douglas 6,000

NOTE: These figures are estimates made by the Atlanta Region Metropolitan
Planning Commission, 1 April 1968.





ATLANTA AREA





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Nearby Cities Affect the Market and Service Patterns of the Atlanta Area

STANDARD METROPOLITAN STATISTICAL AREAS CLOSE 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 Huntsville
Columbus Gadsden
Chattanooga Greenville
Albany Asheville
Augusta—Columbia Charlotte
Birmingham—Tuscaloosa Knoxville
Montgomery Nashville



Atlanta Area, 3 Place of Growth and Variation

SUMMARY:
THE ATLANTA AREA IS A RAPIDLY GROWING NETROPOLIS WITH BOTH URBAN

AND RURAL TERRAIN AND WAYS OF LIFE. THE MAJOR DEMOGRAPHIC CHAR-
ACTERISTICS INDICATE A CONTINUING PRESSURE AND A GREAT CAPACITY
FOR INCREASED AND APPROPRIATE SERVICES.

Major 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 A-yr,
colleges, 6 special purpose institutions, 3 area technical
schools.

OCCUPATION‘s largest demand is in retail and wholesale trade,
government, service business, manufacturing.

INCOME varies greatly: One county with 36% over $10,000 another
with 25% below $3,000.

CAPITAL INVESTMENT was near 300 million from 1963-1967, much of
this for transportation equipment.

TRADE is active: 3 interstate highways intersect, 8 airports with
800 daily flights, 13 railroad lines of 7 systems.

FINANCIAL headquarters of Sixth Federal Resarve District.

OFFICE SPACE abundant: Fifth in nation. .

COMMUNICATIONS extensive via telephones, mail, 4 daily and 20 weekly
newspapers, 5 television and 19 radio stations.

Note: This information taken from "Atlanta Silhouettes," ARMPC, Atlanta,
Georgia n.d.; "The Georgia Piedmont Regional Economic Investment Plan,"
State Planning Bureau, Office of the Governor, Atlanta, Georgia, n.d.



1960 — 1980 Population, Estimates and Projections

County 1960(1) 1965(2) 1970 1975

Fulton 556,326 599,300 649,425 704,046
DeKalb 256,782 350,400 485,541 658,520
Cobb 114,174 150,900 209,722 281,481
Clayton 46,365 66,000 93,483 135,988
Gwinnett 43,541 54,600 58,077 66,192
Douglas(3) 16,741 21,339 29,700 36,500

Total 1,033,929 1,242,539 1,525,949 1,882,727 2,

(1) U.S. Census

(2) Long—Range Plan, Hospital and Health Planning Dept., CCAA, Atlanta, 69.,
Jan. 1968, p. 6 (mimeographed).

(3) Douglas County Figures, 1965—1980, interpolated from Land Needs, 1968,
Douglas County, Ga., ARMPC, Table D.

DIRECTIONS OF POPULATION GROWTH 1960-1968
ATLANTA SMSA

FORSYTH
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WALTON

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COWETA HENRY
CLAYTON

1980

829,163
757,518
337,019
161,126
76,094
45,000

205,920

NOTE: Percentages show share of SMSA
(including Douglas County) growth
that has occurred in each direction.

SPALDING



Population 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 ACCOM—
PANIED BY A GROWTH TOWARD THE OUTER COUNTIES,

Text:

The needs for health facilities, manpower and services must be antici—
pated well in advance.

Present information allows a reasonable prediction of the size, con—
stituency 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.



Census

U4 S.
Rand Corp.

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0
6
9
1

1975:

Under 1



The Planning Area Boundaries 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 PROGRAMS AND
ACTIVITIES, SOMETIMES THE FIVE COUNTY "STANDARD METROPOLITAN STA—
TISTICAL AREA" OF ATLANTA IS USED AS A UNIT. SOMETIMES PROGRAMS ARE
SUBDIVIDED BY COUNTIES 0R COUNTIES ARE COMBINED IN OTHER WAYS. THE
SIMILAR JURISDICTIONAL AREAS ARE CONVENIENT AND THERE IS A TENDENCY
TOWARD MAKING BOUNDARIES OF RELATED PROGRAMS IDENTICAL. IN ANTICIPA-
TION OF THIS TREND AND EXPANSION OF ATLANTA (SMSA) BY THE BUREAU OF
CENSUS, THE COMPREHENSIVE HEALTH PLAN WILL HAVE ADJUSTABLE BOUNDARIES.

(1)

1
( Much of this material taken from An Atlas of Multi-County Organizational

Units, Department of Geography, Univ. of (38., 1968



PROBLEMS IN DELINEATING REGIONS

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PROGRAMS, REGIONSI AREAS, AND DISTRICTS

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Civil Defense; o‘erational Areas Control Centers

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State Nurses Assoc. Districts



Community Action Agencies
State Representative Districts



Congressional Dis tric ts
State Senatorial Districts

Cooperative Extension Service Districts

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Economic Develo-ment Re;ions

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Metro Atlanta Council Local (19v :

Soil & Water Conservation Districts

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State Em-lo ent Service Districts

office of Economic Opportunity (0
Community Council Social Planning Areas

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Farmers Home Administration Districts

Soil Conservation Districts I

Federal _J_udic ial Distric tsO

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Georgia Bureau of Investigation Districts



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Public Health Districts

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Pk) Appalachia & Piedmont (0) WC West Central District
(if) A Atlanta District (O) Ca Carrollton District
([1) D Decatur District Cl Clayton District
M Marietta District





Organizational and Procedural Arrangements for Comprehensive
Health Planning

SUMMARY:

THE PROPOSED COMPREHENSIVE HEALTH PLANNING AGENCY WILL BE STRUGTURED SO
AS TO BE IN CLOSE COORDINATION WITH THE METROPOLITAN ATLANTA COUNCIL OF
LOCAL GOVERNMENTS 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. OTHER PLANNERS IN HEALTH OR HEALTH-
RELATED FIELDS WILL BE INVOLVED T0 VARYING DEGREES.



Applicant:
In order to facilitate interaction of the major planning groups in

the metr0politan area, the Metropolitan Atlanta Council of Local Govern—
ments OAACLOG) will be the applicant agency for comprehensive health 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
for supervising and conducting comprehensive health planning is indicated
herein as the Metropolitan Comprehensive Health Planning Council (Metro

CHP Council).

Relationships among MACLOG, Metro CHP Council, and CCAA:
Using as a model the relationship between the Georgia Regional Medical

Program and the Medical Association of Georgia, in which the latter is the
applicant agency, and the former actually conducts the program, including
final policy formulation, the proposed relationship is that MACLOG will be
the applicant agency, Metro CHP Council conducts the program and formulates
policy, and administrative support is provided by the CCAA. There will be
individuals serving on the CHP Council who are also members of MACLOG or
the Board of CCAA. To insure cooperative efforts and joint planning in
overlapping projects, it is planned to establish a "MetrOpolitan Conference
of Planning Chairmen“, bringing together the Chairmen of MACLOG, CCAA, CHP
Council, and Atlanta Region Metropolitan Planning Commission ARMPC). In
addition, there will be a "metropolitan Conference of Planning Directors”,
bringing together the executives of the four agencies. From time to time,
other planners will be invited to participate in these conferences. It is
anticipated that joint staff activities will occur where projects involve
physical planning (ARMPC), social planning (CCAA), health planning (CHP),
and other forms of planning such as crime and delinquency (MACLOG). Of
course, major portions of health planning will continue to be done in

other planning staffs, such as hospital authorities, city and county plan-
ning offices, etc. These will be coordinated, insofar as health aspects
are concerned, by the Metro CHP staff.

Facilities:

MACLOG, CCAA, ARMPC, and UHF will be housed in the same building.
This close proximity will make possible sharing of numerous facilities,
such as library, public information, duplication and mailing, etc.

For additional information, see the section on Facilities in the sec-
ond Section of this prepossl volume.

_ 16 a



ORGANIZATION FOR COMPREHENSIVE HEALTH PLANNING

confreo‘l’ual
relaiion

Oiker Pbfifl{‘5
$46. ($3

Abbreviations:

ARMPC Atlanta Region Metro. Planning Commission
CCAA Community Council of the Atlanta Area
CHP Comprehensive Health Planning

DHEW (U.S.) Department of Health,Education & Welfare
MACLDG Metro. Atlanta Council of Local Governments

Bd Board

Conf Conference
Dir's Directors

Chmn Chairmen
Plng Planning



Cooperative Arrangements made for funds, personnel, services,

Title:
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 RESOURCES.



COOPERATPVE ARRANGEMENTS WITH OTHER PROGRAMS

I'll: Irll'lrlflfll'lllilil‘l EI.'|IIJ| EIJI !| || || Ii II” :I ”ll" II II II” |[lililllllllilllilllilil "II II IHI IIHIIIIJ'HIIII II'IIHII'IIIIIIIIII'II'II |I||'|I|I||'II|||l|I.||'|'.|f|I|I|1|I|IIIIIIlIIIlIIIlIlIlIiIII Illfll Illl |.'||'|I||'|l|l|l|'|

DHLW
Dept. Health,
Education &
Welfare

Local Health Agencies

letro Atlanta
Council of

Local Govts.

Metro Comprehensive
Health Planning
Council

*See Appendix for Details.

a personnel
MACLOG

.technical
assistance

Comprehensive Health
Planning Staff

Community Council
' of the Atlanta
Area, Inc.

Administrative Services'
Housing, Furniture,supplkm

Personnel policies*

Ancillary Services—m

library, duplicating,
mailing, etc.



Planning is Based Upon Commonly Available Data

SUMMARY:

THE LOCAL RESOURCES FOR QUANTITATIVE DATA IN THE HEALTH CARE FIELD ARE
RATHER LIMITED BOTH IN AMOUNT, AVAILABILITY, AND COMPARABILITY, THE COM—
PILATION 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.



Implications for Comprehensive Health Planning in Environmental
Health Fields

SUMMARY:

THE METROPOLITAN ATLANTA AREA HAS MADE NOTABLE STRIDES TO IMPROVE EN-
VIRONMENTAL 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 IM—
PLEMENTATION, AND INCREASING EFFICIENCY IN OPERATION.

Text:

Environmental Health programs being developed or recommended for
the Metropolitan area include:

1. Water and sewer plan implementation - a natural follow-up
to current water and seWar planning should include recom-
mendations 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 programming: a continuation of the work
ARMTC is doing now.
Metropolitan Solid Waste Plan — MACLOG.
Mobile Home Park - ARMTC — Study of requirements on location.
Vector Control Program - EDA - Demolition Project.
Comprehensive study of problems and possible long-range
solution for solid waste and garbage collection and disposal.
Development of a long—range plan for industrial and office
parks throughout the area - ARMTC.
A study of future housing requirements: as they relate to
population forecasts, income, employment, and location.
This study is now being held in sbeyance.
Up—dating of Airport Plan - ARMTC.
Study, up-date and revise all elements of land development
and facilities plans.
ARMTC - The need for nature preserves and related outdoor
recreation facilities has been established. Implementation
is now needed.
Flood control project by Corps of Engineers.
Atlanta Housing Authority: re-develop public housing area;
rat control; health clinics for project area; and neighbor-
hood renewsl project (yearly basis).
Georgia Safety Council: organizing Teen Safety Councils in
all high schools in the state of Georgia; conducting industry
safety seminars throughout the state; driver improvement for
truck drivers; driver improvement through the defensive driver
course; conducting injury control program.



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 RE-
SOURCES OF THE MAJOR EDUCATIONAL INSTITUTIONS IN THE ATLANTA AREA AND
THE STATE OF GEORGIA ON BROADENING THE INTELLECTUAL BASE OF THE POPU—
LATION, 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
Cities acting under contract with Departments of Housing and Urban
Development and Health, Education and Welfare.) This network of
"Urban Observatories" 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 neces—
sitate 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 organi~
zational 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 is structured to
provide specialized activities, including short courses. in—
stitutes, 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.

C) 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 I.IFE CENTER

BOARD
OF
REGENTS
GRADY
HOSPITAL



















GEORGIA
STATE
STATE COLLEGE LOCAL
GOVERMNT GOVERNMENT
AGENCIES AGENCIES






DIVISION OF
URBAN PUBLIC
SERVICE









SCHOOL OF
URBAN STUDIES




INTER-UNIVERSITY
URBAN COOPERATIVE

URBAN
OBSERVATORY








HEALTH
AND
HEALTH RELATED
INSTITUTIONS





_ 33 _

Local Health Departments, Atlanta Area

CENTERS AND CLINICS

Fulton County Cobb County (cont‘d.)

Main Center & offices Austell
Adamsville Mableton
Alpharetta Powder Springs
.Ben Hill Smyrna
Buckhead

Center Hill

College Park Clayton County
Collins

East Point ' Main Office
Fairburn Forest Park
Hapeville College Park

Howell Mill Fayetteville
Jere Wells

Lakewood
Roy W. McGee
Neighborhood Union

Northeast Main Center
Palmetto Buford

Red Oak Norcross
Rockdale - Duluth
Roswell
Sandy Springs
South Fulton
Techwood

we

mew

Main Center,
Douglaaville
DeKalb County

Main Center & offices
Doraville

Kirkwood

Lithonia

North DeKalb
Scobtdale

Southwest Dekalb

Stone Mountain
Tucker

Cobb County

Marietta
Acworth



County Financing Slate Allotments

July '67 — June '68

I-‘ulton $ 403, 181—

nch'alb 269, 127—
(‘obb 122,271—
Clnylon 52,049lll
Gwinnett 18,760-
I)nuglas 21,119-

#1101; readily available

4mm: n1

Centers

6099 £fi5~§mnf

PUBLIC HEALTH CENTERS
WW

Metropol 1 tan At lanta Area

are!

Manpower

425
199
47
38
21
8

Admission by Service

Mental Health V.D.

T.

B.

7,479 83,109 6,91‘1

2,925 63
2,169 128
964 6
484 4
*__E

GUINNETT

SP3
I
1

I
‘ fitment LLI

3
1

a.

.363
,089

5]":r
59?.

0 HEALTH CENTERS
SINCE 1967

4: HEALTH CENTERS





WATER. AND SEWER DISTRICTS IN THE ATLANTA AREA.








_ \ -
N‘K
QDACUL an
“-. \







' I
I “1"?‘fifih LE U a | :I 1 4 s
h' ' -:-:—
/_¢ '1 LEGE 'II ’I ‘ ‘f mu Inn-us
I ‘Rfi! ‘JIINIDUNI‘UU NC“
’ “JUN All fill. HMIYS
fil

,
J I I EXISTING FACILITIES

. Atlanta — II. :1. Clayton [1.1.1:

. Atlanta — Sandy :YEfl. Plan:

. ntlonn - Dray Crook Plant

. Atlanta - South River Plan:

. Atlanta — Intrnnch-onl: Creel. Flnnl.

. Atlantl - Illa: River “not

Fulton County — Industrial Hnn Plant
Fulton county - Norah Creek Pllnt

ll
\ kg”
,,
c N
. Fulton County - Morning Creek Lagoon

[
L
L .
co. ‘ ¢
. Jointly Owned Cm crook Plan:

/'
”‘7 ' \q l 11. Fairburn _ north-jun Plan:
I L. 12. FnlrhurnvSourhnide Plant
F L l N T R I V 13. val-en: Plant
. l
I



{possesses
A

fie
7p:
~71.

...
D‘UWHIUNM’WMH

u. Alon-tetra Lagoon
15. Cullen Fork - Southeast Plan:

16. Clayton Gout: _ Flint Riva: Plan:
1?. Elly-ton Cnuntr - Rock Out Rood Luann
l 2*. Atlanta Am Depot Plan:
35. noon County — Shoal Creek Plant
26. noxalh County — Snapflnnor Greek 'Plont
23'. Mall: County - Lngnon
28. Lithonia — loot Sever Outlet
M 29. Lithonia - South Sour Outlet
Y SEWAGE TREATMENT 30. Conn“ — South Sou-u Outlet
. SECONDAR 11. Congo“ — North Sm: Outlet
TR TMENT 32. Foreman Lagoon
o PRIMER?! SEWAGE E1“ 3]. Laurence-ville Plan:
E 34‘:- mronoovll 1e Lennon
0 UNTREATED SEWAG :5. Mord Hm
u: > TA 36. L‘s-ins, Luoonn
POTABLE WATER IN KE 31'. Acworth Plant

35. Kenna-nu Plant
“w“, "a,” nugmmu. um Luna‘s-5': 39. Hal-1on- - Hon: Side Plant
In or... hum-o “"‘" ““""‘ ‘0. Bil—lotto — South Slat Plant
u. Hal-lau- - Root Side Plant

#2. Marietta — Southmt Side Plan:
U. Inokhatd Flank

In. Cobb County - Church Road Plant
#5. Cobb County — South Cobb Plan:
is. Sawm- - [inhumane Crook Plan:
I“. Aunt-:11 Plant

is. Dougluvlue Plant





State Health
Planning Council
Advises ”A"
Agency in
carrying out

its goals

C omprehensive State Health

Planning'Agencx - "A" Agency
Develops comprehensive state health

plan. .
Identifies health problems. ‘
Recommends policies and programs.
Provides consultation and coordinates
programs.

Areawide Planning Agencies -
"B" Agencies

Relates health programs in anarea
within a comprehensive frame-
work.

Liaison with appropriate health
agencies in an area to help carry
out goals.

Conduct periodic evaluations and
studies.

Review local grant applications.

Gathers and analyzes data.

Public Voluntary
health health

agencies agencies
(local) (local)





. EUGENE T. BRANCH. Chufmnt-I u! :F'IL' ”mm! m‘ him-nun
@m‘glfirfiufififilfifi? cscu. ALEXANDER, I'm: anniml'."
C JOHN IZARD. I'Ix'e Chain-”hm - ‘
. Q I— .
_ ‘1'“ r:._ a .a ‘ MR-o. THOMAS H. GIBSON, Autumn
Q ”‘k‘xacflfi 0% like DONALD H. GAREIs. {roman-Ir
Assamese
A. '
yea Inc. ‘ DUANE W. BECK. Ewwrh‘t' Duet-m:-
ONE THOUSAND GLENN BUILDING. 120 NIARIETTA ST“ N. w. ATLANTA. GEORG‘A 30393 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. Spills:

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,

Wfim
Rap ael B. Levin , Ph.D.

:Director, Comprehensive
Areawide Health Planning

RBL:az
Encl.

--69-

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 RE-
LATIONSHIPS 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



ORGANIZATIONAL CHART OF COMMUNITY DEVELOPMENT IN
COMPREHENSIVE HEALTH PLANNING

25-member core of planning efforts to direct task
force assignments.

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 representa—
tives 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 recom-
mendations. 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 Health 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 COMPRE-
HENSIVE HEALTH PLANNING COUNCIL WILL PRODUCE AN EXEMTLARY 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 over-
crowded 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 community leaders under auspices of

the Chamber of Commerce. Health problems were recognized in four basic
categories:

Services
Facilities
Manpower

Financing

Task forces of the Council and other community members have been assigned
to determine needs, resources, and possible solutions in these areas.

Implications for Success:
1. The Chamber of Commerce has had a leading and beneficial

role in organizing the CCHC. Support and participation
have already been secured from major segments of the com-

munity.

2. Planning involves government officials, 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 bull support for CHP. -

-56—

POLICY - RECOGNITION - SUPPORT - ACTION

$ FOR PROJECTS $ FOR PROJECTS

' ROJECT APPROVALS
REGOGN IT ION
$ FOR
PLANN ING ( 50%)

RECOGNITION 5 cup AGENCY $ ma PLANNING

W
HEALTH CARE $ FDR COUNCIL, LOCAL

AGENCIES PLANNING STAFF
E RECOMNDATIONS
IN TECH. ASSISTANCE l FitEOOGNITION RECOGNITI N T
(___i s
@913
fl m

GOVERNMENTS

l.

'42»
*‘o
429

$ FOR PLANNING

CHAMBER OF COMMERCE
FOUNDATIONS

$ FOR PROJECTS OTHER BUSINESS INDUSTRY

ACTION . (IMMUNITY CHEST
E LOCAL GROUPS
PROJECTS ETC.



Procedure for Policy Implementation

SUMMARY:

FUNCTIONS OF THE METROPOLITAN CHP AGENCY WILL INCLUDE RESEARCH, COORDINATION OF VARIOUS
GROUPS, AND POLICY DECISIONS IN THE HEALTH FIELD. AS A PLANNING BODY, THE COUNCIL AND
STAFF WILL DEPEND UPON ACTION GROUPS FOR IMPLEMENTATION OF ITS POLICY. FEDERAL, STATE
AND LOCAL GOVERNMENT RECOGNITION OF THE AGENCY WILL BE KEY FACTORS IN THE ABILITY TO
INFLUENCE ACTION WHICH WILL IMPROVE HEALTH FACILITIES AND SERVICES.

The following functions and relationships will provide a basis for ensuring implementation
of policy.

Functions of the CHP Agency (Policy Board and Staff):

1. Conduct research in community health problems.

2. Develop background for policynmaking; use systems analyses, cost-benefit analyses,
etc.
Coordinate activities of all health planners in the community.
Review health action projects originating in the community.
Provide technical assistance to action agencies.
Originate health action projects where needed.
Conduct community liaison and education in health matters.
Give adjacent areas assistance in health planning on contract basis.

. Make policy decisions for the community in health matters.

Relationships between the Agency and other groups:

The CHP policy Councfl_will be representative of all health concerns in the
Metropolitan Atlanta area.
Recognition of CHP Agency responsibility and authority in planning areas is
expected on all levels of governmental and health—concerned group involvement.
Funds for exercising agency functions will be sought from federal, state and
local governments, Their support will indicate recognition and delegation of
health planning policy decisions to this agency.
Foundations, business and voluntary health organizations may be expected to provide
some funds for planning. .
Local governments and independent health agencies will receive benefits from CH
through technical assistance in planning, coordination of efforts and recommenda-
tion of priorities.

6. Federal funds for any given project will need approval of the CHP Agency for
allocation.

The above being factors, respect for the CHP Agency will be an inherent trait necessary
and present for implementation of policy decisions. Recommendations made to governments,
other planning agencies, hospital authorities and the like, wiIl be carried out by those
groups with desired assistance of the CHP staff.

Effectiveness of comprehensive health planning:

The interrelationships among CHP and other local governments and agencies is designed to
insure mutual respect and dependence. Whereas the CHP Agency depends for its existence
on the recognition and financial support of the other groups, they, in turn, depend on
the existence and recognition by State and Federal offices of the CHP Agency for much

of the Federal funding they require. And whereas the CHP Agency depends on the reapect
for its competence and fairness by local grOups for its effectiveness in originating
new plans, the local groups depend on the CHP Agency review for implementation of

plans which they originate. Thus, it is in the interests of all that relationships
begin and continue on a harmonious and mutually helpful basis.

- 54 _



CHOICE CHOICE 0

OF FUNDING 0F PR’OGRAM
LEVEL ALTERNATIVE

EFFECTIVENESS"
M

nesouncas PROGRAM - OUTPUT - IMPACT '
“~___——F-“W¢’_‘—-—__ur’

o MONEY

0 PEOPLE
OFACI LI TIES

PROGRAM GOALS
OUTPUT .
EF =

FICIENCY INPUT ACTIVITY LEVEL
DETERMNANTS*
a REQUIREMENT
.NEED
9 DESIRED LEVEL
COMPREHENSIVE HEALTH SERVICE-

MULTIYEAR PROGRAM AN

'I
II
M
I"
WI!
'0‘”!

f
79
"99’
w
III

":0

(Ill/ll.

"ill/fly;

VIIIIIIIIII
on."
m...

'l
'I'IA
'3'
I'll."



The Need fnr Planning Programming System for Comprehensive
Health Planning

SUMMARY:
PLANNING AND PROGRAMMING SYSTEMS OFFER GREAT PROMISE TO AREAWIDE PLANNING

AND OTHER GOVERNMENTAL ORGANIZATIONS AS A MEANS OF SYSTEMATICALLY RELAT—

ING 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 RE—

SOURCES.



Basic Purpose:
The basic purposes of a planning and programming system are to:

'tpermit rational choosing between objectives,

*oermit rational choosing between programs,

ifacilitate selecting rational levels of programs,
ifacilitate review and evaluation of program accomplishment.

Major Characteristics are:
ithe identification of the fundamental goals and objectives

of the area;
isystematic analysis of alternative ways of meeting the area-

wide goals and objectives;
“Ithe presentation of alternatives to the decisionfinaker;
-kexplicit consideration of future year fiscal implications

(5-year program goals) at;
— preferred funding level, or
- stringent funding level: and
ithat proposals and decisions are properly supported by docu—

mented 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 busi—
ness 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 objectives 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 govern—

ments in policy formulation.
A method of relating areawide planning and programming to the

financial process of the State and local communities.

-62—

_'[9_



'nm 1; 1' on
Air

Wa te r /
.Fffifd—P Karmic—e [m1 / '\
/ ‘

____ Rodi a ti n /
rLS§_t';_1'-.1..elfl.e_1}t5 KES1-—.flaenc‘3l/- I; ‘31 in \
1 .















'_, f ..H” Waste disposal on

I . ‘ I C’ -§F ,, - ,
"_ :I/[l _




Title: Information Gathering and Analysis Systems and Technigues to be Used

SUMMARY:

THE BASIC INFORMATION SYSTEM WILL INCLUDE THE (A) COLLECTION, (B) QUANTI-
FICATION, (C) STORAGE, AND (D) UTILIZATION OF DATA PERTINENT TO THE OTHER
PHASES OF THE PLANNING PROCESS, PROBLEM AND RESOURCE DETERMINATION, IM-
PLEMENTATION, AND EVALUATION. EVALUATION OF THE PLANNING ITSELF SHALL BE
DONE BY THE COMMUNITY AT LARGE THROUGH ITS EXERCISE OF SUPPORT. EVALUA-
TION OF PARTICULAR PHASES OR OPERATIONS WILL BE BUILT INTO COSTS-BENEFITS
ANALYSIS AND SUPPLEMENTED BY INDEPENDENT INVESTIGATION.

Research Technigue
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 alter—
native plans for action.

Evaluation Technigue:

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 community 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 OH? Board by their respective
groups.

The "public" will be an implicit'evaluator through its usa and non-use
of programs.



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 alcoholism.
Degenerative and chronic diseases.
Citizen role in prevention and care.

Costs of health care; insurance patterns.



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 HERE 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 SEEN IDENTIFIED AS MOST LIKELY To DEFINE THE SCOPE OF THE FIRST
YEAR‘S 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 problems and prevention 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 scope 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
divided into priority categories on the basis of the impressions deveIOped
to that time, and about half of them were designated as needing further
study. This, in turn; was accomplished through the mechanism of problem
area "task forces".

Problem Area Task Forces

Groups of interested and knowledgable persons in the community were asked by
the various 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 forces
ranged in size from two or three individuals to more than 20. They were given
instructions as to how to go about gathering their data and how to report
their findings (see Appendix ), and were assisted and encouraged by one

of the Staff. Some 27 of these task forces were eventually formed, and their
reports, in many cases quite voluminous, are presented in Volume III of this
proposal (in condensed form). A great deal of thanks is due to these hundreds
of people, health providers and consumers alike, for the insight which they
contributed to the understanding of this community's problems.

Scope of the 1970 Effort

The 14 problem areas shown on the facing page now seem likely to define the
scope of the first year's efforts of the permanent comprehensive health planning
agency.

-54—



COMBMNITT INVOLVEMENT ROUTE FOR BUILDING A POLICY BOARD BY CONSENSUS

(‘\_'!\A FCMS COM J CA] [PA

a I ’10 Community Involvement Panel

FFMS , .
At.COC C s 01 C #70

1 meetings 2 meetings 1 meeting 2 meetings

meeting

Community Involvement

Community Involvement
Steering Committee

Steering Committee
‘36 ‘34
meeting Ad Hoc Nominating Groups

WM“-

6 meetings

Smnll Groups
(many)

_ CCAA Community Council of the
Comprehen51ve Health Atlanta Area. Inc.

Planning Council Atcoc Atlanta Chamber

Org. of Commerce

o 10 Local Governments CISCXC

3 Major Planning Agencies
50 Orgs. 20 Health Providers

- 2 Business and Labor
1 eetin '
m g 1 meeting Beeh' 17 Poor and Near-Poor FCMS Fulton County

35 Medical Society

Community Involvement
Steering Committee
Executive Committee

C's of C Chamber‘s of Commerce

JCAHPA Joint Committee of Area

1 indicate number of people at meeting(s). Health Professional
Associations

Notes:

D several members per organization



Organizational History of the Applicant

SUMMARY

THE COMMUNITY COUNCIL OF THE ATLANTA AREA, INC., A NON-PROFIT
CORPORATION CHARTERED UNUER 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

HEALTH PLANNING COUNCIL (CHP COUNCIL), WHICH WAS BROUGHT INTO BEING

BY A COMMUNITY INVOLVEMENT PROCEEDURE RESULTING IN SUBSTANTIAL CONCEN-
SUS. THE STAFF WILL CONSIST OF THE CHP ORGANIZATIONAL STAFF, AUGMENTED
BY ADDITIONAL PROFESSIONAL AND SUB-PROFESSIONAL MEMBERS.

COMMUNITY COUNCIL OF THE ATLANTA AREAI INC;

The Community Council of the Atlanta Area, Inc., was established as

a community planning agency :m 1960; previous to that date it was the
Planning Division of the Atlanta United Fund. In 1963, the Council
Launched the West End Demonstration Project with the purpose of finding "new
ways of solving economic dependency (poverty)"; the activities of this
Project let to the design of the initial application by Atlanta and Fulton
County for funds from the Office of Economic Opportunity. The result was
the Economic Opportunity Atlanta (EOA) agency was established. In 1965,
the Council entered into a contract with Atlanta to deveIOp a long range
plan for Urban Renewal under the Community Improvement Project (CIP) which
producaithe information, development plan, and method of "grass roots"
resident participation 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 (CHE;

The CHP will come into existence on June 5, 1969, and will assume the
active role of policy making in health matters when the permanent agency

is established January 1, 1970. This Council was brought into being through
extensive process of community involvement and concensus-seeking. After
several preliminary meetings of possible sponsors, a group of "convenors"
brought together a "Community Involvement Panel" representing 170 offices,
agencies, and organizations Concerned with health. This Panel on March 13,
1969 elected a "Community Involvement Steering Committee" of 36 members,
and an Executive Committee. Thus the development of organizational guide-
lines, the methods of reaching them, the nomination and selection of
permanent members of the Council became the goal of this Steering Committee,
which in turn resulted in the formation of a Comprehensive Health Planning
Council on June 5, 1969. The membership (as shown on the opposite page)

is drawn frOm five broad categories of community groups; well-distributed
by geographic areas, socioeconomic status, ethnic backgroup, providers and
consumers, public and private sectors. (Members of (HP, representation,
organizations and functions are on pp. 80-85.)

STAFF

Hembers of the Organizational Staff and titles and descriptions to
staff to be recruited to become the permanent staff of the planning
agency are listed On pages 78 and 79.

-52-



BACKGROUND OF HEALTH PLANNING EFFORTS

(1)

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.



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 PRO—
GRAMS RELATED TO HEALTH HAVE BEEN CONDUCTED SINCE 1960. THE COUNCIL HAS
WORKED CLOSELY WITH FEDERAL, STATE, AND COUNTY AND CITY AGENCIES, PRO-
FESSIONAL AND VOLUNTARY GROUPS AND INDIVIDUALS TO RAISE THE LEVEL OF HEALTH.

Current Status:

The following paragraph taken from "Narrative Plan for Comprehensive
Health Planning" by which the Governor designated the Georgia Department
of Public Health as planning agent for the Siate of Georgia attests to
the capacity of the applicant planning 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-health
planning. These are the Community Council of the A1lanta
Area Inc. the Uniied Community Service of Savannah-
Chatham County. Inc., and the Georgia—Tennessee Regional
Health Commission. The Department has maintained liaison
with these agencies throughout their existence because of
their broad inierest in human resources planning This re—
la1ionship is expecied to continue."



0

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
HEALTH ATTAINASLE FOR EVERY PERSON". LOCALLY, THIS MEANS DEVISING AND ADOPTING
STRATEGIES FOR THE USE OF HEALTH RESOURCES WHICH HILL 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 CDNCERNED
ELEMENTS IN THE COMMUNITY WILL BE NECESSARY FOR SUCCESSFUL IMPLEMENTATION OF
POLICY.



In 1966, the United States Congress enacted Public Law 89-749, the "Partner-
ship for Health" act. Under this law, the States, and.through them, areas
within the States, must assume responsibility for comprehensive health
planning. The Congress declared that "fulfillment of our national purpose
depends on promoting 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 depends on an
effective partnership, involving close intergovernmental collaboration, official
and voluntary efforts. and participation of individuals and organizations;

that Federal financial assistance must be directed to support the marshalling
of all health resources-—nationsl, 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".

The term "comprehensive" means that every aspect of the health picture in
the six-county metropolitan area must be taken into account in the planning
process. This includes not only-the treatment of illness and injury, but
their prevention, and the compensation for any lasting effects which they
may leave. Thus, in addition to the manifold activities of medical and
paramedical personnel in the variety of health treatment facilities, planning
must consider environmental controls of the air, water, soil, food. diaeasa
vectors, housing codes and construction, waste disposal, etc. It must
consider needs for the training of health personnel, for the improvement of
manpower and facilities utilization, and for the access to health care.

It includes the fields of mental health, dental health, and rehabilitation.

It must be concerned with the means of paying for preventive measures and
for health care. '

The term "planning" means, first, that problem areas and potential problem
areas in the entire field must be identified,and their magnitudes assessed.
The trends of the problems must also be assessed, and projected for future
years. Technical and organizational bottlenecks must be identified, and
planned around . Second, the community's resources-in meeting its health
needs must be equally carefully identified and projected, in terms of pro-
feesional and subprofessional skills, facilities, and financial resources.

-43-

Third, since a considerable amount of planning is already being done for a
number of projects, hospital authorities, counties, and municipalities,

which affects the community‘s health picture, ways must be found to make
maximum use of this capability, and coordinate it into a community-wide
comprehensive planning effort. Finally, planning must preserve and encourage
the highest level of professional competence in the entire health system,

and must make use of the insights of all concerned in the community health
system.

The overall task of putting together such an organization is thus seen to be
a problem in "systems" analysis and development. Since the total resources
of the community are likely to remain smaller than the demands which an ideal
health system will place on the resources, rational and just methods of

. assigning priorities to the various needs must be developed. A cost-benefit
analysis is essential to any auch decision process, and, considering the
literally hundreds of specific health needs in the community, it is likely

that the cost-benefit model must rather Boon make use of modern computer
techniques.

The Partnership for Health law requires that such planning be done with
people rather than for people. Therefore, maximum participation of health
"consumers", health professionals, governmental units and agencies, and other
community organizations is a necessity. The law is telling the States and
communities that they will be given increasing responsibility and power to
determine their own best health interests. In order to exercise this power
most effectively, a maximum degree of concensus must be attained among those
community elements concerned with health. To this end, participation of

such elements is mandatory, so that a true'partnership for health" among

governments, health providers and consumers, rich and poor, black and white,
urban and rural, may‘be achieved.

* *

GOAL FOR 1975:

WIMBLE, 1 HAVE CALLED THIS
MEETING TO INFORM YOU THAT SE28? SQESN’éIAPcfisrz-TFNSASEE
THE CLAUDE CLAY LOCAL SHOOT-OUTS ARE DOWN
UNDERTAKING PARLOR 73%... THE ACCIDENT RATE HA9
'5 'N THE THROES 0F DROPPED TO AN ABSURD LEUELL.
; PLAGUES ARE AT AN ALL-TLME
_ as? ' LOW! IN'SHORT} AT—
. - mm ,IS IN THE
CLUTCH ES OF A GLOW
OF HEALTH 0F
NEAR EPIDEMIC
., PROPORTIONS'

.._.......---—--‘-""h-t

from Atlanta Journal and Constitution
25 May 1969
”Tumbleweeds" by Tom K. Ryan





STATE OF GEORGIA. government

NUMBER OF FEDERAL AGENCIES

SERVING STATES FROM ATLANTA
REGIONAL HEADQUARTERS.




nnnnnn

ATLANTA POPULATION

1940

1350

1950

NEXT 25
YEARS 2 MILLION



V2 1 l V: 2
Number 0! People (In Millions}



REGIONAL CAPITAL OF THE SOUTHEAST

-47-

uuuuu







........

.........

.......
-----

RAPID TRANSIT STATIONS
0N INIY'M $‘5‘EM



n r=0
u
. at new“:
. ,, o.” nun-u;
um . o.u
F—'_'_.
... u :;-. .: ,.

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 installations 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 pre-
sent 4?. 5%

- Major items in transportation are automobile (GM & Ford) and air-
craft (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 Tel-
ephone & Telegraph Co. I
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 statioas; over 19 radio
stations, news coverage by 3 national TV networks, 20 weekly news—
papers and regional operators of AP, UPI, Wall Street Journal, New
York Times, Time Magazine, Newsweek and Business Week.

Higher Education
A major regional function of the Atlanta Area (SMSA).

- Headquarters of the Southern Regional Education Board
and for the Southern Association of Colleges and Sec-
ondary Schools.
- There are a number of recognized colleges and universi-
ties in the Area of great importance to its economic potential.



The Economic Status of the Atlanta Area

SUMMARY:

THE ATLANTA AREA HAS MANY SPECIFIC URBAN PROBLEMS. WHILE GENERALLY PROS-
PEROUS DUE TO ITS GROWTH AS AN INDUSTRIAL, BUSINESS, FINANCIAL, EDUCA—
TION, 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, IM-
-MIGRATION 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
MEDICARE, 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 summer 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, several
creeks and lakes.
--Lake Lanier and Allatoona Lake are within 50 miles of Atlanta
The reddish clay-soil of the Area is moderately fertile, but
susceptibility to erosion has diverted much of the land to less
demanding uses such as pasture and forests.







- 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.

-Rai1roads - 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 air-
lines are headquartered in Atlanta. 800 scheduled arrivals and de-
partures daily.

-Naterway 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 city" 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 52 , 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, growing in numbers, who will create a demand
for retirement homes, medical care facilities and passive
recreation equipment; this will affect construction and
industrial production;
impact of automation which will accelerate competition for
available jobs.

Government
Government is big business in the ATLANTA AREA.



SELECTED RANKINGS & CHARACTERISTIC
OF GEORGIA (From State Data & State

Rankings, Part 2 of 1966—67 edition
of Welfare Trends)

HEALTH MANPOWER

U.Sfiank
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 Manpower

SUMMARY:
THE NUMBER OF PRIVATE PHYSICIANS AND DENTISTS AVAILABLE TO THE PATIENT IN THE

6—COUNTY AREA IS AIMDST THE SAME AS THE NATIONAL RATIO. OTHER PARTS OF GEORGIA
HAVE RELATIVELY FEWER PHYSICIANS AND ABOUT HALF AS MANY DENTISTS FOR THE POPUr
LATION. REGISTERED NURSES ARE CONSIDERABLY MORE ABUNDANT IN THE ATLANTA AREA
THAN NATIONALLY OR ELSEWHERE OVER GEORGIA. THE NUMBER OF SANITARIANS ALSO

COMPARES FAVORABLY WITH OTHER AREAS.

THE COMPARISIONS MADE HERE ARE NOT RELATED TO NEEDS, WHICH IN MANY CASES IS
GREATER IN METROPOLITAN AREAS, THAN IN SMALLER AREAS.

HEALTH MANPOWER RESOURCES, 1968

L

Area Ph 51c1ans | Dentists H Registered Nurses 3' Sanitarians
Private IPersans IRegistered? Persons» Active Persons per

per M Active Nurse

t

Douglas M S
Gwinnett 16 g ' 6478i 81

. 5

12
Cobb 135 1294 .3242? 35s
DeKalb 216 1637 E 109 3452‘ 1,571

Fulton 864

_6 County 1257 1031 .
Georgia 3165 1143 1296 1 3744 312,368

U.S. 188772 1036 I'90716 2157 909,131

m

Clayton 20 3935 - 14 5564'
52

National & State data are taken from Health Resources Statistics,1968,U.S. Dept. HEN

Sanitarians: Provided by Mr. Furman B. Hendrix, R.S., Ga. Society of Professional
Sanitarians, May, 1969.

____._____I__________I__________________.________________.____.____.___._________________
Nurses: Roster of Registered Prof. Nurses, Board of Examiners of Nurses for Ga.,1968.

Dentists: Office of Dental Health, Ga. Dept Public Health, June, 1968.

Physicians: Bio-Statistics Service, Ga. Dept. Public Health
For more complete table see Appendix.



A PROFILE OF PERCENTAGE OF NEEDS
MET AND UNMET FOR HEALTH FACILITIES
IN HILL—BURTON SERVICE AREAS,
ATLANTA, SMSA, 1968

UOHEJIIECIE’VBH
8193 11119; 81101

‘2. Met Needs I

IEJIdSOH Iezeuag

2. Unmet Needs U

anew: 93:1,}, pus on songs“;

We

209,200

SOUTH FULTON AREA 221,200
I Scuth Fulton, Clayton
Coweta, Fayette

DECATUR AREA
DeKalb, Rockdale
North Fulton

CITY OF ATLANTA AREA 460,000

LAWRENCEVILLE AREA 95,800
Gwinnett, Barrow, Walton

1’: Based on the Georgia State Plan for Hospitals and Related
Facilities, Revised ?/1/68, Branch of Medical Services and

Facilities Planning, Georgia Department of Public Health

...41-



Facilities: ludluding Hospitals, Nursing Homes. 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 80 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 corresponding
underutilization of obstetrical beds and pediatric beds
2. Need for development of rehabilitation services which prevent or
lesson the demand for acute health care. (see Profile)
Lack of extensive diagnostic and treatment centers, and of night
clinics to serve the poor who work during the day.
Lack of agreement on providing expensive facilities such as a
.community radiological treatment center. '
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 home
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 full-
time paid physicians.
4. Utilization committees in hospitals and nursing homes are gaining status.
Obstacles
l. 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 functions to lesser
trained patient care personnel.
4. Distorted insurance benefit structure which require inpatient status
to pay for diagnostic services.
Possible Solutions
Build new hospital and nursing home beds only based on effective demand.
Give greater attention to rehabilitation of patients.
Develop progressive care facilities such as ambulatory self care.
Develop»"Day HOSpitals" diagnostic outpatient services, night clinics.
. Operate full services of the hospital on Saturdays and Sundays, or
”round the clock" double shifts for surgery etc.
Remove the stipulation that the patient occupy an inpatient bed in
order to get insurance coverage for diagnostic and minor treatment
services.



-'---.- ._.__,...,_ _ _ __ . ._ .....‘__ ‘_ _, _ _' __ ____ _ ,___ ._.,_*.
SUMMARY;
NOT ONLY HAS THE INVOLVEMENT OF RELATED GROUPS REDUCED THE THREAT OF CHANGE,
BUT IT HAS BROUGHT INTO REALITY THE BASIC TEENE OE THIS PROPOSAL: PARTNER—
SHIP -— SOUGHT AND DEVELOPED. THE COMMUNITY COUNCIL'S HOSPITAL AND HEALTH
PLANNING STAFF HAS BEEN IN CLOSE TOUCH, BOTH FORMALLY AND INFORMALLY, RITE
OTHER RELATED PROGRAMS, PROJECTS, ACTIVITIES AND RESOURCES. NUMEROUS PRIVATE
AND PUBLIC ORGANIZATIONS HAVE CONTRIBUTED IN SIGNIFICANT WAYS TO THE PREPARAJ
TION OF THIS PLAN AND HAVE BEEN INCORPORATED INTO THE DESIGN FOR_A CONTINUING
PLANNING PROCESS TO IMPROVE THE LEVEL OF HEALTH IN THE ATLANTA AREA.

“mt? .-

Methods of Involvement:
Joint board members (mandatory and voluntary)
Staff exchange
Review procedures
Referral arrangements
Information exchange
Consultation (formal and informal) (l)
Umbrella organizations

Staff meetings (regular and called) (1)

Committee and Task Force memberships

(I) See Appendix for Chart of INTERAGENCY RELATIONSHI?S: HEALTH PLANNING,
which lists some Specific contacts.





Current Resources:



AREA



a






...... ”...—“...-..“ -_.—...........,.._ .....- ......EF, ..._.._.,_,_._._,.._.__...._.-
....._.....\_....__.__..._.._..4-.__...J _'._.'_.-..'_._..-..__..‘_,;...:"_"¢'g 223;“ _.'._..:.r____.’ _.£._.""_.fl..1.:... .z. _. _

iDcpt. Health, l‘ducation,hell'u1c, Community
Profile Center (info. cxchun;:c, consultation‘
Comwunic.ah1e Disease Contci (consultnlion) EAJ

--...._._.._.v ....-... -... ..._. W""‘"_"‘"'"'
...L... ....__._._-..fi._-.....J- ...-_1...._.a..-.‘......u- ...-.... ...-

FEDERAL










Office EOOnOMic Opportunity (info. eNchangc) {_
. Dept. Health, Education, WelIaIe (info. exchange, cousu].— j



..._.,

tation)

' Dept. of Labor, Dept. of Labor Statistics (consulLuLion,
info exchange)

:Emory Universitv Medical Schocl (consu11ntion)

-._.....—.,.....__ «When—...HHH

REGION








Wu...q,._..._ .. _1_._. ...“... .wnfifi -.. .'
-n....- ._ ”.....- ..__ .4_.L._..'.‘.-...¢:.. ...—4. 4.3.1.4;1”. ._" -

.._,.._ ......__..._—._—.,._ “WT—aw... ..... ,
LL,..L...:.........1.I....4_‘ -.....— .. ...-_‘.....“ .1._._.-.




.. Ewan..—.—_m.__,., - . ..., _ ..-... _.
;_H- ...... “...—4.-.”. W .11.- 2:2,-”1HJLULEE2 .

{Dept. of Public Health: Planniig OIiice, Oll'icc of Cnmlpthani\L
Health Planning, Office of Bio~Statistics,l1nnch oi Luvitouu
mental Health,Facilities and Construction Division, Licensurc
Division (info. exchange, consultation, board members, review}

STATE Univ. of Ga. Center for Management Systems, (info. exchange, con—
- sultation), Georgia State College (consultation), Ga. Tech,
School of Sanitary Engineering (consultation, info. exchange)
Georgia Hospital Association (consultation)
Medical Association of Georgia (censultatiou)
Ga. State League for NUTsing (staff exchange)
Ga. Nursing Home Assoc. (staff exchange)

Health Insurance Council (info. exchange)

- . -....._.... . .. .L‘Mmrr W3
- “3' ‘ ' ‘ ' ' "132-31.11253. mmxmtmmm‘”;ww
Atlanta Region Metropolitan Planning Commission (info exchnu_re, con:

sultation, board members)

Georgia Regional Medical Program (umbrella organization,reviow)

Georgia District Hospital Association (consultation, joint board )

Atlanta Area Society of Registered Professional Sanit1rinns (info.
exchange, consultation)

Metro. Atlanta Mental Health Association (staff exchange)

Ga. Society for crippled Children & Adults (consultation, info.
exchange, staff exchange, joint board) . '

Visiting Nurses Association (staff exchange, joint board)

Ga. State Nurses Association Training Program (staff exchange)

Blue Shield & Blue Cross (info.exchange, consultation)

American Cancer Society, Georgia Div. (joint board, consultation)

_ Ga. Heart Association, Inc., (joint board, consultation) _

1 Community Chest, Agency Relations & Allocations Division (joint

{ board/staff)

. Senior_CitJPens Service of Metro Atlanta,_





#4.“...A—4—d-‘AH':















Model Cities 'consuitaiion st1iI'exch1nge)
Atlanta University (consultation)
Economic Opportunity Atlanta (staff exchange, consultation, joint board)

County Public Health Depts. (staff exchange)

Fulton County Medical Society (consultation, joint boards)

Cobb County Medical Society (consultation) '
City of Atlanta, Air Pollution Control Division (consultation, joint bonrd)i

‘ Atlanta School System, P. T. Association and AdIU1t. Education (Inf?! 9\CDID:C?f

II:

The Comprehensive Health Planning Staff

...—.73., _ -w,-_ W-...-..,r...-w._.. _ _-__........., “...—_‘..-.. “......— - .._....._.__, "......” .-.... ...—HFWH— .
_‘..".--msws- __._._.........._._......_,-_-._._.._..._._._...-_‘--- ...-... - .: ...... - ...-...... --.... 5.1-...; -._.L. .—..-...-....‘.‘.....=....—.-_.._:_..._......a.n.u.

SUMMARY: -
THE FUNCTIONS OF THE COMPREHENSIVE HEALTH PLANNING STAFF ARE (A) TO CONDUCT

RESEARCH IN COMMUNITY HEALTH PROBLEMS, (B) TO DEVELOP BACKGROUND FOR POLICY-

MAKING THROUGH SYSTEMS ANALYTICAL METHODS, (C) TO COORDINATE THE ACTIVITIES

OF ALL HEALTH PLANNERS IN THE AREA; AND (D) TO PERFORM CONTRACT SERVICES

AND TECHNICAL ASSISTANCE ACTIVITIES. THE STAFF INCLUDES A DIRECTOR OF
COMPREHENSIVE AREAWIDE HEALTH PLANNING AND OTHER PROFESSIONAL AND SUB—PROFESSIONAL,

PERSONS.

- - - _. "_-"'~ - - 'WT "- ' ""'"'- -‘ '-'-" W-‘EM '-"7 "m’_-L""’M‘—m '-
'.-_L___x- Mfl—n—h—LMMJrZM" 2' ...... 4- -

Planning Functions

The planning functions of the staff consist of two major sections: (a) the
coordination and review of plans originating in the health and health~related
offices throaghout the community, and (b) the origination of plans in areas
not covered by other offices and agencies. The latter is expected to consist
in large part of systems~analytical studies, including cost—benefit analyses,
which cover the entire range of health problems and possible solutions.

I N C O M P.L E T E



COMPREHENSIVE HEALTH PLANNING STAFF
INITIAL ORGANIZATION '

Director
Secretary 4

Associate Director . Associate Director ’
Systems Research & Evaluation Admin. & Organizational Liaison
Systems Analyst Organization Liaison
Research/Evaluation Planner Reighborhood Liaison
Environmental Health Planner Plan Review/ Technical Assistance
Liaison Planner Secretary 3
Statistician

Secretary 3
Secretary 2

_ 39 _

.v. -. “s. _ ...... ...... ...—...... -... . .

_‘WWI—Jk- m1 .... r



The-Metropolitan Atlanta Council for Health (Comprehensive Health Planning Council)

Wm‘wwfiufir”HM-...-u1hTwm._—..__._.._.__...‘—,':._—T_.—..'..,r__.__...__..._..-.u_ .- _ .
...—.....-” ...A.n_-.+__-_._;,'_.._.._u.._+__-._.__._.:___._.._.____. -...L.-.___-._.." -..-.-..

SUMMARY:

THE FUNCTIONS OF THE METROPOLITAN ATLANTA COUNCIL FOR HEALTH ARE (A) TO

MAKE POLICY FOR THE METROPOLITAN_COMMUNITY IN HEALTH MATTERS AND (B) TO

SET POLICY FOR GUIDANCE OF STAFF ACTIVITIES. THE COUNCIL'REVIEWS HEALTH
ACTION PROJECT PLANS ORIGINATING WITHIN THE COMMUNITY, AND ORIGINETES

HEALTH ACTION PLANS WHERE NEEDED. THE COUNCIL .IS RESPONSIBLE FOR CONDUCTING
COMMUNITY LIAISON AND EDUCATION IN HEALTH MATTERS.

- . .- . 'FF—‘n . _ -.‘-‘--1--!v~‘.-w-—--~-=-r.~=——u~ m—v—.—-w~ _"_""'"_J""".‘Ti‘.'—'I—'—-:."""'1-1'—'—.|.. . — ‘w.
a-A—a—hMWbM'n-Qamfl ‘-A_me4L—&Hm-Ai_fiymfi£bn'm'

Council Structure

As firovided in the By—Laws, the Council is structured as a "working board".
All policy matters are decided by the full Council. To facilitate such
activity, the Council will form several groups of committees for Specific
tasks, each group supervised by a vice president. The committees will
report to the Council, and recommend actiOns in their areas of competence.
A number of the committees will work closely with the staff in such areas
as project review and community liaison.

INCOMPLETE



COMPREHENSIVE HEALTH PLANNING COUNCIL H STRUCTURE

Council
President
r—HMT‘“ ’“—T' ‘T‘__ l
VicePresident ' Vice—President Vice—president Vice—PreSIdentV1ce—Pres1dent
Project Review Counc. Function Special Needs Liaison & PR Administration
Facilities Organization _Ieighborhood State & Fed. Budget & Finance
proj. rev. review liaison liaison



Environmental Program & Needs of the Local Council Personnel
proj. rev. orientation disadvantaged liais0n

Mental Health Long—range Needs of Public relations Fund Raising
proj. rev. planning youth & information

COMIVIITTEES *

Manpower I .Legal counsel
proj. rev.

*Esch committee is chaired by a Council member; Vice -Presidents
of Counci.1 oveisee and encourage activities of the
groufisof committees shown.

:I::z:::::::::: - - ~ ~ Tfigz:=_""’“*“"EEEEILSEILT“I3ZEIZ223312222333255223355133
Executive Committee: Nominating Committee:
President of Council Selected from membership of Council,
A with due regard to makeup of the Council.
Vice—Presidents (5)
Duties: .
Nominate a slate of officers prior to
the annual meeting
Duties: - Nominate a new nominating committee
Carry on activities between ' prior to the annual meeting
Council meetings; recommend— Nominate organizations, on a rotating
ations subject to Council basis, which will name members of

review the Council to take office at the
next annual meeting

Nominate replacements for vacancies
as they occur

Secretary

Personnel Committee

Selected from Council membership
and community at large.

Duties:
Recommend selection and salary

of Director for Council action
Formulate personnel policies, in—
cluding salary ranges

_ 91 _



Membership on the Council

_ -——._.—_-——n __ .r-e-r-r- . - _ ,.q.__w.wh_..wiw_, WWW...
-.hW—+_m__.___x_.H——_-._Hm_-._-M._-_._-.__x__._._-_....._-..__..;__;‘.'—_:...'-_._._‘ ‘ ‘- ' ‘

SLR'LNLARY:
MEMBERSHIP ON THE COUNCIL SHALL BE DRAWN FROM TWO MAJOR GROUPINGS: THOSE WHO

WILL-SERVE BY VIRTUE OF OFFICE IN -A MAJOR PLANNING ORGANIZATION OR LOCAL
GOVERNMENT, AND THOSE WHO SERVE THROUGH BEING NMIED BY APPROPRIATE ORGANIZATIONS
OF ImALTH PROVIDERS AND CONSUMERS. MEMBERSHIP IS DRAI'L’N FROM SOURCES BROADLY
REPRESENTING THE ECONOMICJ ETHNIC, AND GEOGRAPHIC BACKGROUND OF THE COlmlUNITY.

-- humus. m 'r— _s'm"rrr:;wfia__irrvv—m ......_.'..... m :QWWW scarier—53;.

INCOMPLETE





MEMBERSHIP ON COUNCIL — Scheme 6



Number Group Selected/electedvby '
3 _ MACLOG, CCAA, ARMPC virtue of office (chairmen)
26 ' ' County commissions virtue of Office (chairmen)
1 City of Atlanta virtue of office (mayor)
3 ' Municipal governments F municipal associations or
of counties ' county commissions (in rotation) I
20 Heclth providers:
4 MD's medical societies (in rotation)
1 MD, psychiatry Ga. Psychiatric Assoc.
2 DDS's dental societies (in rotation)
2 Public health public health departments (in rotation)
(recommended: 1 MD, 1 other Specialty)
2 Health facilities hospital, nursing home associations, etc.l
(both private and authorityw— in
rotation) .
1 Medical educator school of medicine .
1 Paramedical educator allied sciences schools, etc. (1h rotation
1 RN nursing associations (in_rotation)
2 Voluntary health agencies CCAA Permanent Conference and State
Association of voluntary agencies _
(in rotation) i
1 Social worker NASH local chapter [
1 Skilled paramedical technical associations (in rotation)
1 Semi—Skilled paramedical organizations,-if any; otherwise _
‘ . ' nominated as an individual ;
1 Health ins. industry “ Health Insurance Council ’
17 Poor and nearspoor '
7 EOA's Atl-Gwinnett, Clayton, DeKalb-Rockdale
2 Model Cities ' ' I
3 PTA‘s . Cabbagetown, Cobb, Douglas (others in
- ' rotation) l
5 other organizations NWRO, Southside Health Center, TUFF,
_ NAACP, Urban League (1 each) (others
in rotation)
2 Business and labor Chambers of commerce, unions (in
.' rotation)
52 ’ TOTAL

The term of "virtue of office" members to coincide with occupancy of office. Term
of other members, three years, one—third rotating off each year. "In rotation"
indicates that at successive elections different organizations or groups within '
the same category will be asked to select members.

A nominating committee of the Council will be responsible for assuring such rotation.
For the first election ad hoc nominating committees in the major categories above

are being asked to submit names of organizations, for review by CCAA Executive Committee.

..93-

wan—n mvfi-m ...—’... ..



Title: Working to En5ure Effectiveness of the CH? Council _



SUMMARY:
THE METROPOLITAN COFmREHENS‘IvE HEALTH PLANNING COUNCIL IS A NEW

KIND OF POLICY MAKING GROUP. EFFECTIVENESS WILL BE MEASURED BY THE ,
EXTENT TO NHICH MEMBERS PERFORM SPECIFIED FUNCTIONS OF BOARD nmmFR— '
SHIP. A NIDE RANGE OF commune RESOURCES WILL BE USED IN TRAINING H



FOR BOARD ACHIEVEMENT.

M . 'P-"V‘FV‘W—J 1"". .“"-"'""'F- .‘r— - - - .. . —.-— _ . “Wan—n...- . ..-.-.- ---
L—m‘a- 1......“_._._._=,.....___i. ..,,,__._m- . . .. _, . ~..,:F""".~ u ‘.. . n . ..., “Lu... .5.-













Charagteristics of the CHPC Board:

7K7 COnSumers and providers, economic and ethnic mix, geographic
distribution.

(3} Veteran 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
incere groups) have not planned together or Worked as equals.

Perception of health problems will be influenced by the special
interest which each member represents.

Thus, successful functioning of the Board will depend upon effec-
tive participation of members both as representatives of subgroups ard
as 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 community, beginning 1 January 1970, some 6% months
_will elapse before the Council is called on for Official functioning.-
During this period, a number of activities are planned for the purpose
of familiarizing the Council members with the extent of the health
planning actions which they will be called on to evaluate and
guide. The period will also be used to vauaint the Council members,
one with another, so that they can select Personnel Committee and
Nominating Committee members most effectively, several months
prior to the Annual Meeting in January, 1970.

Some of the training and familiarization activities contemplated are:

0 introduction to principal health problems in the area

0 field trips to health facilities and areas of severe health need

0 training in effective Council and committee participation

0 experience (with Community Council staff) in reviewing planning projects

0 introduction to systems analytical procedures, and methods of basing
decisions on cost—benefit analyses, etc. '

0 joint meetings with other planning groups and with health activity staffs

_ 96 -

_ _W._._._._.._.._._._.___.___. .. v... _ . ..

_,.‘,_..__ ._ _

”HRMMNQ for @GMM‘HEBHIL EFFEMHWENESS-










I MPLEMEN’I‘
LEARNING
EXPERI ENCE




LEARNING
EXPERIENCE

EVALUATE EXPERIENCE
THROUGH COUNCIL
MEMBERS' BEHAVIORS

DETERMINE NEEDS
(ASSESS STATUS OF
COUNCIL IN FUNCTION)












COUNCIL
MEMBERSHIP
FUNCTION

- 97_—

By—Laws of the Council

_ _ ‘__ .W _ ......_._,._ _.WW ..__..._._......._... ..._..__.._...._._._,. -____.._........._.....
1.32% ...-......l. _‘.xmflg. gmmwmfimgw ...... a. ....__,._..-._.L‘:T‘_-‘_-. -_._-:

SUI-E-UIRY:
THE BY—LAWS OF THE COUNCIL ARE DESIGNED TO FACILITATE A-IAxn-Hm POSSIBLE
PARTICIPATION IN HEALTH POLICY I-UITTERS BY THE MEMBERS OF THE COUNCIL, AND
TO "BUILD BRIDGES“ To LOCAL ORGANIZATIONS CONCRERNED WITH HEALTH MATTERS.
THEY SPECIFY THE BROAD FUNCTIONS OF THE COUNCIL AND STAFF, EUT ARE INTENDED
To PROVIDE FOR SUFFICIENT FLEXIBILITY THAT THE COUNCIL CAN COPE NITH
CHANGING AREA CONFIGURATIONS AND HEALTH NEEDS. --

m

.The By—Laws consist of 13 Articles:
I. Name and Location
II. Purpose
III. Membership
IV. Duties and Powers of the Council
V. Meetings
VI. Officers and Executive Committee
Committees
Legal Counsel
Audit
General
Adoption
Associate and Affiliate Memberships
Ammendments

Important Provisions:

Some of the principal by—law provisions are Shown on the facing page (99).

Other By~Laws: .
Current BynLaws of the Metropolitan Atlanta Council of Local Governments and

. of the Community Council of the Atlanta Area, Inc. are included in the
Appendices to this volume of the proposal.



CHP COUNCIL — PRINCIPAL BY—LAW PROVISIONS

A. Council Membership and Terms

1. Chairmen of majOr agencies (3) and of county commissions shall serve for the
duration of their terms ‘
Representatives of organizations shall serve three—year terms (except for
some elected at the first election); 1/3 of these shall be selected each year.
Two three—year terms, maximum
Majority shall be health "consumers"
Approximately 1/3 shall be poor and near-poor consumers
Selection process shall take into account geographic and ethnic distributions in
the community
Selection process shall be determined by a nominating committee made up of
Council members. In selecting organizations and groups who will name members
to the council, the nominating committee shall achieve rotation among eligible
groups and organizations.Typical eligible organizations or grox's air Iniicated
in the following:
a. municipal governments group: municipal associations
b. health providers group: medical societies, denial societies, hospitals and
other_facilities, mental health professional organizations, public health
_departments,-Voluntary health organizatious, nursing associations,
skilled paramedical-associations, unskilled paramedical groups, social
work agencies, educational institutions, insurance councils.
business and labor grOUps: chambers of commerce, labor organizations
poor and nearwpoor: EOA‘s, PTA‘s, HUD projects (e.g. Model Cities),
voluntary agencies (c.g. Urban League, Legal Aid),- spontaneous
organizations (e.g. Welfare Rights, TUFF, etc.) ' ‘
8. Alternates may be designated; specifically understood that they act for regular members
Council Meetings

At least six per year (contemplate'monthly)
Quorum is 20 voting_members .
Majority of voting members shall decide
Roberts Rules govern

Council Structure
‘1. Officers nominated by nominating committee, or from floor; elected by majority

vote of Council _'A

2. Executive Committee shall consist of the officers (7)
handles business between Cduncil meetings _
actions subject to review by Council at next meeting

3. Nominating Committee selected from members of the Council

4. Personnel Committee selected from Council members and others

5. Other standing and ad hoc committees as needed .



BY—LAWS

ARTICLE I '— NAME AND LOCATION

1. The name of this organization shall be "The Metropolitan
- Atlanta Council for Health", hereinafter referred to as the "Council".

2. The Council's principal office shall be located in the
City of Atlanta, Georgia.

ARTICLE II — PURPOSE
The principal objectives and purposes of the Council are:

A. To establish and maintain comprehensive areawide
health planning activities, identifying health
needs and goals of the overall community and its
sub—areas to stimulate action to coordinate and

'make maximum use of existing and planned facili—
ties, services and manpower in the fields of
physical, mental and environmental health.

To establish a system for gathering and analyzing
data on the characteristics of health problems in
this area.

To recommend goals and methods of achieving them,
and to make policy decisions for the community in
health planning matters.

To coordinate activities_of all health plannerS'in
the community.

To collaborate with adjacent health planning areas,
and to perform health planning services on a contract
basis for adjacent area units, as requested.

To review health action project plans originating in
the community.

To provide technical assistance to public and voluntary
action agencies in preparing plans and procedures for the
attainment of health goals; to provide similar assist~
ance to Georgia State health planning efforts.

To originate health action project plans where needed.

To provide continuing liaison and informational ser-
vices to ensure communication of planning progress to
the general public and the appropriate agencies and
organizations involved in carrying out the intent of
Congresa as set forth in Public Law 89—749 relating to

comprehensive areawide health planning.

- 100 —



ARTICLE III - MEMBERSHIP

1. The Council shall be composed of not less than thirty—five—
(35), nor more than fifty~five (55) members. Members shall be drawn from
the following organizations and community groups, broadly reflecting
economic, ethnic, and geographip,background distribution of the area:

I

A. Members by virtue of office shall serve for the
duration of their terms of elective office:

1) Chairmen of County Commissions
2) Chairmen of major planning agencies
3) Mayor of the City of Atlanta

Members named by community agencies and organizations

1) Organizations naming members shall be designated
in the following categories:

a) Municipal governments

b) Health providers

c) Business and labor

d) Poor and near—poor consumers

At the first election, the term of office for
one-third of theSe members shall be fixed at three
years; the term of an additional onejthird of these
members shall be fixed at two years; and the term
of the final one-third of these members shall be fix—
ed at one year. At the expiration of the initial
term of office of each reapective member, his
successor shall be named to serve a term of three
-years. Members shall serve until their succesaors
have been elected and qualified. No member shall
serve more than two (2) consecutive three—year

terms.

The Selection process for these members shall be
determined by a Nominating Committee of Council

' members. In selecting organizations and groups
who will name members to the Council, the
Nominating Committee shall achieve rotation among
eligible groups and organizations. I

A majority of the Council members shall be non—providers
of health services.

Approximately one—third of Council members shall be poor
and nearnpoor consumers.

Each organization shall be authorized to file with the

Secretary of the Council the names of alternate members,
not to exceed the number of representatives to which it
is entitled. Any regular member of the Council may call

upon alternate(s) from his organization to attend and

'— 101-



to vote in his stead at any meeting which the regular
member is unable to attend.

Organizations other than those constituting the Council

at the time these rules and regulations are adopted may

be invited to name representatives in a stated number to
the Council uptn recommendation by the Nominating Committee
and approval by the Council at any meeting of the Council,
provided that ten (10) days advance notice of such pro—
posed action is mailed to each member at his last known
post office addreSH,

ARTICLE IV - DUTIES AND POWERS OF THE COUNCIL

1. The Council shall be the final authority for approval of
activities proposed in planning actions, and on all matters of policy related
to comprehensive areawide health planning.

2. The Council shall consider the annual budget presen.ed by the
Budget and Finance Committee, and after any revision, it may determine to be
advisable, it shall adopt the same. It shall make such subsequent revision on
the budget as it may deem advisable after consultation with the Budget and
Finance Committee and the Director of Comprehensive Areawide Health Planning.

3. It shall have the power of approval of the President‘s appointments
of committee chairmen and legal counsel.

4. It shall appoint the Director of Comprehensive Areawide Health
Planning, and fix the terms of his compensation, tenure, and reSponsibilities,
giving due consideration to the recommendations of the President and the Personnel

Committee. . ‘_ .

- 5'. It' shall appoint the auditor as provided in Article IX of these
BY—LAWS. '

_ 6. It shall require periodic reports on Operations from the various
committees and_from.the Director of Comprehensive Areawide Health Planning.

7. It shall fix the time and place of the Annual Meeting of the

Council.
8. _It shall pass on applications for admission to the Council of

additional adjacent areas deSiring to participate in comprehensive health
planning with the metropolitan Atlanta area.

ARTICLE V — MEETINGS
1. The Council shall hold at least six (6) regular meetings per

year, to be called for the first Thursday in the scheduled month, or on such
other convenient day as may be decided from time to time by majority vote.

2._ Special meetings may be called by the Presidentand shall be
called by the Secretary at the request of.fifteen (15) members of the Council.

a-log _



3. Notice of each meeting shall be mailed to each member of the Council

at his last known post office address at least ten (10) days in advance of-the
meeting.

4. Twenty (20) members,of the Council shall constitute-a quorum for
the transaction of business at any meeting of the Council; the presence of less
than a quorum may adjourn a meeting until such time as a quorum islpresent.

5. A majority in number of members present and voting at a meeting
at which a quorum is present shall be_required for approval of any action by
the Council.

6. Each member of the Council is entitled to one (1) vote at any
meeting at which he is present.

7. ho proxy votes Shall be allowed. A duly appointed alternate
member, however, may vote in the absence of a regular member representing the
organization for which he is designated alternate. In such case, the alter—
nate member shall be considered a member for the purpose of determining a
quorum .

8. The Council may act by mail, wire, or telephone between regular
meetings, but in such case the concurrence of a majority in number of members
shall be necessary and shall be subject to confirmation at the next meeting of
the Council so that such action shall be recorded in the minutes.

9. The first meeting of the Council, after January 1 each year, shall
be Considered the Annual Meeting for the seating of new members named by organiza—
tions,and election of officers and nominating committee members.

10. The Administrative Year of the Council shall extend from Annual
Meeting to Annual Meeting. ‘ ' '

'\

ARTICLE VI - OFFICERS AND EXECUTIVE COmMITTEE

1. Officers

A. Officers of the Council shall be a President, five (5)
Vice-Presidents, and a Secretary, who shall be elected
annually from among members of the Council by a majority
vote of members present and voting at the Annual Meeting._

Officers so elected shall serve for one year, or until their
successors have been elected. No officer shall hold the
same office for more than three (3) consecutive terms.

Vacancies in offices occuring between Annual Meetings of
the Council may be filled by election by a majority vote

of members present and voting at any meeting of the Council.
figgicers ¥otfiée8ted phall serve until the next Annual

1mg 0 ounc
2. President

A. The President of the Council shall be the chief officer

~ 103 —







of the organization and shall preside at all meetings of
the Council and Executive Committee. The President shall,
subject to the approval of the Council, appoint the
chairmen of all committees, except the Nominating Committee,
and shall be a member, ex—officio, of all committees; and
shall, with the Secretary, Sign all obligations authorized
by the Council which may be beyond the authority of the
Director of Comprehensive Areawide Health Planning; and
shall, with the approval of the council, appoint legal
counsel.

3. Vice Presidents

A. There shall be five or more vice presidents, who shall
assiSt the President, and shall coordinate the activities
of grOUpS of committees of the Council. These off‘cers shall
be designated Vice—President for Council Function, Vice
President for Liaison and Public Relations, Vice President
for Special Needs, Vice President for Project Review, Vice
President for Administration, and such others as the
Council may designate. '

4. Vice Presidents may preside

A. A Vice President shall pre91de at any meeting of the
Council or Executive Committee in the absence of the
President, and in such case shall have all the responsi—
bilities and perform all the duties of the President.

The order of precedence for this—function shall be:

Vice President for Council Function, Vice President for
Liaison and Public Relations, Vice President for Special'
Needs, Vice President for Project Review, and Vice Presi-
dent for Administration.

B. The ViCe Presidents shall have and perform such other
' 'duties as may be assigned by the President or by the
-Councili '

5. Secretary

A. The Secretary of the Council shall handle the general

' correSpondence of the Council and shall cause notices

'to be sent of all regular or special meetings of the
Council. ' -

B. he shall cause minutes to be kept of all meetings of the

-- l t. . - ‘ S - ' ' '
Egufléatéringrst‘fiélcgfifici “$1 trieamlé‘l‘éfinasfg fiéiie'ébsied
time after each meeting.

I

C. He shall preside at meetings of the Council in the
absence of the President and the Vice Presidents and in
such case shall have all the responsibilities and perform

-.all the duties of the President.

- 104 -



D. The Secretary shall have and perform such other duties as
'may be assigned by the President or the Council.

5. Executive Committee

A. The Executive Committee shall consist of the President,
Vice Presidents and secretary of the Council.

Duties of the Executive Committee shall be to handle matters
pertinent to Council business during intervals between
meetings of the Council.

Actions and recommendations of the Executive Committee,
shall be subject to Council review and rapproval at the
next.meeting of the Council.

ARTICLE VII H COMMITTEES

1. Statutory Committees

A. A Nominatin; CJMthiCG shall be elected from members
of the Council, with due regard to the makeup of the

Council. The duties of the Nominating Committee shall
ine‘ ude:

1. Nominating a slate of officers prior to the
Annual Meeting.

Nominating a new Nominating Committee prior to
the Annual Meeting.

Nominating organizations, on a rotating basis, which
will name members of the Council to take office at the
next Annual Meeting.

4. Nominating replacements for vacancies as they cecur.
B.' A Personnel Committee shall be elected from Council
membership and the community at large. The duties of
the Personnel Committee shall include:

1. Recommending selection and salary of Director
for Council action.

2. Formulating personnel policies, including
salary ranges. '

The Chairman of the Personnel Committee shall be a member
of the Council.

2. Other Committees

3A. Other standing and ad hoc committees may be designated,

elected or appointed, as needed. Chairmen of all standing
committees shall be members of the Council.



ARTICLE VIII" LEGAL COUNSEL

1. Legal counsel shall be appointed by the President with the
approval of the Council. All matters involving interpretation of State and
'Federal law, local ordinances, and tax questions shall be promptly referred
‘ to such counsel for opinion and advice. '

ARTICLE IX — AUDIT

l. The fiscal records of the comprehenSive areawide health planning
'activities shall be audited annually by a certified public accountant, appointed
by the Council. The auditor‘s report shall be filed with the records of the"
organization.

ARTICLE x - GENERAL

A. Any notice required to be given by these By—Laws
may be waived by the person entitled thereto.

2. Contravention

Nothing in these By-Laws Shall contravene applicable

rules and regulations, procedures, or policies of the
U. S. Public Health Service, or of the Georgia Office
of Comprehensive Health Planning.

Parliamentary Procedure

A. The latest revision of Robert's Rules of Order shall
cover the parliamentary procedure at all meetings of the
Council and of the Committees, where not in conflict with
these ByuLaws.

4._ Publicity

A. No publicity releases to the media shall be made or
authorized by any organization represented on the Council,
or by any member of the Council without prior clearance
by the Director of Comprehensive Areawide Health Planning.

Acceptance of By-Laws

A. Any organization accepting invitation to designate
membership on the Council shall by their acceptance attest
to their active participation and to their agreement to

- abide by these By—Laws.

ARTICLE XI.— ADOPTION

Effective date

A. These By—Laws shall become effective immediately upon
adoption by the Council.

- 106 —



ARTICLE_XII — ASSOCIATE AND AFFILIATE MEMBERSHIPS
1. Associate Membership

A. At the discretion of the Council, sub~areal compre—
hensive'health councils may be admitted to associate member—
ship in the Council. The Council shall fix general quali—
fications for such associate membership.

B. As a condition of associate membership, sub~area1 compre~
hensive health councils shall admit to membership all
members of the Council residing in the area of the sub“
areal council.

0. Each associate member council is entitled to send an
observer to meetings 0? the Council.

' 2. Affiliate Membership

A. At the discretion of the Council, organizations other
than sub~aroal comprehensive health councils may be
admitted to affiliate membership in the Council. These
may include such organizations as voluntary health agencies,
professional societies, citizens‘ associations for health
concerns, etc. The Council shall fix general qualifi—
cations for such affiliate membership. '

B. Each affiliate member organization is entitled to send
an observer to meetings of the Council.

ARTICLE XIII - AMENDMENTS

1. 'Method

A. These.By-Laws may be amended or repealed by a majority
vote of the members of the Council present, and voting
at any meeting of the Council at which a quorum is present,
provided that written notice of such proposed changes
Shall have been sent to all members not less than ten (10)
days prior to the date of such meeting.

— 107 -

STEERING COMMITTEE

Mrs. Thelma Abbott Dr. Napier Burson, Jr. *
521 W. Columbia Avenue Baptist Professional Building
' College Park, Georgia 340 Boulevard, N. E.
I ‘ _' Atlanta, Georgia 30312
Hon.:S. S. Abercrombie, Chairman' -
Clayton County Commission Hon. T. M. Callaway, Jr.
Clayton County Courthouse DeKalb County Commission
Jonesboro, Georgia 30236 c/o Callaway Motors
. ; 231 West Ponce de Leon Avenue
Hon. L. H. Atherton, Jr. Decatur, Georgia 30030
'Mayor of Marietta
P.0. Box 609 Mrs. Mary June Cofer
Marietta, Georgia 30060 443 Oakland Avenue
' Atlanta, Georgia 30312
Miss Dorothy Barfield, R. N.
Chief Coordinator of Nursing Services Mr. Gary Cutini, Regional Rep.
Georgia Department of Public Health Health Insurance Council
47 Trinity Avenue Life of Georgia Building
Atlanta, Georgia 30334 600 W. Peachtree
. Atlanta, Georgia 30308
Mr. G. X. Barker, Ex. V. P. '
International Brotherhood of Electrical Dr. F. William Dowda
Workers 490 Peachtree Street, N. E.
Fifth District Office 1 Atlanta, Georgia 30308
I421 Peachtree Street, N. E.
Atlanta, Georgia 30309 Mr. J. Wm. Fortune
.' ' Mayor oi Lawrenceville
Hon. Ernest Barrett, Chairman 290 Old Timber Road, S. W.
Cobb County Commission ' Lawrenceville, Georgia 30245
P. O. Box 649
Marietta, Georgia 30060 Mr. Drew Fuller
' _ ' Fuller 8; Deleach
Dr. J. Gordon Barr-ow, Director 1726 Fulton National Bank Bldg.
Georgia Regional Medical Program Atlanta, Georgia 30303
938 Peachtree Street, N. E. _ .
Atlanta, Georgia 30309 Miss Jo Ann Goodson, R. N.
- - I , " Wesley Woods '
Mr. M. Linwood Beck, Executive Director 1825 Clifton Road, N. E.
Georgia heart Association Atlanta, Georgia 30333
2581 Piedmont Road, N. E. _ . .
Atlanta, Georgia 30324 ’Mr. Fred J. Gunter, Administrator
- _ , I~ South Fulton Hospital
Mr. Herschel T. Bomar, Chairman 1170 Cleveland Avenue
Douglas County Commission ' . East Point, Georgia 30344
Douglas County Courthouse I ‘
DouglaSville, Georgia 30134 Dean Rhodes Haverty
' - 1 - Georgia State College
Hon. William H. Breen, Jr. ' School of Allied Sciences
Mayor of Decatur 33 Gilmer St., S. E.
c/o First National Bank Building Atlanta, Georgia 30303
Decatur, Georgia 30030

Appendix E—l



Page 2 — Steering Committee

Mr. Maynard Jackson Mr. Lyndon A. Wade, Executive Dir.
Emory Community Law Firm A1lanta Urban League
, 551 Forrest Road, N. E. 239 Auburn Avenue, N. E.
Atlanta, Georgia 30312 Room 400
" ' Atlanta, Georgia 30303

Mr. Burch Lu Jarrell :
Route # 1 ' Dr. Robert E. Wells,

Box 24 1938 Peachtree Road, N. W.
Duluth, Georgia 30136 Atlanta, Gcorgia 30309

‘Hon. Walter M. Mitchell, Chairman Joseph A. Wilbur, M. D.
Fulton County Commission 615 Peachtres Street, N. E.
409 Administration Building Atlanta, Georgia 30308
165 Central Avenue, S. W. .

Atlanta, Georgia 30303 Mrs. Daisy Bigshy
585 Gibbons Drive

Mr. John L. Moore, Jr. Scottdale, Georgia

Attorney—athLaw

C & S National Bank Building

Room 1220

Marietta and Broad Streets

Atlanta, Georgia 30303

Dr. William W. Moore, Jr.
Suite 616

1293 Peachtree Street, N. E.
Atlanta, Georgia 30309

Mr. A. B. Padgett, Trust_0fficer
Trust Company of Georgia

P. 0. Drawer 4655

Atlanta, Georgia 30302

Mr. Dan Sweat
Assistant to Mayor,
City of Atlanta

City Hall .

Atlanta, Georgia 30303

Dr. Charles B. Teal, Jr.

Gwinnett County Health Department
300 South Clayton St.
Lawrenceville, Georgia-30245:

Mr; Bill Traylorl
1397 Oxford Road, N. E.
Atlanta, Georgia 30307

Dr. T. 0. VinSon,_Director
DeKalb County Health Department
440 Winn Way .
Decatur, Georgia 30033

Appendix E—2.



MEMBERS OF EXECUTIVE COMMITTEE
OF

COMMUNITY INVOLVEMENT STEERING COMMITTEE

FOR

AREAWIDE COMPREHENSIVE HEALTH PLANNING

NAME

Hon. Howard Atherton

‘Mr.

Linwood Beck

Thomas Callaway

. Drew Fuller

. Fred Gunter

Walter Mitchell
A. B. Padgett
Oscar,Vinson
Lyndon Wade

Robert Wells

AFFILIATION
Mayor of Marietta
Director, Georgia Heart Asa)c.
Commissioner, DeKalb County
Chmn. Health Committee, Atl. C. of C.
Administrator, So. Fulton HOSpita1

Chmn., Fulton County Commission

Chmn, CHP Steering Committee

Director, DeKalb Board of Health

Director, Atlanta Urban League

Chmn. Fulton County Med. Soc. Board

‘.

Appendix EH3

VIEWPOINT
municipalities
voluntary agencies
Maclog
commerce
hospitals
county govts.
Community Council
Public Health
consumers

medical professions



Honorable Ivan Allen
Page - 2 -
February 28, 1969

volunteers, both individuals and groups. Since that time

the Steering Committee has been at work and we have now

come up with a Specific preposal for the establishment of
such a volunteer agency. As it now stands, it appears that
the Sponsors will be the Atlanta Junior League, the Community
Council of the Atlanta Area, Community Chest, the Atlanta
Chamber of Commerce, and E.O.A.

We simply want to talk with you and Dan and get
your suggestions and reaction to the plan. We believe that
volunteers constitute the largest untapped resource for help
on our urban problems. Making this resource truly effective
is not an easy task, but it has been done in other cities and
there is no reason why we can't do it here. Also, we feel
that a permanent organization of this type will provide a

means for injecting newcomers to Atlanta into activities
involving their interests which will help us to maintain
a sense of community as Atlanta expands. I understand that
our appointment is for 2:00 o'clock, and we look forward to

Seeing you.

Best personal regards.

Sincerely,

./
Eugene T. Branch

ETB:hm
Enclosures

cc: Mr. Dan Sweat

JONES. BIRD Ex HOWELL



.DRAFT

A VOLUNTEER COORDINATING AGENCY “"

Purpose:

To provide a central point where volunteer activities could be co-
ordinated, developed and organized so that the vast reservoir of man and
woman-power who are looking for ways to make constructive, significant
contributions to the community can be utilized. This would be more

than the traditional volunteer bureau. It would not only work with exist-

ing programs but also deve10p new areas of service for individuals and
. ffi

/1\

groups and be innovative in its approaches For the mo ‘part it would

be organized, administered and Operated by volun ‘rts functions” <
‘Qrg'

would vary according to the group or or §2§§§n1 as wo incr Wltkv ...:
_'xr‘_
Functions: ._ \ @V _
re

1. AGENCIES REGISTER d be<3\1)%e% gencies can

Q§§§Xfi s and group progects.
. ®:3$3% place where individuals_or groups
can register €j§§§§:om fihdwn to an agency or program where his

capabiliti





register th

2. VOLUNTEERS



erests can be used to best advantage.

3. SCREENING — t would conduct an initial screening of volunteers
to protect the agency from clearly unsuitable applicants, while
the agency retains its right to select its own volunteers.

4? EFFECTIVE - It would offer leadership on the effective use of
volunteers. Develop innovative programs and provide new areas of
service. .

'5. TRAINING - It would provide orientation and training to volunteers

of,both a general and specific nature so that volunteers would be

better prepared for and have a clearer understanding of their'
assignments and how they fit into the health and welfare picture
of Atlanta.

6. COUNCIL OF CIVIC ORGANIZATION — It would provide a framework for
communication among civic organizations regarding their own areas of
community participation.

7. EDUCATE PUBLIC * It would conduct regular programs to educate the
public about projects and problems in the fields of health, welfare
and enrichment.

3 WORKSHOPS - It would develop as part of its educational program the
following workshops: .

8. workshops with supervisors of volunteers.
b. Workshops with 'bdministrative volunteers" (policy making boards,etc.).
c. Workshops designed to vauaint new—comers (and others) with pro-
grams and agencies, problems and opportunities in the fields
of health, welfare, enrichment and education.
d. Separate workshOps for volunteers in the areas of
1. arts
2. health

3. education

4. poverty
5. recreation
Organization:

It would be staffed by a full—time, well qualified paid Executive Director
'and a full-time paid secretary at thenout set. Staff would be added as

necessary to take care of the expanding program. (See Job Description)

The Executive Director would be assisted by volunteer chairmen of
Recruitment, Screening.Education, Job Development, Agency Relations

and Public Relations. They wOuld serve for a two year term.

The agency would be government by a Board of Directors with a total
membership of 25. It would be composed of the above mentioned volunteer
chairmen; representatives of agencies, serving on a rotating basis;

a representative each from the Community Council of the Atlanta Area, Inc.
and the Chamber of Commerce; people who are representative of volunteer
programs (Model Cities, Economic Opportunity Atlanta, Urban Training,
VISTA); people who are representative of organizations (Junior League,
Council of Jewish Women, Junior Chamber of Commerce, Kiwanis, Women's
Chamber of Commerce, United Church Women, etc.){ people who are re—
presentative of labor and the business ari'professional community. These
Board members would be selected as individuals by the agency's nominating
committee to be representative of a certain sector, interest or expertise
rather than to represent their own organization.

Sponsors:

The following agencies and organizations have shown interest in it and

indicated support. Representatives have been meeting as'a Steering

Committee and have helped shape this proposal.

1. Atlanta Junior League
2. Community Council of the Atlanta Area, Inc.
3. Community Chest

4. Atlanta Chamber of Commerce

Location:

Preferably the physical facilities should include the following:

1. Office Space for a minimum of seven people (four staff and
three full time volunteers).
Adequate parking nearby for a minimum of fifty cars.
Be in an area that is well lighted, and where staff and
volunteers would feel comfortable when attending meetings at

night.

4. A large meeting room in the building or nearby that could be

utilized for training sessions or conference meetings.



Personnel

Project Director
Executive Secretary
Fringe benefits

Permanent Eguipment

desks, executive @ $150
chairs, executive @ 90
desk. secretarial

chair, secretarial

side chairs @ 30
electric typewriter
manual-typewriters @ 220

file cabinets. 5 drawer @ 100
equipment maintenance

a.“ H «labialm

Consumable Supplies

Office supplies and postage
Educational materials

Travel

Local. 15,400 miles @ .10 per mi. $ 1.540
1 out-of-town trip 300

Miscellaneous Expenses

Rent - 1.200 sq. ft. @ $3.00 per _
Sq. ft. per year $ 3,600

Telephone 900

Insurance and bonds 150

Promotion and publicity 1,000

Auditing - - 600

Organization dues 250

Publications 75

Meeting space for training classes

and board meetings, 80 days

@ $30 per day 2,400

Total Costs

Minimum'staff

could be donated

minimum necessary
to train 300 vol-
unteers

to reimburse 6
peeple for travel
and public relations

could be donated

could be donated
could be donated

could be donated



Staff - (Job Descriptions)
The Project Director will be responsible to the Board of Directors.
a. Duties and Responsibilities_
(1) Administration of the program. Guidance and supervision
of all staff engaged in the project.
Promote the volunteer Project in all necessary areas

particularly public and voluntary agencies, and to the

general public. Interpretation of the goals to the

volunteer Project.
Reaponsible for all publicity of the program. Review
all assignments for speaking engagements.
Supervisor of volunteers who will organize, plan and
develop all training classes.
Select and work with volunteers and agencies in developing
curriculum for classes. Edit training manual and select
all materials used in course.
Work with Board of Directors of the Volunteer Project and
sub-committees in operation of program.
Work with volunteers to deve10p contracts with agencies and
organizations for training programs for other volunteers.
Program planning and development for future expansion of
the Volunteer Project.
b. Qualifications

(1) Executive ability necessary for the administration, promotion
and implementation of the Volunteer Project.

(2) Ability to relate to individuals and groups both professionals

and volunteers. Good judgement in selection of staff, faculty

'and trainees.



2.

-Experience and skill in community organization. A thorough

(6)

Secretary

knowledge of the health, welfare and education resources

of the community.

Understanding of the needs of lower income people in order
to plan training programs that will equip volunteers to
make significant contributions toward meeting some of these
needs . J

Background and academic degree in Education, psychology,

social work.or a related field.

Administrative experience.

The secretary of the Volunteer Project shall be responsible to the

Director of the Volunteer Project.

a. Duties and Responsibilitigs

(1)

Personal secretary to the Project Director, i.e. appointments,

_telephone calls, personal files, etc.

Supervision of all office clerical work. Should be capable
of prOperly coordinating all work, insure proper dis-
tribution of workload and relieve the Director of tasks which
come with supervision of clerical work.

Personally responsible for all documentary typing, program
development, evaluation, proposals, budgets, etc.

All dictation and transcription for entire department.

All typing for recruitment and publicity.

Record all sessions in connection with evaluation and in
regular training sessions when necessary.

Minutes of all meetings requiring the use of shorthand.



(8) Direct supervision of all filing procedures. See that
all records are filed regularly and properly.

(9) Keep complete records of all supplies and postage charged
to the Volunteer Project

b. Qualifications

(1) Good typing Speed.

(2) Excellent shorthand speed to enable her to take verbatim

notes at all conferences and teaching sessions where
necessary.

(3) Good overall understanding of office procedures and
policies.

(4) Ability to work well with people, with initiative to do a
job on her own without involved instructions. Ability to

supervise additional clerical staff.

.MG:ja -
-2/13/69



NEW SLOT FOR THE VOLUNTEER

A Talk With
Joyce Block and Dr. Timothy Costello

Waiting for a bus or subway that-

never comes, sending a child off to a
school that doesn't open, or trying to
keep warm in an apartment that has
no heat is all part of everyday life in
New York City. But, a new form of
government, which New Yorkers have
come to think of as ”the Lindsay
style,” has emerged. By efficiently
using an almost untapped resource
known as "volunteer power," the na-
tion’s largest and most problem-prone
city is surviving the urban crisis.

Back in 1965, when the Federal gov-
emment first launched its “war on
paverty,” New York City’s Economic
Opportunity Committee {the local ad-
ministrative anti-poverty agency)
found itself inundated with offers
of help from numerous individuals and
organizations. Mrs. Ruth Hagy Brod,
then an EOC staff member. was asked
to channel these offers into neighbor-
hood anti-poverty agencies.

The complexities of the city made
Mrs. Brad’s task a monumentally com—

"plicated one and an advisory com—
mittee of community leaders was soon
formed to assist her in conducting a.
Jstudy of the patterns and potentials of
_lvolunteerism in New York City. The
result of their study was this: Antl-
poverty agencies were unable to absorb
any significant number of volunteers.
but there was a great potential for
them in almost every department of
city_g government Out of this study, the
Voluntéér-Cddfd‘narmg Council — the
first central volunteer bureau to _be co-
sponsored by city government and the
volfiiifbffibfidn — was born,

In December 1966, the VCC was
officially inaugurated by Mayor Lind-
say. Deputy Mayor Timothy Costello
was named Chairman, and Mrs. Hiram
D. Black (AILA’s Director of Region
III) was named Co-Chairman. Mrs.
Brod was appointed Director.

During the first two years of its
Operation, the VCC has played a vital

14

role in city government. To find out
if similar bureaus could be used to ad-
vantage in Detroit. Chicago, Les An-
geles, or even in Waterloo, Iowa, we
met with Dr. Costello and Mrs. Black

in the Deputy Mayor’s office, and we
asked them:

Why do you-use volunteers in New York’s
city government?

Dr. Coslello: I think there is a simple
answer and asubtle answer. The sim-
ple answer is that we need to render
perhaps ten times as many services as
we’re able to with the amount of civil
service people we have. Beyond that,
volunteers bring something that you
cannot get from the person whose ser-
II vices you’re buying. They bring spirit,

[Ia sense of dedication, freedom from

,- being captured by procedures, motiva-

tion and willingness to work -—~ some-
times under conditions where you
Eouldn't pay someone else to work.

I don't know if this concept is orig—
inal with me, but for a little while. for
a long while maybe. many people felt
that New York was such a big, sophis-
ticated, cosmopolitan town, that it was

nobody’s home town. But that’s not
the way people feel now. They’re be—

ginning to feel that it is their home
tOWn: they want to be involved in it;
they want to do something for it. This
is true of big business and it's also true
of the people living in Staten Island,
Queens, or Manhattan. They want to
say “I’m doing something for my city."
Mrs. Black: We hope this kind of pro-
gram will be duplicated in other cities
for similar reasons. Once you're in-
volved with a city in the public sector,
you understand many things that you
never understood before, and you can
interpret them to the community in a
much' better way

Dr. COSMIU: Maybe the point that
is being made is a lesson in civics. I
don’t mean just where City Hall is,

1’

and what the Board of Estimate does,
but the subtle kinds of things: Why
does it take so long to get things done? _
Why can’t y0u always solve a problem
in the most rational way? Sometimes
there are community blocks and politi-
cal considerations that are quite legiti-
mate but keep you from doing things
in what my wife would say is the
common-sense way.

Do volunteers need any special skills?

Dr. Costello: Volunteerism is a very,
very sensitive activity requiring pro-
fessional skills. One of the skills re-
quired is learning to build a. demand
for volunteer help that doesn’t outdo
your supply. and that doesn’t produce
a demand in agencies where volunteers
don’t belong and won’t be properly
used. The desirable thing would be to
have a Director of Volunteers in every
agency of city government who would
report to us on what the agency is
looking for. We’re flooded with de-
mands from agencies, many of which
we don’t want to meet because they’re
not suitable, and many of which we
can’t meet because we just haven’t got
an adequate supply of volunteers.

How does the VCC work with city
agencies?

Mrs. Black: We tried to divide the
Council's activities into two sectors,
with program development in both the
public sector and in the private, non-
profit sector—better known as the
volunteer sector. If an agency desires
our advice in developing volunteer
programs, we are available, and we
also will seek them out if we feel that
there should be a use of volunteers
there. We've been very fortunate in
New York because we do have an un-
derstanding administration and a Dep-
uty Mayor who took us under his
wing. The Council has to fit into a slot

in the city; this type of program lust

can’t be off on its own.

-._ ...—....-





Dr. Costello: That’s right, you simply
can’t graft it on to something that is
not receptive to it. It won’t work. The
VCC is kind of a prototype; we’re try-

ing to encourage college students and-
universities to contribute their services,
but this won't work unless you’ve got

receptivity in the top level of admini—. -
stration all the way down the line.

Does the VCC suggest proiects or place—
ment for volunteers in other agencies?

Dr. Costello: Yes. It cr3_at_e_s__t_hem.
You ve got a creative group of volun-
teers who suggest things either be-
cause they have an idea or because
somebody comes in and says: “Look,
this' 15 what I can do, is there any place-
I can do it?" Thats how VCC pro-
grams begin. You look for some place
where the volunteer can do what he
wants to do. That’s pretty much what
happened with Riker’s Island — am I
correct, Joyce?

Mrs. Black: Yes. When men are re-
leased from prison—from Riker’s
Island ~—-very often they come out
without anything; without-a family,
without funds, without a heavy winter
coat. Ruth Brod was telling me the
other day that she had to get a winter
coat for one of the men. He couldn’t
get a job either, because no one wants
to give a job to a newly-released pris-
oner. In a sense, the volunteer involved
with these men is going to be involved
in the buddy system. Each prisoner,
when he is released, is now being met
by one of our staff people and taken
to a place where he is employed or
trained by a union. We also find a
place for him to live, and give him
pocket money obtained from private
sources to supplement him until he gets
his welfare check, which isn’t for two
weeks after he is released.

Dr. Costello: This is exactly where vol-f
unteerism comes in. There is no com-r

bination of services that the city can
provide which would do all of these
things: that is, reach out and obtain a
. job, worry about whether the man has
a coat or carfare, worry about where
he is going to sleep or eat Because
these men sometimes fail — they d0n t
report for duty, or they goof off — the
volunteers go back and talk them into
trying again. There’s no service like
that. You simply can’t buy that kind of
service anywhere.

16

What does the VCC do?

Mrs. Black: It does two things. It re-
: cruits volunteers, interviews them,’ and

. l Irefers —them 'to traditional or non-tra-

ditional settings, depending on what

kind of service they want to do and
-. what their hours are. But it also is a

r Qprogram- -develop_ment kind of _agency.

UDr. Custello: Maybe the term "mar-

riage maker” ought to come into this
picture, too, because Ruth Brod and the
people around her are frequently
matchmakers. There might be some
group who have ideas for something to
do, but they haven't got the resources.
They may not have a bus to provide

'|
l transportation, they may not have the
I

money tounderwrite something, or
they may not have access to some
thing. So Mrs. Brod finds somebody
who has what the group needs and
puts them together. For example, in
Operation Suburbia, she put the fam-
ilies in ghettos and the families in
suburban areas together, and she put
the coffee house people {See Junior
League Magazine, Sept/Oct. ’68) to-
gether with some people who had
money. The Council is always trying
to spin programs off. _,
Mrs. Black: We act as a catalyst. And
I think this is a word that we should
use more and more because volunteer
~organizations are not going in where
they're not wanted. Not only do we
have to be asked to participate but we
also work with the people in the inner-
city by not inflicting or imposing any
of our thinking upon them. This is
certainly the way of the future, and
it's the way they want it.

Many city agencies are ’lroubled with
quick changeover of personnel, money
difficulties, and a host of other problems.
Does this make it more difficult for you
to find volunteers to work with them?

‘llrlrs. Black: Not really. We do not put
r volunteers into a situation where there
1 is no one to supervise and train them.
The Council doesn’t actually train vol-
' unteers,- the training is, done in the
individual agenciesf If we went into
\ tra1ning, wé’d‘ifie to have a couple
'of hundred people on the staff. We
give them only a Moriemtatiol to
the_ field of 1939;13153;
._Dr. Costellbl Sometimes the word ”vol~
unteer" applies to a group of people

who are part of the target population

'1

‘s.

‘1

themselves. That is, they have an idea,
and they want to do something. So you
don’t send white middle-class people
into that neighborhood to help those
people. They are already there, they
just need a little support, a little
money, a little access, a little building,
a little equipment, or whatever, to con—
tinue their own voluntary efforts in
their community. And that's a new
kind'of volunteerism.

i know Ruth was very upset one day
when I suggested that maybe you
couldn’t ask poor people to volunteer;
they are too busy. And she said,
“You can't deny them the opportunity
to be part of a volunteer program. Now
you may have to provide carfare oc-
casionally, or a little baby—sitting
money, but you’ve got to give them the
chance to give something as well as to
take something."

Have any of your volunteers had prob-
lems in the inner-city areas?

Mrs. Black: We haven't had trouble
because we simply don't send anybody
unless they’re truly wanted and _asked
59% Of course, the other thing is that
if we were sending some volunteer
for a specific reason—into part of
the Haryou complex, for example —
we would most likely send a black per-
son in who probably would be ac-
cepted. This is a complex situation.

Dr. Costello: No psychiatrist would
ever attempt to treat a patient unless



all over the place: in the Rent and
Rehabilitation Department, in the Po-
lice Department, in the Mayor’s Action
Center — everyplace. .

What do you see for the future? In what
direction do you see the Council moving?

Mrs. Black: One of our goals is to have
it move into other cities. Our first

- phase of operatiou is over —- the phase
’ )of developing volunteer opportunities

I Mnd the public sector cooper—ate. I see

the patient wanted help, and I think
the safimha—principle applies
to volunteer assistance —you don’t
impose it on anyone who hasn’t asked
for it. That is not to say that you don’t
cultivate the demand. You don’t sit
back in your ivory tower and wait for
people to come, It wouldn’t happen
like that. Nor would we send anybody
down to Harlem and say, ”Here are
some people,- they’re eager,- they talk
English. Can’t you use them?” No
good, it wouldn’t happen that way.

Does the Council do a lot of work with

any of the new-line poverty agencies such
as the Urban Coalition?

Mrs. Black: We have been working
“filth Urban Coalition, and Mrs. Brod
has been developing volunteer pro-
grams with them. Because it’s just
getting off the ground, the Urban Coa-
lition hasn’t been as involved with
volunteers as they wished to be, or
hope to be in the future, Eventually
they want to have a pretty strong
volunteer program, and they’ve recent-
ly hired a Director of Volunteers.

What about MENU or UPACA or any of
the grass roots community organizations?

Mrs. Black: Yes, we hage worked with
the community organizations “
UPACA is one. But don’t forget we are
also working within the city in public
departments. When we started, we
only had volunteers in the hospitals
and in the schools. Now we have them

the VCC moving more and more in
the direction of copperativeprggrams.
l also see it moving into more pro-
grams in the inner-city and into areas
where no one has ever before thought
of using volunteers.

In the future, we want a main office
in the heart of the city at City Hall,
and then we plan to decentralize. We’ll
keep our central office, but we also
hope to have Borough offices. Our
most recent proposal asks for funds to
establish the Borough” offices on a mo-
bile basis, with a mobile unit going
around recruiting and interviewing.
We feel that this would be 'less ex-
pensive than opening an office in each
Borough. We’ve got a lot of peeple in
Queens who don’t want to volunteer
in Brooklyn or in Manhattan and vice
versa. We need Borough offices .in
order to reach all the people who really
want to volunteer. Maybe next year
we can tell you that _we have decen-
tralized. Or maybe in a couple of years.

Do you feel that the Council has become
a fairly needed component in city govern-
ment? (You probably can’t call it essential
because volunteers are certainly not an
essential component.)

Dr. Costello: If you talk about good
government in the largest sense — in-
volving people, and reducing the guilt
that people feel, giving them the
chance to contribute. things that you
can’t buy ——~ then- it’s essential. Now
if you’re talking about the minimum
society, where you just get a minimum
of services, and minimum involvement
from citizens, then of course it’s not
essential. But in terms of good spirit,
morale, and the capacity of people for
getting to know the other side of life —
both sides— then I think volunteerism

is essential for the health of society.
No doubt about it.

Would it be safe to say that you think
volunteers are becoming a more impor-
tant part of society?

Dr. Costello: I certainly do. I’ve been
reading Herman Kahn’s book, The
Year 2,000, and he says that increas-
ingly we are not only developing pri-
mary occupations and secondary occu-
pations, but also tertiary occupations.
Woman’s prime role is becoming less
central to her life, and less capable of
satisfying her full range of interests.
Most of us are going to have to find
volunteer activities in order to fulfill
all the capacities and needs we have.
It’s going to become increasingly im-
portant, not only in terms of what the
city needs, but in terms of what the
individual needs.

People are getting less personal sat-
isfaction than they used to because
they’re becoming mechanized or auto-
mated; the human element is taken out
of them. You have that kind of a job;
so you earn your living that way. But
you really satisfy yourself on what you
plan to do on a voluntary basis, be-
cause you’ve got some command of
what is going to take place there.

Do'you think the role of the volunteer in
government will be increasing— not just
in New York City, but in other cities, and
possibly on the national level?

Dr. Costello: We distinguish ourselves
from the. national level because cer-
tainly it’s hard to bring volunteers
from all over the country to Washing-
ton. And the ' Federal government
doesn’t get represented in any dramatic
way at the city level. I t_hi_r1_k_the cities
are the places where you can really do
things. I would say that if 'we—ca'nmget
other cities to do what we’ve been do-
ing, and if we can continue to build
relationships between different seg-
ments of society by having volunteers
from these various groups work to-
gether, then we’ve made a mighty con-
tribution. You can legislate integra-
tion. You can kind of force it by hous-
ing. But the real integration comes
when people choose to work together
on a problem and solve common goals.
And, this is something that can be
accomplished by volunteerism alone.

Bur-bum Bonat and Christine Rodriguez

1?



JAMES L. MCGOVERN "
EXECUTIVE DIRECTOR ;
t
I

METROPOLITAN ATLANTA COMMISSION ON CRIME
ADH).HJVEbHLElDELDNCflHfiHCY][NIL

52 FAIRLIE STREET
ATLANTA, GEORGIA 30303
524-3559

April 10, 196?

Honorable Ivan Allen, Jr. //’ qé;:;;7
Mayor of the City of Atlanta V )fizhf

204 City Hall
Atlanta, Georgia ___==::;?'”f

Dear Mayor Allen:

The Community Council of the Atlanta Area, Inc.~and_
the Metropolitan Atlanta Commission on Crime and Juvenile "
Delinquency, Inc. are co-sponsoring a meeting to be held
Tuesday, April 18 at 3:00 p.m. in the conference room of
the Trust Company of Georgia to discuss the problem of the
chronic alcoholic court offender.

We feel that such a conference at this time is imperative

in view of the recent decisions of the federal Courts of Appeal
which held that the chronic alcoholic should not be confined

as a criminal but rather should be treated as one in need of
medical assistance.

Enclosed is a list of those persons invited to attend
this meeting as well as some material relating to the problem
of the alcoholic and a treatment plan prepared by the Community
Council.

We are hopeful that an overall plan in which the repre-

sentatives of the City, County and State will participate will
be forthcoming. '

Yours very t uay, E
t t

mes L. McGovern
JLM:ls

Enclosure



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Report 67-1
march, 1967

TREATMENT PLAN FOR THE CHRONIC ALCOHOLIC COURT OFFENDER

This report is the result of the work of the Advisory Committee on
Alcoholism of the Community Council of the Atlanta Area, Inc., and
was compiled and written by staff of the Council. Approved by the
Executive Committee of the Community Council on March 2, 1967.

Cadenhead, Chairman Eugene Branch, Chm., Permanent Conference
Marian Glustrom, Staff, CCAA Mrs. Inez B. Tillison, Assoc. Dir., CCAA

Committee Members

Asa Barnard, Division of Vocational Rehabilitation
Paul Cadenhead, Atlanta Bar Association

Chaplain Joseph Caldwell, Candler School of Theology

T. A. Carroll, Alcoholics Anonymous

Grover Causby, Georgia Department Family & Children Services

Dr. Sheldon Cohen, Fulton County Medical Society

Mrs. Marian J. Ford, Travelers Aid

Dr. Vernelle Fox, Georgian Clinic

S. C. Griffith, Jr., Atlanta Hospital Council

Bruce Herrin, Emory Univ. Alcohol Vocational Rehabilitation Project
Dr. Sidney Isenberg, Fulton County Medical Society

Henry Jackson, St. Jude's House, Inc.

Wilbur Stanley, Georgia Department of Education

Mrs. Nita Stephens, Fulton County Dept. Family & Children Services
Major John Strang, Salvation Army

Reverend Russell Strange, Atlanta Union Mission

Ernest Wright, Georgia Department of Labor



I.

TREATMENT PLAN
for

THE CHRONIC ALCOHOLIC COURT OFFENDER

Background

The problem of the chronic alcoholic court offender is not a new one in
Atlanta. The courts and many other agencies have been aware of it for many
years, and attempts have been made to meet it. Over 10 years ago, Municipal
Court judges became concerned with the problem because it was occupying an
increasing amount of the court's time. It became increasingly evident that
repeatedly arresting these individuals, trying them, sentencing them, and
having them pay fines, serve time or both, was not alleviating the problem.
Even turning these individuals over to a higher Court as habitual drunkards
helped only to the extent that men spending 12 months in prison could not
be rearrested and appear in court during that time. A large percentage of
those who did serve 12 months in prison were back in jail for "plain drunk"
within days and sometimes even hours after being released from prison.

At about this time, the judges were approached by several individuals, some
of whom were ex—alcoholics, who volunteered their services as a Helping Hand
Society to do what they could to help these individuals caught in what is
regarded as the "revolving door of drunkenness"--arrest-jail—release—drunk—
enness—arrest, etc. At this same time, Mr. Henry Jackson, who had 18 years
of extensive experience working with alcoholics, was added to the Municipal
Court staff as the Director of the Alcoholic Rehabilitation Program.

Judge James E. Webb accepted the offers of help and set up a system whereby
individuals who were brought to court for plain public intoxication could,
by request, be probated to the Helping Hand Society. At the discretion of
the judge and representatives of the Helping Hand Society, an individual was
accepted on the program, and for a probation period of 60 days he was ex—
pected to cooperate with the Society. The program consisted of three essen—
tial things: 1) being a friend to the individual with a drinking problem;
2) helping him find food, clothing and shelter; 3) providing fellowship for
the individual in a new environment away from drinking establishments.

Because of the lack of proper facilities to carry out the functions of the
Helping Hand Society, the program, although successful with some, was unable
to reach the majority of the chronic court offenders, and the Municipal Court
caseload continued to grow at an alarming rate.

In 1961, Judge Webb and the leaders of the Helping Hand Society decided that
if an increase in facilities for the treatment of alcoholism were at their
disposal, they could do a better job of rehabilitating larger numbers of
chronic alcoholic court offenders. They approached the Community Council of
the Atlanta Area, Inc. The Council recommended that further study he done.

The City of Atlanta, Fulton County, and a group of business leaders agreed
to provide the funds for a one year study to be made by the Department of
Psychiatry of Emory University. The study was designed to gather data,



analyze the data, and make recommendations based on this data to better deal
with the problem of the chronic alcoholic court offender and his family. The
study began on July 1, 1962 and ended June 30, 1963. The following is a
summary of the committee's recommendations:

1. That a new facility, an Intensive Treatment Center, be established with
City and County funds to provide inpatient and outpatient services using
a multi—discipline approach. That these services be coordinated with
all other treatment and rehabilitation services for alcoholism.

To continue the Present Helping Hand Halfway House, with some City and
County funds made available for this facility, as a model for the estab—
lishment and development of other halfway houses in the community.

That at least one Alcoholic Information and Referral Center be established
on an experimental basis, in one of the neighborhood areas of particularly

heavy drinking, this Center to be staffed primarily with volunteers.

To provide better training to policemen in the recognition of "intoxi-
cation" and its various causes.

That there be medical screening in the City Jail of all intoxicated pris—
oners immediately following the arrest of these persons. That those in
need of any medical attention he immediately transferred to Grady Memor—

ial Hospital for this medical care.

That the legal procedures now existing be revised so that an individual
can be processed from the time of his arrest until disposition of his
case has been made by the multi—discipline team previously mentioned.

That some of the approaches to alcoholics at the City Prison Farm be mod-
ified so that treatment and rehabilitation can be carried out in this
setting. That an effort be made in the City Prison Farm to evaluate the
mental and physical condition of the alcoholic prisoners and a program

of rehabilitation be instituted for each of these persons.

Some strides have been made in implementing these recommendations, but we
still have a long way to go as will be seen in other sections of this report.
Lack of funds, shortage of staff and public apathy have combined to hinder

progress.

Recent events, however, have made it imperative that we develop and carry
out plans for the chronic alcoholic court offender.

There have been two court cases concerning the chronic alcoholic which have
grave implications for Atlanta. One decision, in the Easter Case, was handed
down by the U. S. Court of Appeals in Washington, D. C., and the other, the
Driver Case, by the Fourth U. S. Circuit Court of Appeals in Richmond, Vir—
ginia. Both decisions were similar and indicative of what path other courts

will take.



The decisions stated that chronic alcoholics Could not be charged with
drunkenness because they have lost the power of self-control in the use of
intoxicating beverages. In Washington, the judge said that a 1947 federal
law on rehabilitation of alcoholics described chronic drinkers as sick
people who needed proper medical and other treatment. However, commitment
for treatment of chronic alcoholics as contemplated by Congress was not
mandatory. The accused may be released but he may not be punished. It was
also the judge's decision that chronic alcoholism is a "defense to a charge
of public intoxication and, therefore, is not a crime, however, this does
not absolve the voluntarily intoxicated person of criminal responsibility
for crime in general under applicable law."

The case is now coming up before the Supreme Court and there is every reason
to_believe that the decision will be upheld. Therefore, it is only a matter
of time before Atlanta is faced with the problem and some planning must be
done so that facilities for rehabilitative services for the chronic alco-
holic will be available, otherwise, there will be chaos and confusion with

wasted effort, time and money.

The problem is a complicated one. Treatment of the alcoholic——to be effect-
ive and 1asting—-requires coordination of services and a combination of

many resources and practices. A multi—disciplinary, as well as a family
centered and reaching out approach, must be used.

Treatment should be directed to three main goals:

1. Permanent separation of the alcoholic from alcohol.

2. Repairing the physical and emotional damage and preventing further
damage. '

Changing community institutions, programs and services to meet the
special needs and problems of the alcoholic. Community resources
should be made as readily available and easily accessible as others.

In addition, any planning for the chronic alcoholic court offender should
be integrated with the planning being done for all other alcoholics and
for other phases of mental health and physical illness. They are all a
part of the same problem and should not be segmented, if at all possible.

Target Population in Atlanta

A. Over half of the arrests made by the Atlanta Police Department in 1966
for non—traffic offenses involved public intoxication.

1. Total non-traffic arrests - 79,092 (does not include juveniles)

2. Arrests involving drunkenness — 47,305. These consist of approx—
imately 12,000 individuals and that about one—half, or 6,000, of
these individuals were arrested on this charge from 2 to 20 times



during the year. It is difficult to say how many of these can be
rehabilitated fully or to some extent.

From the experience of the staff of the Emory University Alcohol Project
in their three and a half years of operation, it is their belief that with
the proper approaches, facilities and staff, a considerable number of
these persons might be at least partially rehabilitated. They are not
willing to dismiss the possibility of assisting even the most hard-core
chronic alcoholic. It is sometimes extremely difficult to determine accur-
ately in advance just who can be helped or how long it might take. They
_believe that it is essential to at least make a sincere effort to treat
each one of these individuals. It is really only through giving each of
them an opportunity for treatment and rehabilitation that we can determine

whether or not they can be helped. It is conceivable that approximately

10,000 of this group of 12,000 alcoholic offenders can be assisted to
improve their total well-being significantly.

Characteristics of the Chronic Alcoholic Court Offender
1. General Characteristics:

a. Product of a limited social environment who has never attained

more than a minimum of integration within the community.

b. Dependent personality without much individual resourCefulness.

c. Individual who has difficulty in c0mmunicating with others.

The following specific data has been taken from the original study
done by Emory University: '

a. Average age of white male - 48.0 years
Negro male - 42.9 years

b. Rate of tuberculosis in this group was found to be ten times

greater than the rate in the general population.

10% of the white males and 3.6% of the Negro males had been
hospitalized in a mental hospital previously.

6. 50% of the white males went beyond the eighth grade in school.

In this group, there was no correlation between the number of
court appearances and levels of education.

e. The Negro males did demonstrate a correlation of the level of

education with the number of court appearances.

1) 50% of the Negro males in the 1—2 court appearance group
went through the ninth grade.



3)

50% in the 3-6 court appearance group went through the
eighth grade.

50% in the 7 or more court appearance group went only
through the seventh grade.

Employment

1)

2)

3)

77% of the Negro males were classified as unskilled labor;
while 32% of the white males were in this group.

40.9% of the white males had had special job training;
while only 24.8% of the Negroes had.

52% of both races were unemployed.

26% of the white males and 14% of the Negro males were
receiving some type of financial assistance.

At the time of arrest, 42% of the white males and only
6% of the Negro males had money available to pay a fine.

Elements to be considered in a Treatment Plan for the Chronic Alcoholic
Court Offender

A. Legal and Legislative

1.

Legislation to give city authority to spend funds for local alco—
holic rehabilitative measures.

The city of Atlanta is in a peculiar position. Under the Reorgan-
ization Plan of 1951, health functions were made the responsibility
of the county and police functions were made the responsibility of
the city. Therefore, city police can arrest an alcoholic for pub-
lic drunkenness, but the city cannot spend tax money to rehabili-
tate him, since rehabilitation is a health function. The Fulton-
DcKalb County Hospital Authority says alcoholism is a chronic ill-
ness and it assumes no responsibility for chronically ill. The
Fulton and DeKalb County Health Departments have no outpatient
clinics for the alcoholic. The State Health Department feels that
it has no responsibility for the alcoholic until reasonable rehab—
ilitative measures have been made at the local level.

There must be a change in the police handling of chronic inebriate
offenders. The following quotation from Peter Barton Hutt, the
attorney who presented the appeal in the Easter Case in the Distric
of Columbia, gives an indication of some of the problems inv01VQd:



"With regard to the police handling of chronic inebriate offenders,
it is my opinion that it is not a false arrest for a policeman to
charge an unknown inebriate with public intoxication, even after
the Easter and Driver decisions. The police should not be re-
quired, at their peril, to make a judgment on the street as to
whether an intoxicated individual is or is not a chronic alcoholic.

"In the case of known chronic alcoholics, however, this problem
raises a far more difficult legal issue. To some, the availability
of the defense of chronic alcoholism still seems more properly an
issue for the courts than for the police.

"But more important, the community should not place the police in
jeopardy in this way. There is no reason why the police should be
'burdened with the ignominious task of sweeping chronic inebriates
off the public streets. I was recently called upon in the District
of Columbia to assist a man who had been arrested 38 times since
the Easter decision. When you take into consideration the amount
of time he spent incarcerated in jail and in various hospitals,
this amounted to l arrest for every 2 days that he appeared on
public streets. Certainly, the answer to the Easter and Driver
decisions is not just to arrest derelict alcoholics eVery day,

duly bring them to trial and then immediately release them back on
the streets without assistance, only to repeat the process over

and over again. This succeeds only in speeding up the I'revolving
door," and in further persecution and degradation of chronic in-
ebriates. It cannot contribute to the elimination of these abuses,
as the Easter and Driver decisions demand.

"In my opinion, the police can and should take two immediate steps
to end the revolving door process, pending development of a broader
community program that I will discuss later in this talk. First,
they should assist any drunken person to his home, whenever that

is possible. Second, where an individual is unable to take care

of himself, the police should assist him to an appropriate public
health facility where he can receive the necessary attention.

Under no circumstances should they arrest known alcoholics time

and time again.

I'The question arises, of course, whether the police may properly
assume responsibility for intoxicated individuals and escort them
to an appropriate public health facility to receive proper medical
attention. If the inebriate does not consent, would the police
incur liability for a false arrest? I have long been of the view
that the police have duties of a civil nature, in addition to
their responsibility for enforcing the criminal law. When a police—
man escorts a heart attack victim to the hospital, he certainly is
not arresting him. Thus, in my opinion, the police have both a
right and a duty to take unwilling intoxicated citizens who appear
to be unable to take care of themselves, whether or not they are
alcoholics, to appropriate public health facilities. And I might



Page 7

add that, in the oral argument in the Easter case, all 8 of the
judges indicated agreement with this proposition. Nevertheless,
law enforcement officers have expressed considerable apprehension
about the possible liability of policemen for false arrest under
these circumstances. Certainly, this question should be resolved
immediately, preferably by enactment of state statutes, in order
to lay the necessary legal foundation for the proper medical
handling of alcoholics."

The court procedure must also be modified. Again, the quotes are
Peter Barton Hutt:

"With regard to the judicial handling of chronic court inebriates,
once a judge becomes aware, through any information of any kind,
from any source, that a defendant charged with public intoxication
may have available to him the defense of chronic alcoholism, he
53? in my opinion, clearly obligated to make certain that the de-
fense is adequately presented. Cases in the District of Columbia,
involving the analogous defense of mental illness, hold that even
if the defendant protests, the judge is required to inject the
defense into the case sua sponte, which means of his own motion,
to make certain that an innocent man is not convicted. Failure to
do so is reversible error, as an abuse of the judge's discretion.
And a decision handed down by the United States Supreme Court in
March of this year is wholly consistent with this position. There
is no reason why these precedents should not be equally applicable
to the defense of chronic alcoholism.

"This means, of course, increased reaponsibility for the judiciary.
Under the Easter and Driver decisions, each trial judge is obli-
gated to take affirmative action to bring an immediate and to the
traditional "revolving door” handling of the chronic court inebri—
ate in his court. No judge, in my opinion, may properly remain
neutral, simply waiting for a defendant to raise the defenSe of
alcoholism.

"Indeed, statistics 1 have reviewed suggest that, throughout the
country, approximately 90-95 per cent of the drunkenness offenders
who appear before the courts have serious drinking problems. In

my judgment, this statistic in itself places upon trial judges an
obligation to inquire into the possibility of the defense of
chronic alcoholism for virtually every drunkenness offender who
appears in the courts. A failure to undertake this inquiry amounts,
in my view, to a derogation of judicial responsibility.

"This also means the demise of the sewcalled court honor or proba-
tionary programs for alcoholics which have sprung up all over the
country as the judiciary's ad hoc answer to the failure of public
health officials to treat alcoholism as a disease. If a defendant
is found to be eligible for a court alcoholic program, then obvi—
ously he should not be convicted in the first place. The Easter



Page 8

and Driver decisions are, in my judgment, fundamentally in conflict
with any type of judicially-sponsored post—conviction program for
the treatment of alcoholism. However benevolent such programs may
be, constitutionally they are a thing of the past. For my part,

I shall he very happy to see the courts step aside in this area,
and to see public health officials take over problems which they
should have taken over many years ago."

Legislation to provide for involuntary commitment of alcoholic
until rehabilitation process is complete. Should be on a health
and treatment basis rather than through courts with penal approach.

The responsibilities of the state and local communities must be
defined and clarified.

The responsibility of after-care when the patient has been released
from the hoSpital should be determined. Who follows—up--the state

or local community?

B. Treatment Facilities

1.

Intake Center and Detoxification Unit

Before any kind of evaluation, diagnosis or therapy can begin, it
is necessary that the individual be detoxified as quickly and as

safely as possible so that the effects of acute intoxification are
no longer present. There is no doubt that the hospital is the
best setting for such treatment. Emergency measures are at hand,
the staff is available and all necessary equipment is there. In
Fulton and DeKalb County, Grady Memorial HOSpital seems to be the
logical place for a Detoxification Center. It is authorized to
take care of emergencies, it has Space and is conveniently located.
It does take care of alcoholics in its emergency clinic. Exper—
ience has shown that there is very little difficulty encountered
in treating alcoholics. Records of hospitals that have admitted
these patients will confirm the report that most of these patients
offer no more difficulty than any other sick person. It is diffi-
cult to estimate how many beds Atlanta would need to take care of
the problem to a fairly adequate degree. St. Louis, Missouri,
opened a 30~bed unit to serve the entire city. Officials reported
that in the first two months of operation, the station operated

at or near capacity with only the alcoholics from two police
districts. It is obvious that if facilities exist they will be
used. Based on the St. Louis experience, which was concerned with
a IoWer rate of arrests than Atlanta has, it is felt that approx-
imately 100 beds would be needed. Staff for 24 hour duty would

be required. This would mean: 9 registered nurses, 9 licensed
practical nurses, 15 attendants (nurses sides or orderlies).

Exact plans would have to be worked out in detail with Grady Mem-
orial Hospital and other professional people who are concerned
and working with the problem.

Inpatient Diagnostic-Evaluation Center

Following the individual's detoxification, he could be transferred
to an inpatient diagnosfirrevaluation center where a complete
work—up could be prepared on his medical, social, occupational,
family and other personal history.

This could conceivably be the present City Prison Farm, which,
when alcoholics can no longer be incarcerated there, would have
room. Alterations and modifications in the structure would have
to be made, but this would not present much of a problem.

The Center should have a multi—disciplinary team approach. Its
staff should consist of medical, psychiatric, psychological,
'social work, vocational, and rehabilitation personnel. The indiv-
idual would stay approximately 5 or 6 days or until plans were
complete for future treatment.

It is hoped that as much as possible treatment would be on a
voluntary basis and that commitment would be only used when abso—
lutely necessary. Full cooperation and willingness of the indiv—
idual to undergo treatment would facilitate the rehabilitative
process.

Outpatient Rehabilitative Treatment

The success of the Emory University Vocational Rehabilitation
Alcohol Project demonstrates that these men can be treated suc—
cessfully in an outpatient setting. Even those who will become
only partially self—sustaining should be treated as those who
eventually will be fully rehabilitated.

The most important and unique feature of the proposed method of
treating the chronic alcoholic court offender is based on the
recognition that these individuals are totally dependent upon
others to take care of them. Knowing and accepting this makes
the task of rehabilitation less difficult and more certain.

Any outpatient service should be based on the Emory Project and
its experience should be fully utilized. The service should
use a multi—disciplinary approach. Represented on the staff
should be vocational rehabilitation counselors, social workers,
clinical psychologists, chaplains, physicians and psychiatrists.
The main emphasis in rehabilitation should be on "reaching out"

for the clients rather than the traditional waiting for the
client to request services. This reaching out is necessary be-
cause of the passive, dependent nature of the alcoholic. Once
he is involved in the rehabilitation process, he must be contin-
uously supported until his total dependency can be changed so
that he is sufficiently independent to function in society and
to maintain employment.





4’

Page 10

Inpatient Extended Care Program-Rehabilitative Service

The Georgia Health Code Act No. 936 (H.B. 162) 1964 session of
the General Assembly, 88-403, states:

"The administrative responsibility for alcoholic rehabilitation
as provided herein shall be vested in the Department of Health.
The Department of Health shall study the problem of alcoholism,
including methods and facilities available for the care, custody,
detention, treatment, employment, and rehabilitation of alcohol-
ics. The Department of Health shall promote meetings for the
discussion of the problems confronting clinics and agencies
engaged in the treatment of alcoholics and shall disseminate in-
formation on subject of alcoholism for the assistance and guid~
ance of residents and courts of the State. The Department of
Health is hereby authorized to establish and maintain hospitals,
clinics, institutions, outpatient stations, farms, or other fac—
ilities for the care, custody, control, detention, treatment,
employment, and rehabilitation of alcoholics, and is further
authorized to accept for care and custody alcoholics voluntarily
applying for treatment or ordered hospitalized by court order

as hereinafter provided, and is further authorized to confine
and detain such alcoholics for treatment and rehabilitation.”

This, then, definitely places the responsibility on public health
and any planning should be done with this in mind. Also, as with
all other phases of the plan, this should be integrated and co-
ordinated with the state and local plans for mental health.

In a conference Community Council staff had with the State Mental
Health Division, it was pointed out that it was the policy of

the Mental Health Division to require that all local mental
health programs should include some provision for the care or
handling of chronic alcoholics. The exact methods to be utilized
are not specified, but this problem must be considered and pro-
vided for in some manner in any mental health program at the
local level. Dr. Donald Spille, Executive Director of the Meta
ropolitan Atlanta Mental Health Association, Inc., is a member
of the Community Council‘s Committee on Alcoholism and will help
keep the Committee advised on mental health program plans.

The inpatient extended care rehabilitative service could be part
of a regional hospital or a center by itself. The stress should
be on rehabilitation to prepare the individual to be a self—
sustaining member of society.

Treatment techniques should include:

a. Counseling and evaluation
b. Physical therapy

c. Work therapy

d. Group therapy



Self government
Lectures and films
Drug therapy
Recreation therapy
Pastoral counseling

Specific plans should be developed by experts in the field.

At present, we have the Georgian Clinic located in Atlanta and
supported by the Georgia Department of Public Health. Fees
charged to the patient are based on income. It is a 50—bed resi-
dent patient hospital and also provides day care and night care.
This serves all residents of Georgia and the patient must be

free of alcohol for 24 to 48 hours. There are also a few private

-hospitals or sanatoriums that accept chronic alcoholics but fac—

ilities are extremely limited and almost nonexistent for those
who cannot pay.

C. Supportive Services

1.

Housing « a great many of these individuals have no place to
live. Some need temporary shelter while undergoing treatment.
Some place must be provided for them which will give them support
and keep them from drinking. Others will need more permanent
arrangements if they cannot return to their own homes or live
independently.

The following are some of the kinds of housing that are recomm
mended:

a. Hostel — a semi-institution preferably in town. Should have
a structured program with some medical personnel in attend-
ance. Can be large, serving several hundred individuals.
There is nothing like this in Atlanta.

Halfway homes — smaller, more individual, less structured.

St. Jude's House, Inc., is at present the only halfway house
in Atlanta. It is supported by rents from residents, contri-
butions from churches, individuals and foundations. It has
beds for 40 residents and provides meals for an indefinite
period of time in a protective setting. The men must be

20 years and older, must have an arrest record for drunken-
ness, must be screened psychologically and physically by the
Emory University Alcohol Project. They must also be suitable
for employment.

Shelters for homeless men that include alcoholics.

The Atlanta Union Mission which is supported by individual
contributions and fees. The Mission provides shelter, food,



e.



Page 12

clothes, Christian counsel and employment for indigent men. On
the average, 200 men are taken care of per night. Approximately
85% of these are alcoholics.

The Salvation Army provides over 700 men with shelter a week.
About 90% of these are alcoholic. It does not accept anyone in
a severe drunken state since no medication or special treatment
is available. These are sent by cab to Grady Hospital or turned
over to the police. The men from the Emory Project will occupy
a special section. The Army staff is responsible for giving the
medication prescribed and will see that the men cooperate with
treatment.

Women alcoholics are housed at 242 Boulevard, N.E. Since August,
1966, there have been 4. Women are always referred to Grady Hos-
pital, the Emory Project or the Georgian Clinic.

Individual rooming houses or hotels. The Emory University Alcohol
Project now has a staff member developing these facilities. With
help and supervision, many of these places could be made accept-
able, kept from deteriorating and provide pleasant places to live.
In most of the "flop houses'I and cheap hotels, the man is exposed
to other drinkers and the atmosphere is not conducive to a

healthy state of mind.

Social clubs where individual can go when not in treatment or
when not working. A.A. meetings provide a form of this.

Facility for individual who cannot be rehabilitated but will
always remain partially dependent on treatment. Social improve-
ment, even if it implies dependency upon the hospital, is per-
haps the most that can be expected as a goal of therapy for this

group.
1) Farm where he can be self—supporting.

2) Work outside of facilities with aid of treatment, but
return to facility for night and free time.

Atlanta Union Mission Rehabilitation Farm for alcoholics and

the aged will open in May. It will house 32 alcoholics to begin
with and the master plan calls for 64. In order to be accepted,
the client must be without a drink for at least 48 hours, sign a
statement of his own free will of intent to stay a minimum of 60
days, to cooperate with the staff and its program of worship,
work and education. The client will not be permitted to leave
the mission farm for the first 2 weeks and afterwards only when
accompanied by Mission Farm personnel; There will be a charge
of $62.50 per month for every man. However, his ability to pay
will not determine his acceptance.



Financial Assistance - part of society‘s basic obligation is to pro-
vide for the destitute. This allows them income while undergoing
treatment and supplements income of those who need permanent care.

The Fulton County Department of Family & Children Services cooperate
completely with the existing facilities for treatment of the chronic
alcoholic. The individual receives temporary financial assistance
as long as he is cooperating and undergoing treatment. The Special
Service Section, which carries a reduced caseload, takes care of
most of the alcoholics so that they can be given more intensive case
work. When an individual applies for financial help and is an alco-
holic, every attempt is made to get him to treatment.

D. Public Education

Public apathy has been one of the most severe obstacles in working with
the chronic alcoholic court of:&nder. As a rule, he is a forgotten man,
relegated to a flop house or prison and given up as a hopeless case. He
remains a burden to society and is one of the most important contributors
to the reservoir of poverty in this country. Once the public understands
and its interest is aroused, the resulting action can become a powerful
force in accomplishing a constructive objective.

A public education program should concern itself with.the following
aspects:

1. Develop community leadership to alert people to the needs and poten—
tial of an adequate and sympathetic approach to the problem.

Acknowledging that alcoholism is a public health problem and, theie-
fore, a public responsibility.

Showing that the penal approach to the public alcoholic is expensive
and inhumane. It has only perpetuated the problem and in no way
eased it.

Demonstrating that there is no simple solution. That treatment of
the public alcoholic to be effective and lasting requires coordina-
tion of services and a combination of many resources and programs.
Understanding of the public alcoholic and homeless individual.
Explaining of problems arising in developing programs and service.
a. Legal and legislative

b. Economics or funding

c. Facilities and services that have to be developed

Describing and explaining kind of comprehensive plan Atlanta needs,
elements involved and how we go about implementing such a plan.



A public education program should be directed at public officials,
special interest groups, as well as the general public.

The Metropolitan Atlanta Council on Alcoholism, working with the Commun-
ity Council, could be the motivating force behind an education program.

Central Registry and InformatiOn Retrieval

The full extent of Atlanta's alcoholic problems is not known. The United
States Public Health Service considers alcoholism the fourth most serious
health problem in the country and the picture in Atlanta is most likely
no different than that in any other city. According to the national
average, it is estimated that there are from 20,000 to 25,000 alcoholics
in Metropolitan Atlanta. This is far from a complete number for statis—
tics are not available for those using private facilities and for those
that never come to the attention of the public. We know that in 1965,
48,783 arrests were made in Atlanta involving drunkenness. We have
these isolated figures but nothing complete, and some agency should be
charged with the responsibility of keeping accurate statistics on alco-
holics and facilities available for rehabilitation.

In addition, the need for a central clearing house has been felt by many
agencies. Alcoholics seek help in many places and often at the same
time, and there is no way of knowing where they have been or what treat-
ment they have received. A central clearing house or central registry
cannot succeed, however, unless it receives the full cooperation of all
participating agencies. The Metropolitan Atlanta Council on Alcoholism
might be able to organize one under a special grant so that money would
be available for trained staff.

Staff Training

Before any kind of service or program can be instituted, personnel on
all levels must be available. At the present, there is a severe short—
age of staff and there is a pressing need for training in the field.
Inducements must be made so that individuals will be interested in work—
ing in the area of alcoholism. All facilities and programs concerned
with the treatment of the alcoholic should be involved with the training
program and this should again be coordinated with the State's comprehen-
sive plan for mental illness of which training is an important part.

The Georgian Clinic has an extensive training program which could be ex-
panded. The Clinic could possibly act as the coordinating agency for

a training program.

Evaluation

For a program of this kind, there should be a built-in system of evalu—
ation of services. Only on the basis of such an evaluation would we be



able to strengthen and develop the program, accomplish any worthwhile
long—range planning, and establish accurate guidelines for the further

deVelopment of the program.

The Research Division of the Community Council will help develop the
evaluation and the plan for it will be incorporated in the final report.

Community Council of the Atlanta Area, Inc.



"IMPTCT OF THE EASTER DECISION ON THE DISTRICT OF COLUMBIA"

by
Richard J. Tatham
(no. Department of Public Health)

This is Richard J. Tatham, Chief of the Office of Alcoholism and Drug Addiction
Program Development, for the District of Columbia Department of Health. I've
been asked to relate to you some of our recent experiences in the District of
Columbia which have resulted from a U.S. Court of Appeals decision last March 31,
1966, in the case of DeWitt Easter vs the Court of Columbia. As many of you know,
the result of this court decision was a reversal of court decisions which found
DeWitt Easter to be guilty of the crime of intoxication, in spite of the fact
that he had clearly established that he was a chronic alcoholic. This decision
was appealed to the U.S Court of Appeals and it was found that alcoholism is an
illness and that it would constitute cruel and unusual punishment for a sick
person to be convicted and punished for exhibiting a symptom of his illness in
public, and it was further established that the essential common law element of
criminal intent is lacking when an alcoholic becomes intoxicated. As a result of
this case, the Court of General Sessions began utilizing the Alcoholic Rehabili-
tation Act of 19h7, which authorized that court, in the District of Columbia, to
suspend criminal hearings whenever a defendant was suspected of having an
alcoholism problem and to commit that person to the Department of Public Health
for diagnosis, classification, and treatment. The h7th Statute had been used

on the average of 100 times each year between the years 1950 and 1963, and was,
therefore, nothing new to the court or to the Health Department. However, in more
recent years its use was discontinued as the court began to develop its own pro-
bation program for alcoholic offenders. Last year the U.S. Court of Appeals
strongly urged the District of Columbia to use its h7th Statute once again and as
a result of this admonition some 3500 individuals have been adjudicated under the
hTth Statute to be chronic alcoholics and the majority of these have been
committed to the Health Department for treatment. At the time of the Easter
Decision, the D.C. Health Department operated three alcoholism treatment facili-
ties; namely, au outpatient clinic, known as the Alcoholic Rehabilitation Clinic;
a hospital unit for intensiVE medical care at the D.C. General Hospital; and, a
brand new comprehensive in-petient, out—patient unit at our Area C Mental Health
Center. However, the latter facility was only in its beginning phases with a
skeleton staff and was not really able to participate appreciably to handle a
court alcoholic problem. Likewise, the in—patient facility at D.C. General Respite;
concentrated on the short-term intensive treatment for delirium tremens,
hallucinosis, and other serious complications of alcoholism, and so very few of
the court-committed alcoholics were eligible for this service. The only remaining
treatment facility is our out—patient clinic. Now in the month immediately
following the Easter Decision, only six patients were committed to the Health
Department. In the month of May, the number jumped up to 100 and by June, 300
new patients were committed to us. By this time, patients were being transported
from the court to the out-patient clinic by the busload with as many as 50 or
more arriving at a time. The out~patient clinic had no choice but to accept these
in spite of the fact that the clinic was not designed to accommodate the needs of
the patients we were receiving. Utter chaos followed. All attempts to utilize
existing Health Department resources resulted only in the addition of a few part—
time people on an overutime basis in order that the clinic could operate evenings
and Saturdays. Now, nine months after the Easter Decision, the same situation
prevails with one exception - we now have an additional facility - a h25—bed,
extended-care rehabilitation center located just outside the District of Columbia
in Occoquan, Virginia. This facility opened Hovember it, 1966, and was filled to



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capacity in less than six weeks, so once again the Health Department is unable
to accommodate all the patients who require in-patient treatment and these

patients are once again going to our out-patient clinic.

A recent article in the washington Post indicated that the Director of this out-

patient clinic is threatening to leave the Health Department unless the situation
is alleviated somehow. The patients are still coming to clinic in droves. While
they are there, they have entered into fights with other patients, members of the
clinic staff have been assaulted, patients hare urinated and expectorated in the

clinic and this has created a situation which threatens the entire survival of a

treatment program that has been in existence since 19h9.

The solution of this problem is not a simple one. One might believe that the
Health Department had not anticipated the reversal in the Easter Case; however,
this is not true. Well in advance of the Easter Decision, the Health Department,
along with representatives from Vocational Rehabilitation, Correction, Adminis—
tration, and walfare Departments prepared an ad hoc report dealing with the
possible impact of an Easter Decision. This report clearly pointed out some of
the problems which might arise and also outlined certain new services and facilities
which might be needed. However, no action was taken by our Board of Commissioners.
The reason for this included the fact that the Commissioners had no assurance that
the Easter Case would be reversed and even if it would be reversed they had no
assurance that the impact would be great. For example, eVen though the Easter
Case would be reversed, the Judges in our local courts might insist that the
question of alcoholism would have to be introduced by the defendant himself and
many alcoholics appearing in court, of course, would choose not to introduce the
problem of alcoholism. By avoiding the question of alcoholism they could return
to their workhouse where they have been long-time residents - they knew that they
would serve an average of 21 days and then could be released without any parole

or any other obligations. However, if they should bring up the question of
alcoholism, they might very well be committed to the Health Department for 90 days
with a possibility that a second 90-day committment would follow. With this in
mind, there was much speculation that the courts would not use the Easter Decision
as a base of future action in very many cases. In addition to this, the problem
was complicated by the fact that the corporation counsel, known in other cities

as a prosecuting attorney, felt very strongly that according to the definition of
our 19h? Statute, there could not possibly be more than 20 or 30 chronic alcoholics
in the entire District of Columbia. Activities since then have proven quite the
contrary. The problem has become so great that it was necessary to set up a
court—coordination program and patient control system in order to just keep track
of the multitude of patients being committed to us by the court. The situation
became so bad that the Health Department was instructed that it must cut off all
voluntary patient admissions at its treatment facilities in order to make room for

the court-committed patients.

In evaluating the problems that have occurred since the Easter Decision, the
Department has consistently fallen back on its basic comprehensive community
mental health plan, which points out the needs for various facilities ranging
from the extended care rehabilitation center we now operate to mental health
center alcoholism units providing both in-patient and out-patient treatment to
detoxification centers to residential facilities such as hostels and half-way
houses. The big problem, obviously, is the magnitude of the program which we
have proposed and the fact that one or two components of the program still do not
alleviate the problem of handling court-committed patients. Until a complete



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system is available and operating which can provide all of the services needed

by this particular patient population, there will be chaos in treating the chronic
court offender. If we do not have community based residential facilities, then
we will either have to expand our in-patient hospital at Occoquan, Virginia,

or we will have to substitute out-patient treatment with all its inadequacies

for this homeless patient group.

The District of Columbia is presently spending approximately $3,000,000 per year
on the alcoholic patients seen by the Health Department. Of this figure,
approximately $1,000,000 a year is expanded on the care of alcoholics having
psychosis who are admitted to St. Elizabeths Hospital and paid for by the Health
Department on a contract basis. The other $2,000,000 accounts for our present
services at the rehabilitation center, at the Area C alcoholism unit and at our
out—patient clinic. Also, the figure includes the cost of providing our court
coordination and patient control system, a small alcoholism TB Program at
Glendale Hospital, and our new demonstration detoxification unit.

As we are busily trying to expand our services to accommodate the needs of the
court—committed patients, We are faced with a new problem which has come to light
within the past few weeks in Washington. Our infonmation indicates that two new
bills are to be introduced to Congress this session. One by the administration,

a second by Congressman Hagan from Georgia. Each bill would introduce a new
concept in law enforcement as each would remove intoxication from the criminal
code entirely. This would mean that if either of these bills was passed, an
individual could not be arrested for being intoxicated only in the District of
Columbia. It would mean that if an intoxicated person is helpless, has no place
to go, he could be escorted by a police or Health Department official to a health
facility for detoxification. He would be kept in such a detoxification faciltiy
until his blood alcohol content returned to the legal lhmits of sobriety and then
could be continued in treatment for alcoholism as a voluntary patient or released
outright. This would mean that our attention to the problems of getting
sufficient hospital care resources for court-committed alcoholics would shift
almost immediately to the problem of obtaining sufficient in-patient detoxification
resources within the community itsalf. I think this is an excellent example of
how dynamic the field of alcoholism has become as a public health problem and
indicates the importance of planning coupled with flexibility; and, above all, it
impresses with the importance of the magnitude of the problem. Most communities
have never accepted the full impact of the statement that alcoholism is the nations
third or fourth public health problem. we have mouthed this saying without
realizing the financial impact that it carries. As I said earlier, our community
is expending approximately $3,000,000 a year on alcoholics. Now I'm talking

about the Health Departments budget - I'm not adding to this figure what the

Police Department, what the courts, what the Department of Corrections, and other
departments are allocating to the care of alcoholics - just the Health Department.
This $3,000,000 figure, in our estimation, will prdbably have to be doubled to a
$6,000,000 annual figure just to take care of the immediate emergency problems
arising from the Easter Decision and the possible new legislation which would
remove intoxication from the criminal code. NOW, in creating these new services,
of course we would hope any new program.would be considered an additional resource
for voluntary patients also; but, it's interesting to note that our 19%? Statute
and the Easter Decision and the possible new statutes removing intoxication from
the crhminal code, all focus on the alcoholic who is a law offender and quite often
the most important patient in this group is the chronic drunkenness offender with
fifty or more previous arrests for drunkenness. This means that today, alcoholism,
even though a public health problem, is reaching the public's attention through
the judicial activities of the community and of the nation; that a complete

_h-

revision of some rather well established principles is being questioned; and
that new approaches are being encouraged; and that these new approaches will
require new funds of considerable magnitude unless the community is satisfied
that the treatment of the chronic alcoholic offender should consist of removing
him from the streets only — and I think this is a very real problem that we

face in firmly maintaining that alcoholism, the skid row alcoholic, the chronic
drunkenness offender, is to become truly a public health problem. That the high
quality treatment, the high standards of services that we provide other alcoholic
patients are made available to the chronic drunkenness offender - now this does
not mean that the chronic offender necessarily can benefit from the same type of
treatment that our other alcoholic patients are involved in; but it does mean
that whatever services are provided for them, they are the highest possible
quality of services to meet the needs of this important patient population.

I have been impressed as I have visited many alcoholism facilties throughout this
nation with the fact that even though the Easter Decision is more than nine months
old and that a similar decision in the case of Joe B. Driver in the Fourth
Circuit Court of Appeals at Richmond, Virginia, have established a new legal
precadent, and that these precedents have been set on both a constitutional and
common-law'basis and there is no doubt that the precedent will spread from state
to state and circuit to circuit; yet in spite of all these things, many alcoholism
programs do not seem to be planning to take care of this situation when it
inevitably happens in their own state and community and I was, therefore, very
pleased to see that in Atlanta there is planning being initiated and that the
Community Council here in Atlanta is drafting a proposal which will be submitted
as an answer to the problems that can arise here; that there are a number of
people interested in the chronic alcoholic offender; and that services are being
demonstrated now which can be extremely important in meeting the treatment, the
rehabilitation, the residential, and other needs of this impoverished group. We
feel quite strongly in the District of Columbia that we have been bogged down in
our own problems for over a year and that it's now perhaps our responsibility to
communicate our experiences and observations to others throughout the country and
Canada in order that some of the problems, the mistakes, and the frustrations ex-
perienced in washington can be minimized elsewhere and it has been with this
thought in mind that I have shared these comments with the staff of the Georgian
Clinic and others who might come into contact with this tape recording.

Richard J- Tatham, Chief

Office of Alcoholism & Drug Addiction
Program Development

Government of the District of Columbia

Department of Public Health
washington, D.C.

RJT: 2—2h-67



INVITATION LIST FOR MEETING ON THE
CHRONIC ALCOHOLIC COURT OFFENDER

Co-sponsored by
Community Council of the Atlanta Area, Inc.
Metropolitan Atlanta Crime Commission

Tuesday, April 13
3:00 P.M.
Conference Room, Trust Company of Gaorgia

Dr. John Venable, Director
State Board of Health

47 Trinity Avenue, S. W.
Atlanta, Georgia

Dr. P. K. Dixon, Chairman
State Board of Health

Gainesville, Georgia

Dr. Addison Duval, Director
Division of Mental Health
Department of Public Health
47 Trinity Avenue S. w.
Atlanta, Georgia

J. William Pinkston, Executive Director
Grady Memorial Hospital

80 Butler Street, S. E.

Atlanta, Georgia

Mr. Edgar J. Forio, Chairman
Fulton - DeKalb HOSpital Authority
P. 0. Drawer 1734

Atlanta, Georgia

Dr. John Hackney, Commissioner of Health
Fulton County Health Department

99 Butler Street, S. E.

Atlanta, Georgia 30303



7. Mr. P. D. Ellis, Chairman
Fulton County Health Department
3230 Peachtree Road, N. E.
Atlanta, Georgia 30305

8. Dr. T. 0. Vinson, Director
DeKaib County Health Department
126 Trinity Place West
Decatur, Georgia

9. Dr. John R. Evans, Chairman
DeKalb County Board of Health
Stone Mountain, Georgia

10. Mayor Ivan Allen, Jr.
City of Atlanta
204 City Hall
Atlanta, Georgia

11. Richard C. Freeman, Chairman Police Committee
Board of Aldermen, City of Atlanta
1116 First National Bank Building
Atlanta, Georgia

12. John M. Flanigan, Chairman Prison Committee
Board of Aldermen, City of Atlanta
245 Third Avenue, S. E.
Atlanta, Georgia

13. Henry L. Bowden, City Attorne§
William Oliver Building
Atlanta, Georgia

14. Judge Robert E. Jones
165 Decatur Street, S. E.
Atlanta, Georgia

15. Judge E. T. Brock
165 Decatur Street, S. E.
Atlanta, Georgia

16. Judge T. C. Little
165 Decatur Street, S. E.
Atlanta, Georgia

17. Judge Robert Sparks
165 Decatur Street, S. E.
Atlanta, Georgia

18. Police Chief Herbert T. Jenkins
165 Decatur Street, 8. E.
Atlanta, Georgia



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19. James H. Aldredge, Chairman
Commission of Roads & Revenues, Fulton County
Fulton County Administration Building
165 Central Avenue, S.W.
Atlanta, Georgia 30303

20. Charles Brown, Fulton County Commissioner
Fulton County Administration Building
165 Central Avenue, S.W.
Atlanta, Georgia 30303

21. Walter M. Mitchell, Fulton County Commisaioner
Fulton County Administration Building
165 Central Avenue, S.W.
Atlanta, Georgia 30303

22. Harold Sheets, County Attorney
Fulton County Court House
Atlanta, Georgia 30303

23. James P. Furniss, Chairman
Board of Directors
Community Council of the Atlanta Area, Inc.
C & S National Bank
Atlanta, Georgia 30303

24. Brince Manning, Chairman
Board of Commissioners, DeKalb County
DeKalb Building
Decatur, Georgia 30030

25. George Hearn, Assistant Attorney General
State of Georgia
Judicial Building
Atlanta, Georgia 30303

26. Paul Cadenhead, Chairman
Community Council Advisory Committee-on Alcoholism
2434 Bank of Georgia Building
Atlanta, Georgia 30303

27. Eugene Branch, Chairman, Permanent Conference, CCAA, Inc.
401 Haas—Howell Building
Atlanta, Georgia 30303

28. Charles Methvin, Director
State Alcoholic Rehabilitation Unit
1260 Briarcliff Road, N.E.
Atlanta, Georgia 30306

29. Jack Watson
King & Spalding
Trust Company of Georgia Building
Atlanta, Georgia 30303



Captain Ralph Hulsey
City Prison Farm

561 Key Road, S.E.
Atlanta, Georgia 30316

Dr. James A. Alford

Alcohol Rehabilitation Project
41 Exchange Place, S.E.
Atlanta, Ga. 30303

Mrs. Marian Glustrom, Planning Associate
Community Council of the Atlanta Area, Inc.
1000 Glenn Building

Atlanta, Ga. 30303

Duane W. Beck, Executive Director
Community Council of the Atlanta Area, Inc.
1000 Glenn Building

Atlanta, Ga. 30303

James L. McGovern, Executive Director

Metropolitan Atlanta Commission on
Crime & Juvenile Delinquency

52 Fairlie Street, N.W.

Atlanta, Ga. 30303





March 16, 1967
RECENT COURT DECISIONS 0N ALCOHOLISM:

IMPLICATIONS FOR ATLANTA AND THE STATE OF GEORGIA

Skid Row has long been recognized as the bilge of our communities. And
the derelict inebriates who reside there represent perhaps the lowest form of
humanity. For centuries, these derelict alcoholics have been virtually ignored,
not only by the average citizen, but indeed by the very public officials who are
charged by statute with caring for them. Instead of receiving the attention and
help that they deserve and so urgently need, they have received nothing but private
disdain and public condemnation. They hare been herded mercilessly through our
courts and jails, in every city in this country, and especially in Atlanta, in an
endless and futile parade.

Early last year two United States Courts of Appeals sought to put an end to
this senseless parade. These courts recognized, as anyone who st0ps to think
about it must recognize, that this was a parade as much of our nation's blind
stupidity as it was of the serious affliction -- chronic alcoholism —- from which
these unfortunate people are suffering. It is these legal decisions, and the
ramifications that they will inevitably have upon Atlanta and the entire State of
Georgia, which I will discuss today. I will be as forthright as I can be in my
remarks. And I trust that you, in turn, will be forthright in your comments and
criticisms of my suggestions.

I

It is appropriate to begin by asking whether Atlanta has a problem of this
kind. After all, if you are fortunate enough to have no Skid Row, to have no
derelict alcoholics, or to provide humane and enlightened treatment for your
chronic inebriate population, then we need proceed no further.

The facts that have been made available to me demonstrate that Atlanta does,
indeed, have a very grave problem. Both a Georgia statute and an Atlanta ordinance
prohibit public intoxication. In Atlanta, there were h0,811 arrests for drunkenness
during 1966, and an additional 6,h9h arrests for "drunk and disorderly," making
a grand total of h7,305 arrests for intoxication. And this figure would be
substantially increased if arrests for other offenses clOSeLy related to intoxi-
cation, such as vagrancy and loitering, were included.

The recent Report of the President's Commision on Law Enforcement and
Administration of Justice, releasedc to the public just last menth, has singled
out Atlanta and the District of Columbia as the two jurisdictions where chronic
inebriate offenders are most harshly persecuted with constant arrest and conviction
for public intoxication. On a per capita basis, the District of Columbia seems
to have outstripped Atlanta slightly in its zeal to put these men in jail,
according to the 1965 statistics used by the President's Commission. As a result
of the Easter casa, however, Atlanta may by now have taken over from the District
of Columbia the dubious distinction of being the Nation's leading exponent of
the theory that sick men should be arrested and convicted for displaying the
symptoms of their illness in public.

During one sample month, November 1966, approximately one—third of the
persons arrested for intoxication in Atlanta paid a $15 fine before coming to
court. By paying this fine, they avoided the distasteful experience of appearing





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in Drunk Court. The remaining two-thirds apparently could not raise $15 and
therefore had no choice but to be brought before the Court.

I have made no study of the Atlanta drunkenness offenders, and therefore
can only extrapolate from national data and rely upon local data obtained from
your State officials. But a national survey conducted during the past two years
has indicated that between 90% and 95% of the drunkenness offenders who are not
able to pay a fine upon arrest, and who therefore are forced to appear in Drunk
Court, hare very serious drinking problems. As I shall describe later, these
statistics have been confirmed with a vengeance in our District of Columbia
Drunk Court during the past 12 months. And I would imagine that the situation is
no different in Atlanta.

In a study conducted by Emory University during 1962 and 1963, it was found
that 6,000 chronic alcoholics accounted for 30,000 arrests. More recently, the
Emory staff has concluded that Atlanta has a population of up to 12,000 individual
chronic inebriate offenders. Whether the correct figure is 6,000 or 12,000,
or somewhere between, it is readily apparent that the problem is staggering.

It could be dismissed only by assuming what the President's Commission on Crime

in the District of Columbia has described as "a callous disregard for human life."
And it can be attacked onlyly what that Commission has characterizad as "a
determination for the first time to grapple with the deep—seated disabilities

of the City's derelicts."

Now let us look at the kind of help given to theSe people by the City of
Atlanta. Again, I rely upon information that has been furnished to me.

It is my understanding that, as a result of the first Emory study, a
comprehensive plan to attack the problem of the chronic inebriate offender in
Atlanta was drawn up. Although bits and snatches have been implemented, it has
basically gone unheeded.

Drunken derelicts who are arrested receive no routine medical treatment,
and are taken to Grady Memorial Hospital onEy if they exhibit a serious medical
problem. Nor is medical help or rehabilitation services available at the Stockade,
where they are sent after conviction.

Paradoxically, Atlanta has a reputation throughout the country of progressive
treatment for alcohlics. The Georgian Clinic is frequently cited for its work --
but I was distressed to learn just a few days ago that it has only 50 beds, and
is expected to serve not just Atlanta, but the entire State of Georgia. The
Emory University Alcohol Project has also been receiving nation-wide attention «—
but, again, I was distressed to learn that its patients apparently come only from
prison, not from the streets, and only for vocational rehabilitation, not for
general treatment for their alcoholism.

Finally, your State Legislature has enacted a statute for the rehabilitation
of alcoholics. But a perusal of that statute readily demonstrates that it is
far more punitive than any criminal statute could be. Upon determination that
an individual is a chronic alcoholic who is in need of hospitalization, and
upon agreement by the Department of Health to admit the individual as a patient,
that man can be held against his will for an indeterminate length of time. There
is not even a requirement that the court find that he is dangerous to the public
safety, or that the Department of Health has adequate and appropriate treatment
programs and facilities for him. Ant it is readily apparent that in Atlanta and
the State of Georgia today, there is no adequate and appropriate treatment program
or facilities for derelict alcoholics.



.3-

Thus, there is no question but that Atlanta and the State of Georgia do
have a problem. There is good reason for all of you to come here today to consider
this matter.

II

The Problem of public drunkenness has been with us for centuries. Under
early English common law, public intoxication was not considered criminal activity.
Drunkenness was considered entirely proper unless it resulted in an illegal
breach of the peace.

Mere public intoxication was first made a criminal offense by an English
statute in 1606. And, today, it remains a criminal offense, with varying
penalties, in virtually every part of the United States.

We need not trace, today, the history of the criminal law as it has applied
to alcoholism-from 1606 to the present. Suffice it to say that the early courts
concluded that, because alcoholism is a voluntarily-acquired disease, an alcoholic's
drinking must be deemed to be voluntary as a matter of law. And since it is a
well-established legal principle that an individual is responsible for all of
his voluntary acts, alcoholics haye been held criminally liable for their public
intoxication, and any anti—social behavior it has caused, down through the years.

The health professions have recognized, of course, that an alcoholic does
not drink voluntarily. In l9h7, the United States Congress enacted a District
of Columbia statute, based upon the best available medical testimony, which
explicitly recognized that an alcoholic has lost control over his drinking.
In 1956, the American Medical Association officially recognized chronic alcoholism
as an illness which should properly be treated by physicians. And in 1966,
the Courts caught up to the legislatures and to the medical profession.

III

I would like to take a moment to describe the two recent court decisions
because of their fundamental importance to the subject we are considering today.

Both cases were based upon the conclusion that chronic alcoholism is now
universally accepted as an illness. In Easter v. District of Columbia, the
United States Court of Appeals fer the District of Columbia Circuit held that
because a chronic alcoholic drinks involuntarily, as a result of the disease
with which he is afflicted rather than as a result of his own volition, he
cannot be branded as a criminal. The Court recognized that public intoxication
is only a symptom of the disease of chronic alcoholism, and ruled that common
law principles preclude criminal conviction merely for exhibiting a symptom of
a disease in public.

In Driver v. Hinnant, the United States Court of Appeals for the Fourth
Circuit reached the same result, but on Constitutional grounds. The Fourth
Circuit held that to convict a chronic alcoholic fer his public intoxication,
which is merely the inherent symptom of a serious illness, would violate the
prohibition against cruel and unusual punishment contained in the Eighth
Amendment to the United States Constitution.



4..

These decisions represent rare unanimity in our Federal courts. A total
of 11 judges considered these two cases -- the full en banc court of 8 judges
in the Easter case, and a panel of 3 judges in the Driver case. Not one judge
dissented from the conclusion that an alcoholic may no longer be convicted for
his public intoxication.

It makes no diffErence whether this result is reached by the Constitutional
approach used in the Driver case, or by the common law approach of the Easter

case. The conclusion is the same. no longer may the age-old problem of the
chronic inebriate be handled by the criminal process. A new method of handling
this problem must, under these decisions, be found by our local communities.

The Easter and Driver decisions are not legally binding in the courts of
the State“ of Georgia. But it is just a matter of time before the results of
those cases will become applicable here. Unlike public officials in the District
of Columbia, you still have a little time to head off a real crisis before it
occurs. Georgia has the choice whether to take advantage of the time left before
action is forced upon it, or simply to sit back and ignore the problem. I would
certainly urge that immediate action be taken, that intelligent long-range plans
be formulated, and that the type of chaos that has followed the Easter decision
in the District of Columbia thereby be ayoided. I will now turn to discuss the
planning and the new procedures that should be instituted in Atlanta and the

State of Georgia.

IV

Nb individual, and no single group, can possibly undertake a program to
replace the present revolving door handling of indigent inebriates through the
courts and jails of Georgia, by a modern program of rehabilitation and public
health facilities. It will take a community of effort, among all public officials
and all interested private groups, to make a revolutionary program of this kind
become meaningful. I will therefore discuss the role that I believe the police,
the prosecuting attorneys, the judiciary, and public health personnel should play
in undertaking new procedures for handling the chronic court inebriate problem.

In discussing this, I shall rely heavily upon two authoritative reports
just recently issued: the Report of the President's Commission on Crime in the
District of Columbia, released to the public on January 1 of this year, and the
Report of the President's Commission on Law Enforcement and Administration of
Justice, released on February 19. I acted as a consultant to both Commissions,
and I am happy to state that the Commissions and I were in virtually complete
agreement on the recommendations that they should make with regard to the handling
of public intoxication by local communities. The two Reports are, in my opinion,
essential reading for anyone interested in the chronic court inebriate problem.

A. Let us first examine the police handling of chronic inebriate offenders.
In my opinion, it is not a false arrest for a policeman to charge an unknown
inebriate with public intoxication, even after the Easter and Driver decisions.
The police cannot be required, at their peril, to make a judgment on the street
as to whether an intoxicated individual is or is not a chronic alcoholic.

In the case of known alcoholics, however, this problem raises a far more
difficult legal issue. To some, the availability of the defense of chronic
alcoholism still seems more properly an issue for the courts than for the police.
But to a growing number of responsible lawyers, who have watched the District
of Columbia police persecute chronic inebriates by daily arrest after the





-5-

Easter and Driver decisions, any police detention of a known chronic alcoholic
for his public intoxication should be condemned as illegal, as well as unconscionable.
This is therefore still an unresolved legal issue.





But more important, the community should not place the police in jeopardy
in this way. There is no reason why the police should be burdened with the
ignominious task of sweeping chronic inebriates off the public streets. Last
September I was called upon to assist a man who had been arrested 38 times for
drunkenness in the District of Columbia just since the Easter decision. When you
take into consideration the amount of time he spent incarcerated in jail and in
various heapitals, this amounted to l arrest for every 2 days that he appeared
on the public streets. Certainly, the answer to the Easter and Driver decisions
is not just to arrest derelict alcoholics every day, duly bring them to trial,
and then immediately release them onto the streets without assistance, only to
repeat the process over and over again. This succeeds in speeding up the revolving
door, and in the persecution and further degradation of chronic inebriates. It
cannot contribute to the elimination of these abuses, as the Easter and Driver
decisions demand.





In my opinion, the police can and should take two immediate steps to end
the revolving door process, pending development of a broader community program
which I will discuss later in this talk. First, they should assist any drunken
person to his home, whenever that is possible. Second, where an individual is
unable to take care of himself, the police should assist him to an appropriate
public health facility where he can receive the necessary medical attention.
under no circumstances should they arrest known alcoholics time and time again.

The question arises, of course, whether the police may properly assume
responsibility for intoxicated individuals and escort them to an appropriate
public health facility to received proper medical attention. If the inebriate
does not consent, would the police incur liability for a false arrest?

I have long been of the view that the police have duties of a civil nature,
in addition to their responsibility for enforcing the criminal law. When a
policeman escorts a heart attack victim to the hospital, he certainly is not
arresting him. Thus, in my opinion, the police have not only a right, but
indeed a duty, to take unwilling intoxicated citizens, who appear to be unable
to take care of themselves, whether or not they are alcoholics, to appropriate
public health facilities. Certainly, this question should be resolved immediately
preferably by enactment of a state statute, in order to lay the necessary legal
foundation for the proper medical handling of alcoholics.

I am confident of one thing about our police personnel. Once new procedures
are instituted fer handling the chronic court inebriate as a public health problem,
the police will be only too happy to cooperate. The police have long suffered under
the public's command that they daily sweep this human refuse from the streets, a
task which provided no possible benefit for their unfortunate victims. They will
be only too happy to see the old system replaced by procedures which will allow
them to help these people back on the road to recovery, rather than just push
them further down into their sodden Skid Row environment.

B. With regard to the handling of chronic alcoholics by prosecuting attorneys,
it is instructive to refer to the Canons of Ethics of the American Bar Association.
Canon 5 provides that "the primary duty of the lawyer engaged in public prosecution
is not to convict, but to see that justice is done."



-6-

This does not mean, of course, that a prosecutor is obligated to defend the
man that he is prosecuting. It does mean, however, that he is obligated to make
certain that an innocent man is not convicted. And in the context of the Easter
and Driver decisions, this means, in my judgment, that a prosecuting attorney is
obligated either to drop the charges, or at the very least to inform the judge of
the relevant facts, whenever he has reason to believe that a defendant may hare
available to him the defense of chronic alcoholism. It is then up to the judge

to protect the defendant's rights.

A truly responsible prosecutor, moreover, would take it upon himself to review
the defendant's record prior to any court prooeeding, and to make appropriate
recommendations to the court on his own motion. The prosecutor is, after all, an
arm of the court and a representative of the community. As such, he cannot
properly remain neutral. He should therefore take affirmative steps to make
recommendations for the non-criminal handling of any chronic alcoholic he is

assigned to prosecute.

Of course, prosecutors are not qualified to diagnose alcoholism. In most
instances, however, the defendant's past record will readily demonstrate a
drinking problem, and will be quite sufficient to lead a prosecutor to recommend
to the court that an appropriate medical examination be made.

The problem, in short, is not to devise ingenious methods by which the
prosecutor may responsibly exercise his public duty. Rather, the problem is to
educate prosecuting attorneys about alcoholism, and to persuade them to take time
from their demanding duties to assist the alcoholics with whom they come in
contact in their daily work.

C. Let us now examine the judicial handling of chronic court inebriates.
Once a judge becomes snare, through any information, of any kind, from any
source, that a defendant charged with public intoxication may have available to
him the defense of chronic alcoholism, he is, in my opinion, clearly obligated to
make certain that the defense is adequately presented. Cases in the District
of Columbia, involving the analogous defense of mental illness, hold that even
if the defendant protests, the judge is required to inject the defense into the
case on his own motion, to make certain that an innocent man is not convicted.
Failure to do so is reversible error, as an abuse of the judge's discretion. And
a decision handed down by the United States-Supreme Court in March of last year
is wholly consistent with this position. There is no reason why these precedents
dealing with the insanity defense should not be equally applicable to the defense
of chronic alcoholism. The D.C. Crime Commission concluded that they are applicable
and that they compel the trial judge pug sponte to protect the alcoholic defendant's

legal rights.

This means, of course, increased responsibility for the judiciary. Under the
Easter and Driver decisions, each trial judge is obligated to take affirmative
action to bring to an immediate and the traditional "revolving door" handling of
the chronic court inebriate in his court. No judge, in my opinion, may properly
remain neutral, simply waiting for a defendant to raise the defense of alcoholism.

I have already mentioned recent information which suggest that, throughout
the country, approximately 90-95% of the drunkenness offenders who appear before
the courts have serious drinking problems. In my judgment, this statistic in
itself places upon trial judges an obligation to inquire into the posaibility of
the defense of chronic alsoholism for virtually every drunkenness offender who
appears in the courts. A failure to undertake this inquiry amounts, in nw'view,
to a derogation of judicial responsibility.



-7-

Some will contend that, because the Easter and Driver decisions are not
bindigg upon the courts of Georgia, it is neither permissible nor desirable for
local judges to apply these decisions in their own courts, even though they may
believe them to he a proper statement of law. Some trial judges believe that,
until an appellate decision is handed down in their jurisdiction, they are
compelled to follow the old view of the law even though they disagree with that
view. In my opinion, this is an erroneous concept of a trial judge's responsibility
to the community.

A trial judge has an obligation, usually stated in his oath of office, to
uphold the Federal and State constitutions. That obligation is far deeper, and
far more important, than the principle of stare decisis. If a trial judge is
convinced that the Easter and Driver decisions are correct statements of the law,
he is in my opinion obligated to implement them in his own court without waiting
for an appellate court to order him to do so. A municipal court judge in
California recently took it upon himself to declare the local intoxication law
unconstitutional, as applied to a chronic alcoholic, and I have not heard it
seriously suggenmd that he overstepped his judicial authority.

The second way in which local judges have avoided applying these decisions
is by refusing to raise the defEnse of alcoholism on their own motion. It
requires little imagination to realize that the average Skid Row derelict does
not read the Federal Reports, much less the newspapers, and has absolutely no
knowledge whatever about his legal rights. Even if he did understand, in some
vague way, that he might have a defense to the charge of intoxication, he
probably could not begin to understand the ramifications of raising that defense.

And of course, none of these derelicts are represented by counsel. Thus, unless
the trial judge assumes the obligation of protecting this man's rights, those
rights never will be protected.

In those areas where the judges have not raised the defense of alcoholism
on their own motion, it has only very seldom been raised by the defendants.
Joe Driver, himself, has been convicted for public intoxication in Durham on
more than one occasion after the Fourth Circuit handed down the decision which
bears his name. I find this perversion of law enforcement intolerable.

Many of the judges who have chosen not to follow the Easter and Driver
decisions have done so because of a sincere conviction that it would be more
inhumane to throw derelict alcoholics back out into the streets, to an uncertain
fate, than it would be to throw them into jail, where they will at least be cared
for. I have no quarrel with the sincerity and humanity of these judges. But
I firmly believe that what passes for humanity in the short run becomes the worst
font of cruel and unusual punishment in the long run.

Acquiescence in the criminal handling of alcoholics virtually precludes
ever breaking out of the revolving door method of handling alcoholics in our
courts. To the extent that the judiciary and the local Bar permits the community
to handle derelict alcoholics as criminals, the community may have little or no
incentive to change that procedure. Edmond Burke once said that "All that is
required for the triumph of evil is that good men remain silent and do nothing."
If the good men in the judiciary and the Bar remain silent and do nothing, the
Easter and Driver decisions could go down in Georgia history as a theoretically
intriguing, but practically meaningless, judicial aberration. And the evil of
handling alcoholics as criminals could be perpetuated in this State.



-8-

One example of what a vigorous and conscientious local court can accomplish
may be seen in the activities of the District of Columbia Court of General
Sessions since the Easter decision was handed down on March 31 of last year.

A majority of the judges in that Court concluded that they are obligated to
raise the defense of alcoholism EEE sponte for virtually all of the defendants
who apeear in the Drunk Court charged with public intoxication. As of March 9,
1967, h,382 individuals had been adjudged chronic alcoholics, and therefore can
never again be convicted of public intoxication in the District of Columbia.
And I would estimate that only a handful of those 15382: individuals raised the
Easter defense by themselves. In virtually all cases, the trial judge raised
the issue on his own motion and referred the defendant to a court psychiatrist

for diagnosis.

The response of the District of Columbia Government to the Easter decision
had initially been one of disinterest and disinclination to act. Our Court,
by making it clear that the decision would be implemented vigorously, soon
forced public officials to abandon this posture of indifference.

These public officials then attempted to put into operation wholly inadequate
procedures which, in effect, would have done no more than change the sign over
our local Workhouse to read "Hospital" rather than "Jail." Again, our courts
responded by refusing to commit any adjudicated alcoholics to this new so-called
health facility, when testimony proved that adequate treatment for alcoholics
was not available there. As a result, comprehensive treatment programs and modern
facilities are now coming into being. These programs and facilities could not
have been Lade possible were it not for the courage and sense of community

reaponsibility of our local judges. This was judicial integrity at its pinnacle.
Our community, and judges throughout the country, can take great pride in these
men.

Some of you might think that the press and the citizens' groups in the
District of Columbia would have heaped abuse upon our judiciary for releasing
this tremendous number of derelict alcoholics upon the community. These derelicts
certainly did not present a pleasing sight to the eye, and some undoubtedly died
who might have lived had they been sent to jail. But the public did not blame
the judiciary. Just the opposite was true. Our judges have been publicly
praised for refusing to continue to punish intoxicated alcoholics, in spite of
the community problems this has raised. But the public press, citizens' groups,
the Bar Asaoejation, and the President's Crime Commission, have severely
crihioized the District of Columbia officials who have failed to provide public
health facilities for derelict alcoholics. And I believe that the same attitude
would prevail in any community in the United States in which the judiciary and
the Bar similarly had the courage to lead the way to new, more humane procedures
for the handling of its chronic inebriate population.

D. Correctional officials should have little or no responsibility for the
treatment of chronic alcoholics. If the prosecuting attorneys and the judiciary
adequately perform their functions, chronic alcoholics will no lenger populate
our prisons, as they currently do. And it is quite clear that a prison setting
is hardly the atmosphere in which to attempt to persuade a chronic inebriate
offender to change his ways.

There will remain in our prisons, nevertheless, some who have been properly
convicted of more serious crimes, who have a drinking problem unrelated to
those crimes. It would obviously be wise for public health personnel to suggest
to correctional officials that some form of appropriate treatment he provided

for these people while they are still in jail, in order to head off future
alcoholism problems.



-9-

E. The primary responsibility for developing practical programs for helping
our chronic inebriate population necessarily rests, however, with professional
public health personnel: dootors, nurses, social workers, and others working
in the area of alcoholic rehabilitation. A Judge can find an alcoholic not
guilty of a given crime with which he is charged, but he cannot develop an
effective rehabilitation program, nor can he order state or federal health
officials to build facilities and develop adequate programs. A prosecutor can,
similarly, only exercise his discretion to prosecute or to drop charges. And
lawyers can defEnd chronic alcoholics charged with crime but cannot offer them
the treatment necessary to prevent similar court appearances day after day after
day. In the last analysis, therefore, we must all rely upon public health
personnel to initiate changes in the present procedures.

They will readily find that when new procedures for handling chronic
inebriates are presented, the police, the courts, and local attorneys will offer
their full cooperation. But the point that concerns me most, I must admit, is
that up to now the health professions have not greeted the Easter and Driver
decisions with the sense of challenge and responsibility that I had hoped for.
New is the time for them to step forward with imagination and dedication to
present new procedures for handling inebriates, new treatment programs designed
to rehabilitate alcoholics, and new legislative proposals to develop an appropriate
legal structure under which these new objectives may be properly pursued. Uhless
this happens in the State of Georgia, the opportunity afforded by the Easter and
Driver decisions may be wasted, and the efforts that have been made to adopt an
enlightened legal approach toward the chronic inebriate offender may be in vain.

One would hope that these new procedures will come voluntarily from the
health professions. If they do not, however, then all law enforcement personnel
in the State -— the police, the prosecutors, the judiciary, and the local Bar --
should take every step possible to force these new programs into existence. The
legal profession has long assumed the duty of a public protector of the rights
and liberties of all citizens. We must be as zealous in protecting the rights of
our derelict population as we are in protecting the rights of those citizens
who are more fortunate in life. I have already described what we have accomplished
in the District of Columbia in just one year. Comparable humane results can be
obtained in Atlanta.

In an article that appeared in the Atlanta Constitution on March 1 of this
year, a representative of the Atlanta Area Community Council was reported to be
pleading for time, and to be making efforts to forestall legal action in Atlanta
that would push for adoption of the Easter and Driver decisions as binding law
in Georgia. I most sincerely hope that there is no delay here, and that plans
for a test case move ahead rapidly. Such a case would be a necessary catalyst
to speed up the reforms that are so badly needed in Atlanta's handling of its
chronic inebriates.

Of course, police and lawyers are not competent to decide exactly what type
of non-criminal public health procedures are most likely to result in rehabilitation
of chronic inebriates. But we are competent, and we do have the duty, to make
certain that the present criminal procedures are not continued. The public cannot
be expected to respect a system of criminal justice that condemns sick people to
jail because they are sick. we need drastic changes in the handling of chronic
inebriates in our local courts, and the legal profession has the power and the

duty to make those changes.



-10-
V

Because of my interest in this prdblem, I have discussed with a number of
public health authorities the type of new procedures that might be adopted for
handling chronic inebriates. I will now outline, for your consideration, my own
conclusions, and those of the two Crime Commissions appointed by the President,
about appropriate new procedures.

For purposes of my analysis, I separate what we might refer to as the derelict,
or Skid Row, or homeless inebriates, on the one hand, from the inebriates who do
hare homes, femilies, and personal resources upon which they can rely. Although
the derelict inebriates represent a relatively small proportion of the total
alcoholic pepulation -- ranging from 3 to 15 per cent, depending upon the statistics
on which you choose to rely -- they obviously represent the vast bulk of the chronic
inebriate problem in our courts and jails.

I would begin by suggesting, as I already have above, that any inebriate who
has a home and family to take care of him.should be escorted promptly to that home
by the police, rather than arrested. Of course, if it appears to the policeman
that the inebriate is in medical danger, he should either be taken directly to a
medical facility or his family should be informed that medical help would appear
to be required.

Perhaps at some future time, when we have completely solved the problem of
handling drunken derelicts, we will be able to provide public facilities and programs
also for inebriates who are not direct public charges. But at this time, when we
cannot even begin to handle our drunken derelict population, I see no reason why
we should also attempt to take charge of those who do have resources of their own,
beyond making certain that they do get back home safely.

Thus, I would concentrate ourpublic resources almost completely upon the
chronic inebriate derelict. And my initial suggestion is that the old criminal
method of handling this population should be discarded and replaced by civil
procedures. This should be done, in my Opinion, regardless whether all or only
part of the derelict inebriates found on the streets may have available to them
the defense of chronic alcoholism provided by the Easter and Driver decisions.

Let us examine for a moment whether there is any valid public policy reason
why a legislature should brand an intoxicated person who is causing no public
disturbance as a criminal. we must face reality. The public intoxication laws
in the District of Columbia never have been, and never will be, enforced uniformly
upon the public as a whole. And I doubt that the situation in Atlanta is different.
Police do not pick up intoxicated party—goers emerging from elegant dinner parties
or our suburban country clubs. I will not be the first to point out that there
are as many intoxicated people on the streets of the exclusive residential areas
of our cities as there are in the Skid Row areas, and you will not be surprised
that very fhw of the prosperous drunks are arrested. Public intoxication statutes
are enforced against the poor, and in particular, the homeless man.

Should we as a civilized nation enact criminal laws aimed solely at a very
small, virtually defenseless, esthetically unacceptable segment of our population,
with the intent of simply sweeping them off the street and into oblivion? In my
opinion, the public intoxication statutes now on the books have no redeeming
social purpose, regardless of the issue of alcoholism, and they should not be
retained. Even worse, by substituting criminal sanctions for public health
measures, these statutes preclude the use of preventive techniques to head off



-11-

incipient alcoholism problems. Disorderly conduct statutes are quite sufficient
to protect the public from hamn and these statutes should both be retained and

fully enforced.

The two Crime Commissions appointed by the President have, for these reasons,
recommended that the present public intoxication statute be amended to require
disorderly conduct in addition to drunkenness. And the President's Commission on
Crime in the District of Columbia has explicitly recognized that the usual mani—
festations of drunkenness, such as staggering, or falling down, or noisiness,
do not constitute any threat of harm to the public, and should not be considered

illegal disorderky conduct.

What, then, should be done with derelict inebriates found intoxicated on
the streets? I would suggest a three—part program.

First, an inebriate who, in the judgment of the police or authorized public
health personnel, is unable to take care of himself, should be brought to a
detoxification center that is staffed with public health personnel, to receive
whatever medical help for his acute intoxication may be necessary. This should be
a voluntary facility. The individual might be required to remain there for some
specified period of time in order to make certain that he will again be able to
take care of himself when he leaves. But he will not have been arrested, and
could not be detained for a longer period against his will.

Second, those inebriates who hays a drinking problem will be encouraged to
remain for a longer period of time in an in-patient diagnostic center, where a
complete work-up can be prepared on his medical, social, occupational, family, and
other personal history. In my view, this should also be a completely voluntary
facility. A genuine offer of meaningful assistance should be the only inducement
used to persuade an inebriate to make use of it. And I might add that, never
before in our history, has gay community reached out to these unfortunate people
with such an offer.

Third, a network of after-care facilities should be established to provide
food, shelter,, clothing, vocational rehabilitation, and appropriate treatment,
rather than simply dumping the derelict.back onto Skid Row. Perhaps the most
important aspect of this part of the program would be residential facilities, to
provide an entirely new atmosPhere that will, hopefhlly, reverse the process of
degradation that has gradually forced the derelicts down to their present position.
As with the other facilities, these should, in my judgment, be entirely voluntary.

I would like to emphasize that a new program of this nature should not, in
my opinion, contain a long-term residential in-patient treatment facility of the

type now used to house the mentally ill. I would oppose any such facility on
both medical and legal grounds.

First, the public health authorities with whom I have conferred have convinced
me that long-term involuntary commitment to a residential facility makes effective
treatment for alcoholism more difficult. From their viewpoint, incarceration in
a health facility has the same degrading effect on the derelicts as incarceration
in jail. Both rob the inebriate of any willingness to attempt to find his way out
of his present situation in life, and make him more passively dependent upon
institutionalization. Those who are currently running programs inform me that
voluntary out-patient care, when supported by residential facilities, has been
highly successful. If the community will only reach out to the derelict alcoholic
with adequate and appropriate help, he will resPond. Once the crutch of Jail is
removed, derelict inebriates voluntarily ask for assistance with their problems.



-12-

my second reason for opposing involuntary commitment prooedures is on
constitutional grounds. We can all agree, I believe, that the derelict inebriate

poses no threat of actual harm to society. And he posas no greater threat of
bent to himself than do airplane test pilots, epileptics, mountain climbers,
cigarette smokers, Indianapolis Speedway drivers, and any number of people who
may refuse medical assistance for their non-communicable illnesses. none of
these people are involuntarily committed to institutions, nor could they be.
I therefore see no constitutional basis for depriving chronic alcoholics of

their freedom. against their will.

The type of program that I have outlined is not a UtoPian dream. It has
been recommended by both Presidential Crime Commissions. And although there was
some dispute among the 28 members of these two Commissions, there was no dispute

whatever on these recommendations. In his February 6th message to Congress on
Crime in America, President Johnson Specifically singeld out these recommendations
for public attention. And Congressman Elliott Hagan of Georgia has now introduced

a bill in the House of Representatives, H.R. 6lh3, that would adopt this approach
for the District of Columbia. It is, therefore, an entirely realistic and
practical objective, and not just an idealistic hope.

Of course, a program of the type that I outline will not eliminate the problem
of the chronic inebriate. There will undoubtedly be a significant number of
hard-core inebriates who will not change their ways regardless of what type of
treatment program is offered voluntarily or forced involuntarily upon them. we
must, therefore, forthrightly face the question of what should be done with them.

Since we can no longer handle them as criminals, as a result of the Easter
and Driver decisions, we are left with two choices. we can either warehouse them
forever on some type of an alcoholic farm, or we can process them through the type
of program I have described above. In my judgment, it would be unwise to institute
a warehousing system. Those who are close to the treatment of alcoholics tell me

that they are not willing ever to write off the possibility of helping even the
most hard-core chronic alcoholic. They cannot determine ahead of time who can be
helped, or how long it will take. In their judgment, warehousing of alcoholics,
regardless of how incalcitrant they may seam, is not medically warranted. And a
warehousing Operation is, in my opinion, clearly indefensible from a constitutional

viewpoint. .

The President's Commission on Crime in the District of Columbia squarely
faced this problem, and came to the following conclusion:

"For these unfortunate people, humanity demands that we stop treating them
as criminals and provide voluntary supportive services and residential
facilities so that they can survive in a decent manner."

This would require, of course, a complete overhaul of the present civil commitment
system in the State of Georgia. And it should, in my opinion, begin immediately.

VI

The alcoholism movement has too long suffered, I believe, from a defeatist
attitude. In the District of Columbia we have shown not only that the public will
accept the Easter decision, but also that it will not tolerate a Government that

refuses to help derelict alcoholics.



-13-

Today, in Atlanta, you are taking a major step forward. But a conference
like this one is just the beginning. What we need now are man-to-man
confrontations among public officials, without fanfare or publicity, in which
practical solutions to pressing problems are worked out on a sensible basis.

If I have one message to lease with you today, I would urge you to start
the job hmnediately.

Talk Presented By Peter Barton Butt To The Atlanta Bar Association,

Atlanta, Georgia, March 16, 1967.



June 4, 1969

' Hr. Raphael B. Levine, Director
Comprehensive Area Wide Health Planning

. Community Council of the Atlanta Area, Inc.
1000 Glenn Building
120 Marietta Street. N. W.
Atlanta. Georgia 30303

Dear Dr. Levine:

Thank you for your letter outlining the organization and function
of the Metropolitan Atlanta Council for Health.

As you know. the Fulton County Department of Health is the official
agency for health matters affecting the City of Atlanta and. normally,
programs involving health and health planning would be the responsibility
of the County Health Department as far as the City of Atlanta is
concerned. I understand, hoovever, that the Comprehensive Ares.-
wide Health Planning Program which will be carried on by the new
Metropolitan Atlanta Council for Health will involve ares responsibility
for developing policy and all the broad sspects of health including
environmental sanitation. water pollution, etc.

Since the City of Atlanta does have major responsibility for production
and distribution of potable water and for collection end disposal of
solid waste and also sewage treatment and dispoasl, I can understand
why the City of Atlanta should have a representative on the Health
Council. Since both the Sanitation Division end the Water Pollution
Control Division fell within the ares. of responsibility of the Public
Works Committee of the Board of Aldermen, I am asking Aldermen
G. Everett Millicsn, Chairman of this Committee, to represent the
City on the Council.

Sincerely yours ,

Ivan Allen. Jr.
Mayor









October 22. 3.969



‘Mr. R. H. Phillips
President ' I
Council of Greater Atlanta. Inc.
151 Spring Street, N.W.
Atlanta, Georgia 30303

Dear Bob: . 1

Please excuse me from making any decisions
concerning additional responsibilities at this time.

I will be glad to discuss the matter of the Council
with you after the first of the year.

{
Gratehlly.

Ivan Allen. Jr.
Mayor

[Alrda





t 4 a

Honorary President
Hon. Ivan Allen, Ir.

President
Mr. Robert H. Phillips

Vice Presidents

Mr. James R. Brown
Mr. Hampton L. Daughtry
Mr. J. Lee Morris

Sanitary
Mrs. Harold Marcus

Treasurer
Mr. James E. Bly'lhc

Pas! President
Brig. Gen. J. R. Ranch, rel.

Member!

Mr. Bernard Abrams

Mr. Ashton 1. Albert

Mr. Carter 1'. Barron, Jr.
Mr. James 5. Briggs

Mr. E. R. Brooks

Mr. John 5. Candler II
Mr. Walter Gales

Mr. Rodney Cool:

Rev. Howard W. Creecy. 5r.
Mr. Richard Culbeuon
Mt. Richard Dolson

Col. Harold Dye

Mrs. John 0. Eichler

Mr. Jerry Fields

Mr. Hilton Fuller

Mr. Nip Galphin

Mr. R. Ellis Godshall

Dr. Marvin Goidslein
Mr. Hairy Goodman

Mr. Donald M. Hastings, Sr.
Mr. Robert D. Henncssey
Mr. M. L. Howell

Mr. Howard Klein

Mr. David L. Kunkler
Mr. C. D. Lefley

Mr. P. Harvey Lewis

Mr. Martin leowsky

Mr. Seymour W. Liehmann
Mr. E. A. McGuire

Mr. Robert Martin

Mr. W. R. Massengale
Dr. Harmon D. Moote
Judge 5am Phlllip McKenzie
Brig. Alfred ]. Osborne
Mrs. Louis Regenstein. Ir.
Rev. James Schercr

Mr. Michael Sortich

Mr. L. M. Shadgeu

Mr. Donally Smlth

Dr. Horace Tale

Mr. Lyndon Wade

Mr. William Waronker
Mr. J. R. Wilson. lr.

Mrs. P. Q. Yancey

Advisory Councll

Mr. Clayton Cassia“
Mr. James Dodd

Dr. Harry A. Fifleld
Mr. mlllal‘fl Frankel
Mr. Ralph H. Garrard
Geo. Alvan C. Glllem, rel.
Dr. William S. Jackson
Mr. Irving K. Kaler
Mr. Hugh Mercer
Rabbi Jacob Rothschild
Mr. C. L. Snead

Gen. {Lt} John L Throclimorfon

Mr. T. Clack Tucker
Mr. Robert E. Wallace. Ir
Mr. Horace T. Ward

COUNCIL OF GREATER ATLANTA, INC.

151 Spring Street, N.W. I Atlanta, Georgia 30303 ' 525-4976

Ereculive Director
Lloyd R. Hoon

October 17, 1969

The Honorable Ivan Allen, Junior

'Mayor of Atlanta

City Hall
Atlanta, Georgia 30303

Dear Mayor Allen:

As you know, you are the Honorary President of our Council.
We regret your departure from the office of Mayor, but recognize
and congratulate you for your wonderful accomplishments and
contributions to this city as its Mayor.

We would hope your departure from that office might be our
gain as we would like very much to have you as a member of the
Council for 1970. The Council meets at a simple lunch four times
a year with a good deal of the work done behind the scenes by key
people and committees. We would be honored to have you as a member
of our Council. we have some very enthusiastic people supporting
it. Incidentally, Blanche Theabom is just joining us and will be
a new member for next year. We are trying to make our Council
more representative of major and important segments of our community.

Won't you let us have your acceptance? Again, thanks for the
great job you have done for a great city.

Cordially yours,

R. H. Phillips, President

Copy to Mr. Lloyd R. Hoon

USO MEMBER AG EN CIES

THE 'I'OUNG MEN'S CHRISTIAN ASSOCIATION 0 THE NATIONAL CATHOLIC COMMUNITY SERVICE I THE NATIONAL JEWISH WELFARE BOARD
THE YOUNG WOMEN’S CHRISTIAN ASSOCIATION ' THE SALVATION ARMY fl THE NATIONAL TRAVELERS AID ASSOCIATION I

USO 15 SUPPORTED THROUGH UNITED FUND

_/ 'I

/ .. I
C O P Y L Mm . C(wcv—CJ—

noseru 'roorlesurr. LAW OFFICES

~ ° 1 9

w .
gfinflgH JONES,BWUD&:HOWELL aymfi~ Lhm; Auk
sownnolhlnane
POBERT L.' OREMAN..JR. FOURTH I-‘LCIOFI HAAS-HDWELL BUILDING

Y .
L MAN H H LIAF‘D ROBERT QJONES

gigigfiaPflfiLTW ATLANTA, GEO R G IA 30303 $9.95..

TRAMMELL Emcncnr Fem—DH WILLIAMS
EndgznvfilfiLg‘xlfii-IJR' loos-I960
WILLIAM BANASSDN

C. DALE HAHMAN .
Dccnm HARRISON January 20, 1970 TELEAlii-EIEEEDEEEOSBOS
CHARLES VILSMITH

CHASE VAN UALKENBURG

RICHARD A.ALL150N

F. M.BIFID.JR.

PEYTON S.HAWE5.JR.

RAWSON FOHEMAN

MARY ANN assess

ARTHUR HowELL III

VANCE O.RANHIN III

CYRUS E.HOHNSBY III

RICHARD M ASBILL

l-,

C

Honorable Sam Maosell
Mayor, City of Atlanta
68 Mitchell Street, S. W.
Atlanta, Georgia 30303

Dear mayor Massell:

It gives no genuine pleasure to enclose a courtesy copy
of the 1969 Directory of Community Services published by the
Community Council of the Atlanta Area, Inc. we have been very
pleased with the reception given this publication and trust that
it will be of value to you.

Yosterday I chatted briefly with Den Sweat about our com-
munity center in the hippie district and the work the Council in
doing in the area of alcohol and drug abuse. A council was
formed a short time ago composed of organizations concerned with
the problem of alcohol and drug chose. Because of the tremen-
done interest in this area. I understand that now approximately
150 organizations have expressed a desire to work through some
sort: of council. The Continuity Council has been providing staff
assistance and guidance to the project. I told Dun that we would
get up a sumary of. what has been done and the present proposed
plan for continued coordinated effort on this problem.

I am aware of the many critical problems with which you are
now concerned and I told Dun that we would be glad to sit down
with both of you and discuss some of our activities at your coc-
vouionoc.

Best personal regards.

Sincerely.

Eugene T. Branch



, ...-._. . .,—_...‘._ .- V1
3'13} mill—‘4 9.“. JILL. EYE-ll" 2‘; 2'2 '-_

_I-‘if1LJSJ't'A'T‘! CLEIH'! E|_|H_.'_:u'r-JG.

January 8, 1970

Mr. Dan E. Sweat, Jr.
Chief Administrator
Office of the Mayor
City Hall

Atlanta, Georgia 30303

Dear Mr. Sweat:

The Interagency Council on Alcohol and Drugs is composed
of 150 public and private agency and organization representa-
tives who are concerned and interested in the problem of alco-
holism and drug abuse. It is chaired by Dr. James L. Goddard
whose background in Public Health and Pure Foods and Drugs has
lent immeasurable support and knowledge to the Council. The
Interagency Council was established to carry on a program of
education, coordinate existing services and stimulate the devel-
opment of new ones.

At present there is a tremendous amount of public interest
in drug abuse and many groups are eager to do something about
it. There are now 4 proposals for Drug Treatment Centers which
the Interagency Council is evaluating in order to make recommen-
dations for implementation. These plans all require support
from the city administration. Since the Council is composed of
and has access to most of the drug specialists in the area the
judgments it makes should be valid and objective. we will be
glad to supply you with our findings and act as a clearing house
for all drug treatment proposals. In this way we can be sure
that the city gets the best kind of services and the kind it

really needs.

Sincerely,

Aim ..f_' 3’ - i :4, .5

Duane W. Beck'
Executive Director

Copy to: Clarence L. Greene
Office of the Mayor

DWB:cfh





Cecil Alexander

Ivan Allen. I”

Ralph A. Beck

Eugene T. Branch
Benjamin 0. Brown
Charlie Brown

W. L. Colloway
Campbell Dosher
Albert M. Dams. M. D



J. G. Bradbury
James V. Carmichael
R. Howard DDles, Jr
Edwin l. Hatch
Boisieuillet Jones

BOARD OF DIRECTORS

Ray J. Efird

J Rufus Evans, M. D.
Robert L. Foreman. Jr.
James P. Furniss
Donald H. Gareis

Larry L. Gellerstedt. Jr.
Mrs. Thomas. H. (3:an
H. M Glosl’er

Elliott Goldstein

ADVISORY BOARD

Mills B. Lone, Jr.
William W. Moore, Jr., M. D.
W, A. Parker, Sr.
Richard H. Rich

Allen 5. Hordrn

Vivian Henderson

Mrs. Helen Howard
John lzord

lro Jackson

Jaseph W. Jones

Alex B. LacyI

Mrs. Maggie Moody
Mrs. John L. Moore, Jr.

John A Sibley



A. 8. Padgett

Mrs. Rhodes L. Perdue
Les H. Persells

J William Pml-rslon, Jr.
L. D. Rizk

J. Randolph Tovlor
Nor Welch

Allison Williams

John C. Wilson

John E. Writ-glenI



Lee Talley

Preston Uoshow
William C Wordlow, Jr.
George W“. Woodrufl'

EUGENE T BRANCH, L'r'auffr ‘..
ELLIOTT GOLDSTEIH.

A. E. F‘sDGE'l'T, in r' (7:... . :- '!

MRQ. THOMAS H. GlElSCJN_ .Tl'r‘rn‘ar‘l;

RALPH .P-r. [EELZK_ Iru'.:mrrr

I {If-.3 ::-:J 1218‘ W. BECK. {'wmn'w‘ Dirtrrm'
ONCE THOUSAND CLFNN BUILDIHG. 120 Nil-'.QIEWUE'L 31".. N. ‘_-"'.". ATLLNTA, GEORGIA 30503

19 January, 1970

T0: Members of the Metropolitan Atlanta Council for Health
.FRGM: A. B. Padgett, Chairman pro tem
SUBJ: Meeting Notice

The_annual meeting of MACHealth will be heldj29 January 1979; Place of the meeting
will be Room 409, 101 Marietta Street BuildinETf-TIEE‘fiiIlfibe 12:00 Noon.

Principal business of the meeting will be the election of officers for the year
1970. Persons elected will serve until the next annual meeting in January, 1971,
or until their successors are qualified. Enclosed with this meeting notice is “
the report of the Nominating Committee. Persons have been nominated for each

of the seven offices, and for a replacement on the Nominating Committee in case
Dr. Wells is elected president. (The president serves, ex officio,.on the
Nominating Committee.)

The second page of the Nominating Cmmnittee report indicates the distribution

of one}, two~, and three—year terms for persent members of the Council. This

is to insure that one-third of the elected members of the Council are elected each
year in the future. The selection for length of term was done by drawing numbers
out of a hat, but assuring that Specific groups (such as medical society

members, health providers as a whole group, etc.) have a reasonable distribution
of 1-, 2—, and 3-year terms.

With the possible exception of our first meeting last June, this is likely to
be the most important meeting of MACHealth's history. Your attendance is
urgently requested. If you cannot make it, be sure your alternate attends:

53. fl lawn/fl

A. B. Padgett, Chairman pro tem

Asp/RBL/la
l

P. S. I regret to have to tell you that, because of budgetary problems, we -
will be unable to hold our "getting to know you" meeting on 7 February.
We shall try to schedule it for March.

ABP







REPORT OF THE NOMINATING COMMITTEE - JANUARY 1970

The Nominating Committee, consisting of Hon. L. H. Atherton, Rev. E. B.
Broughton, Mr. A. B. Padgett, and Dr. R. E. Wells, present the following slate
for consideration of the Metropolitan Atlanta Council for Health:

. For President: Dr. Robert E. Wells

For Vice President
Council Function: Mr. Lyndon A. Wade

For Vice President
Liaison & PR: Hon. Thomas M. Callaway, Jr.*

For Vice President
Special Needs: Rev. Ervin B. Broughton

For Vice President
Project Review: Dr. Luther FortSon

For Vice President
Administration: Mr. Gary Cutini

For Secretary: Mrs. Loretta Barnes

*Has not signified acceptance of the nomination as of 19 January 1970.



MUNICIPALITIES
- Mar-etta.
Breen h Decatur
— Eqr_est Park



























PROVIDERS

‘6rts6n — Uofibunea
McLendon ~ Atl. Med.
Vinton — D.ekalb Med

Wells — _Fulton Med

Miller — Ga. PsacnijtTm“”“—* ""““““*”““+“*"
Gulley ~ No. Ga. Dent
Hamby — No. Dist. Dent'
Cantrell — rulton Fifi. D.



4-

Burge — Atl. Hosp. Dist
Pinkston — Grady Hosp
Richarde_on_:i§r§£3_lfled Sch
Lane h Ga. State H Sci.
Lott , — th Dist Nurs
Beck - Ga. Heart Assoc
Monall_;ufljgm§pp. Hnfigssocs
”Made — Nat Assoc 800 Work
_ Jockers v Med. Tech. Soc
Robinson — Grady (semieskil:
"Cutini — Health Ins.





P0213.-.§«;_.13::}:\II~_2911___.____
Ga.rdner — Atl EOn
Freeman» Atl BOA
.Mooney L-}‘1_tl EDA
GlSflD,~ Clayton E'CA
Souder ~ Clayton yon
Sander-aeKalb—Rockdale BOA
Broughton ~ Gwinne at BOA

_-_aohnson ._—__I«10c“_el_niiie=
Lovett- — Model Cities
C ofer — Grant Park P”A

He .vthorne PTA

EG:i££.1.Q__'I_. .S_.O ' Dggfilfiai..PTA

EMathews h Nat. Welf Rights

Barnes — Southside Comp H.

.Griggs r Tenants United FF
L_ _Ma_r_s_hall ~ At-L NAACP

Kimpson ~ Atl Urban League











BUS_INESS & LABOR

...... __...._______. ___f.__,'_.__._..._m,, '_ _._.___.e.__............_ __..._.__._

Hul'Ier — ntl. C of' Cofc‘g |
Wright — Atl Labor Counc





. . I
Consensauanity -
Contract}. «of the

5:: 5T: .L F'
A r;iic?i~.aflfiaa
EUGENE T. BRANCH. Chairman of the Board of Directors

AE’QQL 1110. DUANE w. BECK, Executive Director ALENE F. UHRY, Editor

1000 GLENN BUILDING. 120 MARIETTA STREET. N.W. ATLANTA. GEORGIA 30303 TELEPHONE 577-2250

January, 1970

S P E C I A L E D I T I O N

——-u---—na—-o-u n—o—n—u—u—o—

W

Eugene Branch, Chairman of the Community Council's Board of Directors,
has carefully reviewed our activities of the year just ended, and now
looks ahead to 1970.

We believe Communique readers will be interested in the following
program Mr. Branch envisions:

The beginning of a new year is a good time for an organization to
pause long enough to consider where it is in the achievement of its goals

and where it is going.

Since others are due the credit, I think it not immodest of me to say
that I believe the Council did a good job in 1969. However, rather than
dwell on the 1969 activities, it would seem more helpful to mention some
of the activities which will be given priority in 1970. In addition to the
normal and on-going activities of the Social Research Center and Permanent
Conference, the following illustrate the activities which will be given
emphasis in 1970:

1. Community Coordinated Child Care (4-C)

The 4—C program is a federal program designed to develop a coordinated
program to provide services to children——and thus make better use of the
community's funds and resources in providing such services. Atlanta was
named a pilot community and the Council was named the delegate agency. A
Steering Committee composed of parents, representatives of day care agencies
and organizations has been elected and is at work. much of our staff time
will be devoted to this activity. This is an outgrowth of our Child
Development Project.

2. Day Care Action Subcommittee

The very fine work of this Subcommittee will be continued in 1970. Its
function is to stimulate interest in day care and help develop new day
care resources. In 1969 the Subcommittee published a Day Care Manual
which provides a step-hywstep guide to those interested in planning and
developing a day care center. The response has been so enthusiastic that
we are swamped with requests by church groups and others for technical
assistance. This important activity also arose out of our Child Develop-
ment Project.





3. Coordination of Services and Planning



One of the most important on-going activities of the Council is that of
bringing together planning and service agencies in an effort to provide
coordination of planning and services. The existing funds and resources
for dealing with our urgent urban problems are extremely limited and all
agencies haVe an obligation to jointly plan and coordinate their activities
in dealing with the problems which are their major concern. Space does not
permit an adequate description of the Council's work activities in coordi-
nation but periodic reports will be given in Communique.

4. Emergency Assistange

Every effort to identify the most urgent problems in our five-county area
has resulted in high priority being given to the need for developing more
resources for emergency assistance. There are many aSpects of the problem.
An Emergency Assistance Committee has been organized and has begun to func—
tion. It has determined to work first on developing resources to deal with
the problems arising out of evictions. Hundreds of families are evicted
each year and there is no organized program to help the evicted families
with such needs as storage space for furniture, temporary shelter, food etc.

5. Other Special Activities



(a) Welfare Committee. Practically everyone agrees that our entire
welfare program must be overhauled. A Welfare Committee is studying various
income maintenance programs, including the Administration's Family Assis-

tance Act, and will make periodic reports.

(b) Advisory Committee for Information and Referral. This Committee

was formed to assist in the improvement of information and referral service
in the metropolitan Atlanta area and to devise means for improving services
to meet the most urgent needs identified by such service. Among other
things, this Committee will help focus attention on the most serious unmet
needs in our area.

(c) Fourteenth Street Multi—Purpose Center. The Council has leased a
house on Juniper Street to be used as a community center for the Fourteenth
Street area. It is functioning and has been well—received. The focus will
be on a voluntary medical clinic, a counseling center and a twenty—four
hour information and referral service. This facility is being operated at
the present time entirely by volunteers. The Center can meet a great need
and we'll keep you up to date on its activities in Communique.

(d) Interagency Council on Alcohol and Drugs. This Council is simply
a "coming together" of established agencies concerned with problems related
to the use of alcohol and drugs. It provides a means by which such agencies
can work together. The Council has divided itself into the following five
Task Forces: Resources and Existing Facilities and Services, Education,
Treatment and Counseling, Speakers Bureau, and Legal Aspects and Legisla—
tion. You've received some information on this important and interesting
activity and more will be forthcoming.

(e) Expandeg_guhlic Enformation Service. We have improved our methods
of getting valuable information to the general public and will give greater
emphasis to this activity. The information gathered by our Research Center
and through our various programs, if properly and attractively passed on to
the general public, will provide our area with a better informed citizenry.
This greater understanding of our problems will in time result in an

improvement in services and funds to meet the problems.







The above are simply illustrative of the variety of activities in
which the Council is engaged. The Child Development Project revealed the
need for further work on such problems as retardation of children, the need

for twenty—four hour child care, learning difficulties etc.

Volunteer Atlanta

The Council is a sponsor of volunteer Atlanta and will continue to
assist this project. As you may recall, Volunteer Atlanta was brought
about largely by the Council and is sponsored by the Council, the Atlanta
Chamber of Commerce, the Atlanta Junior League, the Community Chest, and
E.O.A. Its object is to recruit, train and place volunteers in public
and private agencies throughout the five—county area. We think this can be
one of the most important projects begun in the Atlanta area during recent
years.

Assistance to Groups

The Council is receiving an ever increasing number 0f requests for
technical assistance from agencies, neighborhood groups, and civic organiw
zations. Agencies are requesting assistance in reviewing their programs;
neighborhoods are seeking assistance in the drafting of proposals for
resident-determined programs; and civic organizations are asking for sugges—
tions as to the type of programs in which they might be effectively involved
Thus, technical assistance to neighborhood groups and direct service
agencies is becoming a major role of the Council. We think this role
should be emphasized and that means must be devised to adequately provide
such assistance. The Council is'basically a collection of staff, accumu-
lated information and experience, and skill, and whenever its assistance

can make agencies, neighborhood groups, churches and civic organizations
more effective in their work, we add to the funds and resources being put

to effective use in our community. This type of assistance is one of the
most important functions the Council can perform.

Program Development

During the early part of 1970, we expect to organize a Program Develop-
ment Committee for the Council. This Committee will be made up of Board
members and individuals who are not on the Board. Its function will be to
provide a means for continually reviewing the work activities of the Council
and assisting in the establishment of priority for its programs. The
Council is a social planning organisation which can be an important
resource in the community only if it retains its vitality and flexibility.
If the Council had become rigid in devising its programs, its people and
resources would not have been available to engage in some of the activities
described above which maintain a balance between continuity in those acti—
vities which look to long range improvement and flexibility sufficient to
give the community the benefit of the skill and information available
through the Council's resources. The Program Development Committee will
provide a means for retaining the Council's vitality and balance in its

Work activities.

Obviously there is a great deal to be done to make our fiveecounty
area a better place in which to live. I think it equally obvious that
there is a great deal with which to do the job if we plan and work together
with imagination, enthusiasm and a sense of urgency. So let's roll up our
sleeves and see what we can accomplish together in 1970.





I
C we _ transmits?
ernsaeil @f the '

Anarchists.
EUGENE T. BRANCH, Chairman of the Board 0! Directors

AEQEE’G; 1110. DUANE w. BECK. Executive Director ALENE F. UHFIY. Editor

1000 GLENN BUILDING. 120 MARIETTA STREET. NAN. ATLANTA. GEORGIA 30303 TELEPHONE 577-2250

January, 1970

S P E C I A L E D I T I O N

LOOKING AHEAD

Eugene Branch, Chairman of the Community Council‘s Board of Directors,
has carefully reviewed our activities of the year just ended, and now
looks ahead to 1970.

We believe Communique readers will be interested in the following
program Mr. Branch envisions:

The beginning of a new year is a good time for an organization to
pause long enough td'COnsider where it is in the achievement of its goals
and where it is going.

Since others are due the credit, I think it not immodest of me to say
that I believe the Council did a good job in 1969. However, rather than
dwell on the 1969 activities, it would seem more helpful to mention some
of the activities which will be given priority in 1970. In addition to the
normal and on-going activities of the Social Research Center and Permanent
Conference, the following illustrate the activities which will be given
emphasis in 1970:

1. Community Coordinated Child Care (4—0)

The 4—C program is a federal_program designed to develop a coordinated
program to provide services to children——and thus make better use of the
community's funds and resources in providing such services. Atlanta was
named a pilot community and the Council was named the delegate agency. A
Steering Committee composed of parents, representatives of day care agencies
and organizations has been elected and is at work. Much of our staff time
will be devoted to this activity. This is an outgrowth of our Child
Development Project.

2. Day Care Action Subcommittee

The very fine work of this Subcommittee will be continued in 1970. Its
function is to stimulate interest in day care and help develop new day
care resources. In 1969 the Subcommittee published a Day Care Manual
which provides a step~by~step guide to those interested in planning and
developing a day-care center. The response has been so enthusiastic that
we are swamped with requests by church groups and others for technical
assistance. This important activity also arose out of our Child Develop—
ment Project.





3. Coordination of Services and Planning

One of the most important on—going activities of the Council is that of
bringing together planning and service agencies in an effort to provide
coordination of planning and services. The existing funds and resources
for dealing with our urgent urban problems are extremely limited and all
agencies have an obligation to jointly plan and coordinate their activities
in dealing with the problems which are their major concern. Space does not
permit an adequate description of the Council's Work activities in coordi-
nation but periodic reports will be given in Communique.

4.' Emeggency Assistagcg

Every effort to identify the most urgent problems in our five-county area
has resulted in high priority being given to the need for developing more
resources for emergency assistance. There are many aspects of the problem.
An Emergency Assistance Committee has been organized and has begun to func-
tion. It has determined to work first on developing resources to deal with
the problems arising out of evictions. Hundreds of families are evicted
each year and there is no organized program to help the evicted families
with such needs as storage space for furniture, temporary shelter, food etc.

5- Other Special Activities



(a) Welfare Committee. Practically everyone agrees that our entire
welfare program must be overhauled. A Welfare Committee is studying various
income maintenance programs, including the Administration's Family Assis«
tance Act, and will make periodic reports.

(b) Advisory Committee £25 Information and Referral. This Committee
was formed to assist in the improvement of information and referral service
in the metropolitan Atlanta area and to devise means for improving services
to meet the most urgent needs identified by such service. Among other
things, this Committee will help focus attention on the most serious unmet

needs in our area.



(c) Fourteenth Street Multiqurpose Center. The Council has leased a
house on Juniper Street to be used as a community center for the Fourteenth
Street area. It is functioning and has been wellureceived. The focus will
be on a voluntary medical clinic, a counseling center and a twenty-four
hour information and referral service. This facility is being operated at
the present time entirely by volunteers. The Center can meet a great need
and we'll keep you up to date on its activities in Communique.

(d) Interagency Council on Alcohol andm Mg . This Council is simply
a "coming together" of established agencies concerned with problems related

to the use of alcohol and drugs. It provides a means by which such agencies
can work together. The Council has divided itself into the following five
Task Forces: Resources and Existing Facilities and Services, Education,
Treatment and Counseling, Speakers Bureau, and Legal Aspects and Legisla-
tion. You've received some information on this important and interesting
activity and more will be forthcoming.

(e) Mp anded Public Information Service. We have improved our methods
of getting valuable information to the general public and will give greater
emphasis to this activity. The information gathered by our Research Center
and through our various programs, if properly and attractively passed on to
the general public, will provide our area with a better informed citizenry.
This greater understanding of our problems will in time result in an
improvement in services and funds to meet the problems.





The above are simply illustrative of the variety of activities in
which the Council is engaged. The Child Development Project revealed the
need for further work on such problems as retardation of children, the need
for twenty-four hour child care, learning difficulties etc.

Volunteer Atlanta

The Council is a sponsor of volunteer Atlanta and will continue to
assist this project. As you may recall, volunteer Atlanta was brought
about largely by the Council and is sponsored by the Council, the Atlanta
Chamber of Commerce, the Atlanta Junior League, the Community Chest, and
E.0.A. Its object is to recruit, train and place volunteers in public
and private agencies throughout the five-county area. We think this can be
one of the most important projects begun in the Atlanta area during recent
years.

Assistance to Groups

The Council is receiving an ever increasing number of requests for
technical assistance from agencies, neighborhood groups, and civic organi—
zations. Agencies are requesting assistance in reviewing their programs;
neighborhoods are seeking assistance in the drafting of proposals for
resident—determined programs; and civic organizations are asking for sugges—
tions as to the type of programs in which they might be effectively involved
Thus, technical assistance to neighborhood groups and direct service
agencies is becoming a major role of the Council. We think this role
should be emphasized and that means must be devised to adequately provide
such assistance. The Council is'basically a collection of staff, accumu-
lated information and experience, and skill, and whenever its assistance
can make agencies, neighborhood groups, churches and civic organizations
more effective in their work, we add to the funds and resources being put
to effective use in our community. This type of assistance is one of the
most important functions the Council can perform.

Program Development

During the early part of 1970, we expect to organize a Program Develop—
ment Committee for the Council. This Committee will be made up of Board
members and individuals who are not on the Board. Its function will be to
provide a means for continually reviewing the work activities of the Council
and assisting in the establishment of priority for its programs. The
Council is a social planning organization which can be an important
resource in the community only if it retains its vitality and flexibility.
If the Council had become rigid in devising its programs, its people and
resources would not have been available to engage in some of the activities
described above which maintain a balance between continuity in those acti-
vities which look to long range improvement and flexibility sufficient to
give the community the benefit of the skill and information available
through the Council‘s resources. The Program Development Committee will
provide a means for retaining the Council's vitality and balance in its
work activities.

Obviously there is a great deal to be done to make our five—county
area a better place in which to liVe. I think it equally obvious that
there is a great deal with which to do the Job if we plan and work together
with imagination, enthusiasm and a sense of urgency. So let‘s roll up our
sleeves and see what we can accomplish together in 1970.



I
Cor::::ammamit3r
Cid-amassed}. 0f the

Ailments.
EUGENE T. BRANCH, Chairman of the Board of Directors

Aiflgfl inc. DUANE W. BECK. Executive Director ALENE F. UH RY, Editor

1000 GLENN BUILDING. 120 MARIETTA STREET. N.W. ATLANTA. GEORGIA 30303 TELEPHONE 577-2250

January, 1970

S P E C I A L E D I T I 0 N
LOOKING AHEAD

Eugene Branch, Chairman of the Community Council's Board of Directors,
has carefully reviewed our activities of the year just ended, and now
looks ahead to 1970.

We believe Communique readers will be interested in the following
program Mr. Branch envisions:

The beginning of a new year is a good time for an organization to
pause long enough tO‘consider where it is in the achievement of its goals

and where it is going.

Since others are due the credit, I think it not immodest of me to say
that I believe the Council did a good job in 1969. However, rather than
dwell on the 1969 activities, it would seem more helpful to mention some
of the activities which will be given priority in 1970. In addition to the
normal and onrgoing activities of the Social Research Center and Permanent
Conference, the following illustrate the activities which will be given
emphasis in 1970:

1. Community Coordinated Child Care (4-0)

The 4-0 program is a federal program designed to develop a coordinated
program to provide services to children—~and thus make better use of the
community's funds and resources in providing such services. Atlanta was
named a pilot community and the Council was named the delegate agency. A
Steering Committee composed of parents, representatives of day care agencies
and organizations has been elected and is at work. Much of our staff time
will be devoted to this activity. This is an outgrowth of our Child
Development Project.

2. Day Care Action Subcommittee

The very fine work of this Subcommittee will be continued in 1970. Its
function is to stimulate interest in day care and help develop new day
care resources. In 1969 the Subcommittee published a Day Care Manual
which provides a step-by-step guide to those interested in planning and
developing a day care center. The response has been so enthusiastic that
we are swamped with requests by church groups and others for technical
assistance. This important activity also arose out of our Child Develop-
ment Project.



3. Coordination of Services and Planning

One of the most important on-going activities of the Council is that of
bringing together planning and service agencies in an effort to provide
coordination of planning and services. The existing funds and resources
for dealing with our urgent urban problems are extremely limited and all
agencies have an obligation to jointly plan and coordinate their activities
in dealing with the problems which are their major concern. Space does not
permit an adequate description of the Council‘s work activities in coordi-
nation but periodic reports will be given in Communique.

4. Emergency Assistance

Every effort to identify the most urgent problems in our five~county area
has resulted in high priority being giVen to the need for developing more
resources for emergency assistance. There are many aspects of the problem.
An Emergency Assistance Committee has been organized and has begun to func-
tion. It has determined to work first on developing resources to deal with
the problems arising out of evictions. Hundreds of families are evicted
each year and there is no organized program to help the evicted families
with such needs as storage space for furniture, temporary shelter, food etc.

5. Other Special Activities

(a) Welfare Committee. Practically everyone agrees that our entire
welfare program must be overhauled. A Welfare Committee is studying various
income maintenance programs, including the Administration’s Family Assis-

tance Act, and will make periodic reports.

(b) This Committee
was formed to assist in the improvement of information and referral service
in the metropolitan Atlanta area and to devise means for improving services
to meet the most urgent needs identified by such service. Among other
things, this Committee will help focus attention on the most serious unmet
needs in our area.

(c) Fourteenth Street Multinurpose Center. The Council has leased a
house on Juniper Street to be used as a community center for the Fourteenth
Street area. It is functioning and has been well—received. The focus will
be on a voluntary medical clinic, a counseling center and a twenty—four
hour information and referral-service. This facility is being operated at
the present time entirely by volunteers. The Center can meet a great need
and we‘ll keep you up to date on its activities in Communique.

(d) Interagency Council an Alcohol and Drugs. This Council is simply
a "coming together' of established agencies concerned with problems related
to the use of alcohol and drugs. It provides a means by which such agencies
can work together. The Council has divided itself into the following five
Task ForCes: Resources and Existing Facilities and Services, Education,
Treatment and Counseling, Speakers Bureau, and Legal Aspects and Legisla-
tion. You've received some information on this important and interesting
activity and more will be forthcoming.

(e) Egpande§_ggblic Information Service. We have improved our methods
of getting valuable information to the general public and will give greater
emphasis to this activity. The information gathered by our Research Center
and through our various programs, if properly and attractively passed on to
the general public, will provide our area with a better informed citizenry.
This greater understanding of our problems will in time result in an
improvement in services and funds to meet the problems.



The above are simply illustrative of the variety of activities in
which the Council is engaged. The Child Development Project revealed the
need for further work on such problems as retardation of children, the need
for twenty-four hour child care, learning difficulties etc.

Volunteer Atlanta

The Council is a.sponsor of Volunteer Atlanta and will continue to
assist this project. As you may recall, Volunteer Atlanta was brought
about largely by the Council and is sponsored by the Council, the Atlanta
Chamber of Commerce, the Atlanta Junior League, the Community Chest, and
E.0.A. Its object is to recruit, train and place volunteers in public
and private agencies throughout the five-county area. We think this can be
one of the most important projects begun in the Atlanta area during recent
years.

Assistance to Groups

The Council is receiving an ever increasing number of requests for
technical assistance from agencies, neighborhood groups, and civic organi-
zations. Agencies are requesting assistance in reviewing their programs;
neighborhoods are seeking assistance in the drafting of proposals for
resident-determined programs; and civic organizations are asking for sugges-
tions as to the type of programs in which they might be effectively involved
Thus, technical assistance to neighborhood groups and direct service
agencies is becoming a major role of the Council. We think this role
should be emphasized and that means must be devised to adequately provide
such assistance. The Council is basically a collection of staff, accumuw
lated information and experience, and skill, and whenever its assistance

can make agencies, neighborhood groups, churches and civic organizations
more effective in their work, we add to the funds and resources being put

to effective use in our community. This type of assistance is one of the
most important functions the Council can perform.

Program Development

During the early part of 1970, we expect to organize a Program Develop-
ment Committee for the Council. This Committee will be made up of Board
members and individuals who are not on the Board. Its function will be to
provide a means for continually reviewing the work activities of the Council
and assisting in the establishment of priority for its programs. The
Council is a social planning organization which can be an important
resource in the community only if it retains its vitality and flexibility.
If the Council had become rigid in devising its programs, its people and
resources Would not have been available to engage in some of the activities
described above which maintain a balance between continuity in those acti—
vities which look to long range improvement and flexibility sufficient to
give the community the benefit of the skill and information available
through the Council's resources. The Program Development Committee will
provide a means for retaining the Council’s vitality and balance in its

work activities.

Obviously there is a great deal to be done to make our five—county
area a better place in which to live. I think it equally obvious that
there is a great deal with which to do the job if we plan and work together
with imagination, enthusiasm and a sense of urgency. So let's roll up our
sleeves and see what we can accomplish together in 1970.





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.—I’

a November 1969 {:j%8)

The Honorable Sam Massell, Jr.
ho Pryor Street, S. w.
Atlanta, Georgia

Dear Mr. Massell:

We would like to add our congratulations to the many you have
been receiving, on your election. We should also like to add our
pledge of support and cooperation in your efforts to keep Atlanta

a great and evolving city.

As you know, the Community Council of the Atlanta Area has had
an organizational grant from the Department of health, Education,
and Welfare to bring into being a new agency for "comprehensive
areawide health planning" for the six-county metropolitan area.
The basic work is largely complete. A Sa—member "Metropolitan
Atlanta Council for health" has been established, a detailed
proposal for a five-year work program has been prepared and submitted,
and an organizational structure for carrying out comprehensive
health planning has been created.

However, a number of new,and rather bold departures from tradition
have been made, in an effort to implement, fully, the vision of
Public Law 89-?h9, the "Partnership for health" act. These involve,
in particular, an enhanced role for MACLOG in coordinating health
planning with other major planning activities, and real and
meaningful participation in planning and decision—making by poor
and black citizens of the community.

Your guidance and help in both these areas are urgently needed.
It is not an exaggeration to say that two or three decisions by
you, now, can have an extremely important impact, not only on the
success of health planning in this metropolitan area, but also on
race relations in all aspects of community life, and even on the
threatened “abolish Atlanta" movement. howsrd Atherton is giving
his full backing to the proposals we would like to place before you.

Cecil Alexander
Ivan Allen, lll
Luther Alverson

Ralph A. Back
Eugene T. Branch

Nooier Burson, Jr, M. D.

W. L. Callawav
Bradley Currey, Jr.
Campbell Dosher





BOARD OF DIRECTORS



‘ Albert M. Davis, M. D. H. M.' Glosher Joseph W. Jones
Raw J. Efird John Godwin, M. D. Waller M. Mitchell
Jock. P. Elhcridgc Ellialt Goldsiein Phil Nam-lore
Rufus J. Evans, M. D. Vivian Henderson A. B. Padgell
Robarl L. Foreman. Jr. Mrs. Halinn Haward Mrs. Rhodes L. Perdua
James P. Furniss William S. Howland J. William Pinkflm‘l, Jr.
Donald H. Gareés Mrs. Edmund W. Hughes W. R, Pruirl
Larry L. Gellersledl, Jr. Harry E. Ingram T. O. Vinson, M. D.
Mrs. Thomas H. Gibson John lzord Rev. Allison Williams
John C. Wilson
ADVISORY BOARD
J. G. Bradbury Mills 8. Lone, Jr. John A. SleEY

James V. Carmichael
R. Howard Dobbs. Jr.
Edwin L Halal-i
Boisi‘euillei Jones

William W Moore. Jr, M. D.
Lucian E. Oliver

W. A. Parker, Sr.

Richard H. Rich

Lei: Talley

Elbert P. Tattle

William C. Wordlow. Jr.
George W. Woodrufl

If at all possible, we would like to see you for about #5 minutes
some time during the next ten days to fill you in on the details.
You may recall that one of us (BBL) at your September 17th talk
to the Emory-Grady Family Planning Clinic staff brought up the
question of planning versus crisis-meeting. Your answer stressed
the importance of planning to prevent crises. We believe this
is such an opportunity.

Sincerely yours,

4

<5.
A. B. Padgett, hairman pro tem,
Metropolitan Atlanta Council

é? Health

ap ael B. Levine, Director
Comprehensive Areawide health
Planning

Encl: statement on comprehensive areawide
health planning

newsletters

(Nos. 1 and 6)



February, 1969

COMPREHENSIVE AREAWIDE HEALTH PLANNING

In 1966, the United States Congress enacted Public Law 89—749, the "Partner-
ship for Health" act. Under this law, the States, and through them, areas
within the States, must assume reaponsibility for comprehensive health
planning. The Congress declared that "fulfillment of our national purpose
depends on promoting 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 depends on an
effective partnership, involving close intergovernmental collaboration, official
and voluntary efforts. and participation of individuals and organizations;
.that 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".

The Atlanta metropolitan area was the first in Georgia to apply for and
receive an "organizational grant" for the purpose of defining and developing
an organization which will be capable of doing comprehensive health planning
and obtaining community participation and support in the planning effort.
This grant, from the U. S. Public Health Service, through the Georgia Office
of Comprehensive Health Planning, supports the Community Council of the

Atlanta Area in the professional and organizational effort necessary to
instigate such an organization. Dr. Raphael B. Levine, of the Lockheed~
Georgia Company Systems Sciences Research Laboratory, has been named
Director of the Comprehensive Areawide Health Planning, to accomplish these
organizational objectives. '

The term "comprehensive" means that every sepect of the health picture in
the five-county metrOpolitan area must be taken into account in the planning
process. This includes not only the treatment of illness and injury, but
their prevention, and the compensation for any lasting effects which they
may leave. Thus, in addition to the manifold activities of medical and
paramedical personnel in the variety of health treatment facilities, planning
must consider environmental controls of the air, water, soil, food, diseade
vectors, housing codes and construction, waste disposal, etc. It must
consider needs for the training of health personnel, for the imprOVement of
manpower and facilities utilization, and for the access to health care.

It includes the fields of mental health, dental health, and rehabilitation.
It must be concerned with the means of paying for preventive measures and
for health care.

The term "planning" means, first, that problem areas and potential problem
areas in the entire field must be identified,and their magnitudes assessed.
The trends of the problems must also be assessed, and projected for future
years. Technical and organizational bottlenecks must be identified, and

"planned around". Second, the community's resources in meeting its health
needs must be equally carefully identified and projected, in terms of pro-
fessional and subprofessional skills, facilities, and financial resources.



-2—

Third, since a considerable amount of planning is already being done for a
number of projects, hoSpital authorities, counties, and municipalities,

which affects the community's health picture, ways must be found to make
maximum use of this capability, and coordinate it into a community—wide
comprehensive planning effort. Finally, planning must preserve and encourage
the highest level of professional competence in the entire health system,

and must make use of the insights of all concerned in the community health
system.

The overall task of putting together such an organization is thus seen to be
a problem in "systems" analysis and development. Since the total resources
of the COmmunity are likely to remain smaller than the demands which an ideal
health system will place on the resources, rational and Just methods of
assigning priorities to the various needs must be developed. A cost-benefit
analysis is essential to any such decision process, and, considering the
literally hundreds of specific health needs in the community, it is likely

that the costwbenefit model must rather soon make use of modern computer
techniques.

The Partnership for Health law requires that such planning be done with
people rather than for people. Therefore, maximum participation of health
"consumers", health professionals, governmental units and agencies, and other
community organizations is a necesaity. The law is telling the States and
communities that they will be given increasing responsibility and power to
determine their own best health interests, and that the current Federal
practice of funding health—related projects through specific project—type
grants (such as for specific facilities and specific disease processes)
will phaSe into a system of "block" grants to the states for use as local
emphasis requires. Eventually, only communities which have organized them-
selves for_comprehensive health planning may be eligible to receive Federal
support.



The current Atlanta area project is a pioneering effort. No other communities
in the country have progressed far enough along these lines to provide
patterns as to what we should do (or avoid). We have an opportunity to be

of service not only to our own community, but to others as well.

public items show