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Full text of "ERIC ED225759: An Agenda For the Future. Proceedings from the Conference on Health Planning and Rural Development (Corvallis, Oregon, July 21-22, 1980). Summary."

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ED 225 759 ee RC 013 804 
; TITLE An Agenda’ For the Future. Proceedings from the . 
_ Conference on Health Planning and Rural Development 
(Corvallis, Oregon, July 21-22, 1980). Summary. 
. INSTITUTION | Department of Agriculture, Washington, D.C.; Farm 
7 Foundation, Chicago, I111.; Western Rural’ Development 
; Center, Corvallis, Oreg. : 
REPORT NO WRDC-Paper-12 ; . 
PUB DATE Jul 81 : a) . 
NOTE 9p, ae a 
PUB TYPE - Collected Works - Conference Proceedings (021) 


. _.EDRS PRICE ~ MFO1/PCO1 Plus Postage.» ~- 
DESCRIPTORS Coordination; *Health Education; *Health Personnel: 
' *Health Services; *Hospitals; *Older Adults; Policy 
Formation; *Rural Areas; Rural Population ‘ 
IDENTIFIERS *United States (West) . 


Investigating ways to improve the delivery of health 
Care services to rural residents through health planning and rural 
+ -development activities was the purpose of the 1980 conference. Four 
topics addressed by the participants were chosen because of their 
importance to the rural health systems of western communities and 
because coordination of efforts in these areas would be beneficial. 

Topics included: the role of the rural hospital; health personnel in 

rural areas; rural health education; and special impacts affecting 
Care. Research or position papers were presented on each topic, 
followed by group discussion and descriptions of instances where. 
health planners and rural development specialists have been working , 
together. Participants then formulated recommendations whic@ wére 
categorized according to policy development, coordination, ahd 
research activities. Thesé proceedings present a brief summary of. 
each of the four topic sessions and the recommendations developed at 
ae conference, Appended is a list of conference participants.”. 

AH) . ' 




d Reproductions supplied by EDRS are the best that can’ be ‘made * 
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REO1 3804 


JUIN 1982 

oe . / 3 RECEIVED I - 
Proceedings from the 

“Conferencé on. 
_ Health Planning and - | 
* Rural Developtront . 

An Agenda for the Future 

4 ¢ - . 

é ‘ 

Western Rural Developiment mre 
and’- - 


eeeily represent offtcral NIE 

F SPOS stated in tls docu 

ene has been teproduced a5 
Dave been made to IN POE 

Western Center for Health Planning’. 
TE He: “cooperating: 
ileal = \ duly 1981 

‘ “i 
’ : i 
é A 74 i . i 
A regional center for applied Social science and community development can 
s i cooperating with Land Grant Universities in 
oils | 

idaho, Montana, : 
5 Western Rural Development Center Alaska Arizona California Colorado Guam Hawa Mon t, 
} Oregon State University Nevada, New Mexico, Oregon, iets Washington, Wyoming ne 
Meo, G Corvallis, OR 97331 : Joo? o 
sei . 803-756-3621). , 
Hi a » 
: . “e say § he 
< 2” 
ke : ots i : 



- a 
Tre US Depattment of Agriculture and 
ine Heaith Resources Administration in 
corjuncicn with the Western Rural 
Develcoment Center (WRDC) and the ae 

Western Center tor Health Planning, 

organized and sponsored the Conference 
on Health Planning and Rural Develop. * 
ment An Agenda for the Future Ihe 
conference was hosted by WROCin 
Corvallis Oregon on July 21-22, 1980 In 
addition the Farm Foundation, Chicago 
Ninos provided special financial 
assistance : 

it should be noted that the recommenda 
tions reflect the Consensus of the confer 
ence participants, and do not necessarily 
reflect the views of the Department of 
Health and Human Services. the US 
Department of Agriculture, the Farm 
Foundation, Western Rural Development 


Center nor the Western Center for Healt 
Planning ‘ 

Copies of the following informal papers, 
which were presented at the conferencé 
are available from the Western Rural, 
Development Center, Extension Hall 307, 
Oregon State University, Corvallis, OR 
97331 Inival single copies are tree of 


© Useful Health Models for Rapidly 
Changing Areas Gerald A Doeksen 
WROC Y, July 198! 

* The Integrity of Rural Health Care 
Systems The R&e of the Rural Hospital 
Roger A Rosenblatt WRDC 10. July 
1981 . 

Economic Issu®vin the Reduction of 
Rural Hospital Capacity A Research 
Summary JonB Christianson WROC * 
11 July 1981 F 





investigating ways to mprove the 
del'very of heaitn care services to fuga! 
residents through health planning ana 
rural development activites was the * 
purpose of the conference, wnich was red 
Or yu'y 21 22 1985 in Corvaliis Oregon 
Expe”ence has dempnstrated that ac- 
kMOvseagemnent and reinforcement of the 
compementary goa's of healtn planning’ 
acdsura ae opment fan vea gore! 
erdeavea . 

Tre sonleienee crought together heath 
cianrers Extens.on personnel research 
fers th nterests n healthcare ang | 

"ecera’ DOI CyMakers '0 give.them tne 

Opre”™tuniy to pecome more famil af with 
eacr ctrers pou.ces and oregrams ang to 
excrange ‘deas regarding coordinator of 

TRE SU ISD TS addressed by 're 
comererce pat rants were chaser 
because ch Ire  mporiance te tne cura 

of waster commur tes 
cecause coordination of efforts in 
ingse areas wOu'd be vereficra! These 
tOO'CS Werte 
© Roe othe rura-hosp.tai, 4 
* Heath DEersorne n rural arez 5" 
® Rua: hea tr education and 
* Specia: mpacts affecting rusa! health 
care, > 
ReSeaicn oF DOSIt‘ON papers were 
presert edon each topic followed by group 



4 $C455.0n arid descriptions of instanées 7 
vinere health giannerS’and rural develop ' 

MEN! specialists Nave been working 
toge*ner Cor‘erence participants then 
‘ormuated recommendations which were 
categorized according to policy develop 
ment ccordination and résearch activities 
Treseproceedings will present 4 brief 
summary of each of the four topic sessions 
andibe recommendations developed at 

the conference 

Role of the rural hospital 

Recent efforts togeal with the problems 
of rurai Nealth care delivery have over- 
JooKed the role of the rural hospital 
Physicians very often expect access to” 
hospitals for professional and economic 
reasons Infact there is evidence to 
support the proposition that physician 
recruitment and retention are closely 
related to availability of hospital services 
Recognizing the hospital as a critical link in 
the tural health care system, the confer- 
ence participants Hae the current 
economic obstacles faced by hospitals 


future activites ce 

Aretent nd:cation of tnis type of : 
cooperat-on's the agreement signed 
between tre USDA ard tre Departmentot 
Heath Eaucation and We:'are (Currently 
tha Department of and Human 
Se ces) to coordinate the funding for 
corstructior and operation of sural health 
certers “Wore recently ata conference of 
heaith qeanners and rural development 
spec a.sis n Washington. OC twas 
cong used tha! coordination of activities at 
ireregora eve! would be most effective 
Tre Covvafes conference emphasized the 
de'very of reatn care Services inthe rural 
West "re maonty of conference partici- 
Carts were "om the Inirteen western 

arg tre rasicctureg ‘rat would ensure 
frecy at ty : 

Rural "os ta's are in economic trouble 
‘ora varety of reasons As the medica! 
profess on Decomes moore and more 
technica! rural hospitals with their smajler 
Patient loads nave not been able to afford 
expensive and sophisticated equipment 
sor id devetop tHe technical expertise 
required to operate the equipment In 
mahy instances this has led to a decrease 
in the demand for hospital care at the 
sm@iler rural hospitals in favot of care at 
the larger hospitals in more populated 

“areas Thisttendency towards decreased 

demand has been accelerated by im- 
proved transportation systerns to urban 
areas Atthe same time that rural hospitals 
are experiencing a decrease in demand, 
they aré facing rising costs. ancluding 
costs due to compliance with federal and 
State regulations ; 

Consequently, many rural hospitals 
have closed in recent years, and many 
more are near closure There is Concern 
aes ae to close hospitals have not 
b Sed on a complete accounting of 
Costs. such as increased travel Costs, , 
increased medicakrisks, and effects on 
local economies Although overbedding 
may be a problem in some areas, I! ts likely 
that a restructuring of the functions of the 
rural hospitai would be More appropriate ~ 
than clostre in dealing with the current 
economic forges : 

This restructuring process would in- 
clude estimating the number of persons 
served by the hospital and the type of 
inpatient services required by that popula- 
tion over time It could then be determined 
for each inpatient service if the local 
hospital could provide that service 

’ ve 




, * . 
“Health aah in rural areas 
¥ the drt nercy 

. * 7 . Soler, ete Bey Ss 
i oo ate7 deets Byars ree 
‘ : 
. . Noo spope ates th 
F a eS nee IG aay Ue We oad 
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v 2 ad ft 7 Si Sig: ae %,. 
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F Z c » 7 e 
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ates ca oper aa aE 
\ F ae) ON Rte ican ae cae Terres aa 
. ey Bo OMe ata tat 
: BS USE Og ates Albee 
; uel 3 4 Tale “ym toc, of 
’ * Coe oe a me ey Catter Torry 2"@Qa~ 
“PASE LTO o> Se Ly ’ 
Pa 7 *: 
@ crea. SF 5 aera i 
be . 
eee tne a notte 
’ - . . eo 
. e 4c Bue Teer gobies 
~ . P OCR et bat ow of toca + ear 
i ‘ 4 : LAUR lon ME toa lag imenange g 
a Ca matters 2 ov tization 
¥ - 
3 a Oe Ee Cat ew > required of the 
P : Dilee ota + odertomeet’a vide 
e ae Fey . 
\ ere Tre ces sgciatamente,tgung 
. Ua oT ety 
. Tee Gert OG heaitn personnes in cura! 
.* aa as beer Geait with by trang and 
BEWE OEIC DIG es s10nals WhO Can deal 
aor the sroblem, associated with 4 rural 
. £4." 6 acd by neiping thebommunity 
‘ 2 acd accept nealth professionals 
oe Steseges which nave been succe-.ftiul on 
eo. Beatre g witn thi, problem inc ude 
: feed dealth Education Genter, (AEC; 
wre ches entially decentralizedtie 
: ‘acting funchon of the medical center - 
“e ’ 4 a Make rural exPONeNnces akey part 
‘the professional training The AHEC 
‘ a ‘ Sonal shown thal an exposure to 
. - raat health endeavor, and problem, 
& * Nas IN 5OMe Instances increased 
P ray 2 Sax megcal student, interest in working in 
* P . £ MALES | 

_bercent of the Coaland 100 percent of the 
aah hale Conterenge parcipant, exam 

4 . z . . >) 

Wee gue the 

Sh gery weenie kw taveugin ie 
ELIE See tk. i Dac kgtbungs 

MOS Lie elo LrOdrams wh on 
tase 2 2 Cratos erpenerce avaua 
cet, wd Students 4uroubtne 

“he Sos Tstot ar AMEC 

coe SE Le lal or er tryna to dee! 

e eh Peg the Stes PS WO afem Ort 
Ree TO De gee Se * Cot eso ity fm aa * 
ea a ary 

Rural health education , & 

ere Ula Un ae tes dete hegre 

Stes & ~  etiCe becdige Uf 
Feet te ae en of tne mpc 
Te Ft let tae ment ard Guay CF 

eer me, Mage te gras 

. mT SC ag TUTE Cope g 
a a Tete rah he Hea th 

Pe id 
- Soe mn rare Cut at 
é | " . v. 

a ee eae gy eett yoy r 
ee Pee ee angr NOL de y 
et at A MA oe Creat erin vith hedge 
MDL dies ey around ne 
Pe I OL Gy Tees IN KO At 
eye Freeing tne Medic ai 
core yey 

Gor Pot aenerally accept and ¢ 
ea tr education and promo 

hor ac4ar Tega part o*practice 

HI" a, Peagith education has not 
Ce ved broed “nancial support A major 
"eases ‘ort 5+, tne lack of ducumentation 
or Mew card of health edur ation 

CIOgrams 7 F eereration hip between benay 
Sta Changes and decreases in morbidity 
aod marta ty +s difficult to quantify 
Corsequenty broad furtding wilnotukely 
De Avadable unt! there is evidence that 
Peath education ss cost effective in 7 
IMprOvIPZ health status Perhaps the best 
aporuach '¢ te addres. those health 
educdalion programs which are most easily 
defended such 4s those relating to 
smoking hypertension and obesity - 

Special population impacts 
affecting rural health care 

The woridwide energy crisis has led to 
an increased dependence on domesuc 
PMEIGy 4 Ninety seven percent of 
{he avaiable national energy 16 1p Cgal and 
rl shale and federal Region VIN has 50 

earn 6 

ined the’st trains on rifral health care 
Totem, in parts of fhe West due to this 
ne fed led dependence: jon domestic ener 

Gy LOG es ¢ 

Many rural COMMUNES wilt EXPENenc 
iq r&fpldpopulation influxes, to develop 
energy feoources Theshealih systems of + 







o- a 

qd ir adaition: these fap d 

S €as CISc €a' SdoeoMIONEs ate. 
a rlegceva & de vanelty o* sac a 
a haber at ral hee cems such aS 
a Qerck drugapuse arg” 

a erserovom™aunity ‘pagers 5 
ory tesmedf ire reaitn reeds c' the 
YOR? breton’ Bul 'Gac sc 7 
cle det re” 
ormtown comeru: 
ms ° cormc 

y MMountar 


Recommendations §- - 

Policy development 

“re Cdol "ud MEAIN DO Es’ 4,0 
Ceet dhe crea aime maf qtegratun 
WET IT! ah LS Joven oment agence 
“rs Leturee aporcach dom cote 
Lert y ot ize —. eee: ‘NC Udi" G 

we tc Ing ar rsonner Curranty, 
rere sasteat Bi a or heb attempts to 
"eCOG" Z2'TED QhtOl dil ‘uraiareas andia 
oromcie inte'3s ,ersmental appraache; to 
3 i 

viems This strategy 5 
“te House Smail Communi 
yvooment Policy state 

r December 197% tr 

or Seoigmber 24 198G the Rura: 
Beye opmes TActiP L 96-355) was signed 
Saw es sded in this legislation the. 

ita) 33 
amare Wet bro 

ces ong 

‘or Sma. Comm unity and Rural Develop 

mert on USDA ‘or ‘facilitating the imple 

mentaron of the Rural Development Act of 

1972 angestabichment of a Working 

Group for Rural Development to assist the 

secretary of Agr culture in designing 

coordinating and implementing'federal 
rural development efforts in cooperation 
wr rural development programs of state 
and iocal governments* 

Policy recornmendations de. veloped al 
ine Conference on Heaith Planning ard 
Rural Ge velopment 
° Continue to < support legislative effort, 

which seek to maintain active rural 

‘development activities and centers in: 

"USDA and HHS ; 

* An important factor in developing policy 
ivtocal leadership Itis essential to seek 
the knowledge, ideas, and suggestiens 
of these leaders if policymakers Wish to 

eo. = 

a GGs:"gn Of Under Secretary ; 

r planners, educators 

FP oPeG hat ine e"orts of this 
3S we as Otrers will Relp establish a- 
7 "he sharing of technica: 
ce ‘pap d growth communities 

uae ae 

cee rar 

cv o™sde for pianning ‘or 
ies dé very Pas Deen devel 

seu Eten, ae 
aDy Extens 

ODS POs C7 agents in Oklahoma in 
Vat s'aie Excers.on agents and HSA 
CeO Te 4.8 WOrmed Cooperatively to 
OneCas" "72 "2a IP Crofessorais aNd 
? aia ce reeded in Oklanoma 
var perod This type of 

wOse Sg afrangement coulda 
cre? ocaiitres and could be 
"ett yen pianning ‘or the ‘ 
> o fated grewtP areas inthe 


, ae 
. , 
Thess dressing i sues nrura, 
a’@4a5 0 or etfoctive manner The 

de 2 oomect  fipcalreadersnipis « 
~portact or rural areas to be able to 

take Ine «1 ative and responsibility for 
'6C-4 Neath problems 

e Eroyurage tra exchange of information 

nottahona! flexipnity and cooperation 

among ‘edera! State regional andlocal 
programs © formulating health care 
pol'cy wh cn rreets rural needs Federal 
and state programs must be evaluated 
ore perspective of local resources 
befdre they are implemented’ 

* Modification of reimbursement policies 
and regulations which have an adverse 
effect on the viability of hospitals and 
CHIC, IN tural areas 
Regulations regarding personnel licen 
Sure Shouid be reviewed and wpBre 
necessary Modified to allow for differ 
ent mixes of health professionals to 
deliver care in underserved rural areas 


Cooperation and interaction among 
federal state regional and local health 
and researchergis 
imperative to maximize output from linfited 
resources and avoid duplication of effort 
The Land Grant universities through the. 
Cooperayve Extensidn Service the Depart 
ment of Health and Human’Services 
through its Health Systems Agencies 


(HSAsy'and regional offices, and the US 

Department of Agriculture through its, 
various divisions have begun to share 
information and experiences More of this 
int eragency coordination 1s warranted to 
deal atfettively with rural health concerns 

} : 






Recommendations developed in the rural nosp:tats, The objective is to aid 
. ‘area of coordination hea'th planners in determining the levele 
", ® Increase the cooperative efforts be and scope of services that can be 
ic tween the Department of Health and offered appropriately and satgiy atthe 
. : Human Services andthe US Départ 10Ca' evei 
: mentor Agriculture to share research « Derer~™.re the immediate and long-term 
: ard technical ass:stance to rural areas ™Mpacis Of fura: hospital Closure onthe 
especially at the federal and regionai overaii economy of a community 
7 feveis - Likew Se determine the effectofanew - 
, * Maintain the unkages between AHECs facvisty Or expansion of an old facility on 
. and teaching research institutions and economic growth + 
estabdlisn nnkages among AHECs Hedith * the ievel of economic 
Systems Agencies ahd the Extension ncen' ,@ that is necessary to retaina’ 
Serv ce.1 order to coordinate heaitn Provider 'r an area andthe possible * 
education e'torts and develop a channel IMpact Of providing that incentive 
’ 3° communication tpough public and private expenditures 
° ‘or state level linkages with updet various financing arrangements \ 
*2dera and state agencies Lang Grant * Determine the extent to which econom 
esttutons ardiocalHealthSystems ‘ic CoMpertion exists between provid: 
Agerc es for dissemination of researo> ers Ths research should examine the 
a7 3 °23Cu'ce data related to hneaith ; etrects of distance and population on 
pet TS3 OE wey Nruralareas crov ders ard tne types ovheaith care 
© Corte ce the predass of devempine » 'esOu’ces available ateachsite The , 
COTS Co Chetface Delweer Pegiih 3 results o'th 3 type of research could 
Cares researcrers Extension per Nee determine the influence of one 
s057e and community develoomen: Drow der on the viability of another 
, crogras State ruratdeveiopmen: orovider in he same or Nearby 
, TOUTS SSMOUIG 7c 'ude representation commun ty 
"Tom Dea th p'anre’s and Land Grant * Develop methodologies and systems of 
4 VErSitles to provide a mechanism ‘or communities aad HSAs of 
€9 taborat.on on rura! concerns within rapid Dopuigtion growth or decline and 
the otructure of State government While- potential impact on anarea shealth + 
. Mere 5 2 desire tor some type of formal care system ; 
+ 4 relat onsnip bet ween.nealih system * Develop antnropological and‘sociologi- 
gences and Land Grant universities it cal methods for educating health 
$no' necessary to wait for this . personnel to the realities of rural areas 
a ; organizations venicle to initiate ex Similariy develop means to help rural ‘ 
+ change Fo’ example several Extension residents gain realistic expectations of . 
( professionals currently attendiocal - .” “medical personnel and the delivery 
HSA meetings and include HSA Staff as system 
01” authors in various projects This , * Assess the characteristics of the’ 
'/De of Cooperation should be eter Oppulation and thei health priorities to 
developed . evelop an effective health education 
* As tne proad range of technical program ~ ‘< e 
r Pie tah nek Saas nee ae * Evaluate and redefine standards for | 
tetas oe health education in the school system 
institution regiohal fural development Teal ic at tank 
: centers and regionathealth planning € final act of the parteipants o pe 
_ , centers stould be supported as the foci Conference on Health Planning and Rurat 
“ . x ,. ‘OF Coordination and dissemination of Development was formation of a Working 
“ lechnical assistance on community Committee on Rural Health with the, = 
: development'and rural health commitment to carry forward these . 
- 5 fa recommendations The Health Resources 
, Drobiems— and solutions : 3 
7 Administration and the U S Cfepartment of 
Research Activities . Agriculture have taken thé witiative to * 
iz ; Collaborate on rural health issues and 
oe There are crucial gaps in scientific along with the Western Rural Development 
: ‘ Loan ob uratngalih Care problems __ Cantar and the WestemCenter far Health , 
‘ eievant baseline information should be Planning to torr the organizational 
developed for evaluation of proposed and jehicle for disseminatidn of the results of 
bh * ~ ongoing projects and demonstrations this conference \ 
‘ Research RCP OEREA aH AMS . _ !tis the hope of the sponsors of the 
* Giventimited concentrations of relevant conference that better integration of rural 
faculty the regional research approach —_heaith programs and activities will result 
needs to be developed toinitiateandto — Eurther. it 15 our hope that in this era of 
Suppport work in the area of health constrained resources we will rnore y 
oe . a *° ASSess the care and the -effectively use those resources ayailable 

e economics of procedures perfo?med in to us 


' Conference on Health Planning and :* 
Rural Development: An Agenda for the Future 

+ ten 

es -_« ss % é Corvallis, Oregon — 
Participants ae | July 21 22 1980 
ws . "Mary Afearn " Nancy Dooran 
oe eo , EDD ESCS USDA é Planner Nortrwest Oregon Health « 
: Depa er| of Agncurture and Resource Systems Agency 
: ' cOonom.ics , 5201S W Westgate Drive 
"4 O: egor State un'vers:ty . \ Portiand Oregon 9722) 
D Corva''s Oregor 37331 ; 5Q3'297 8241 
vetfrey Bae Harty Fergusor r 
t oY UMWers ty O° bo orago FreHA Deparment of Agriculture . 
dea tr Screrces Carver S Ag’ cy ture Bulding, 
: S050 East gin Avenue * Roor 685" . 
soos Cecye Ce.orade sl26. : Wash ngtos DC 29250 
2 20% 996 7877 492 677 evguae (LS 
: ? Steorer Borrey « Morte ee ‘arg. , 
i Executive Dracte * Cooperat..e Extension Service 
ra ‘ © Weestere Apzora dea tr Systgms agency Montana State | oe ‘ 
CenturyPlaza Nt. . Bozemar Montana 59715 
"28" West2Zdin Steet SS 406°994-3561 ; 
: : Roc™ 439 ros 
Yama Anzona 86368 , Raioh Giidroy4 
. txecutwe Director 2 
; Bruce-Brggs * Montana Heaith Systems Agency 
/ one : ‘  Executve Director . . Chairman Forewarning Device For, 
Mie *  Mon-Dak dea'th Systems"Agency - Energy Development ; 
F . 1727 South University Drva 324 FuljerAvenue  . .* . . 
. ‘Fargo North Dakota 58103 * Helena Montana 59601 ' ‘ 
; 791 2800002 ° 406/443 5965 
von Christianson 7 “Bernal Green ” 
Bepartment of Pubs Policy Planning Leader Health and Education Program 
, ang Agministration and Department of Area 
Ecoromics “Economic Development Division: 
7 . Ur vers sity of Anzona ~ USDAYESCS/EDD Room 492 
a > Tucs07 Anzona 8572! _— S0012thStreet SW. - ot, 
BOZ E26 198% > . , Washirigton DC 20250* : aot 
a o 2 
; bas , Sion Cotsen? 202/447-8673 . 
. & . ' Department of Agricultural Econormcs steve Jasperson ns 
ar Unversity of Cai.fornia Executive Director ’ 
v f Davis Carfornia 95616 ‘ Eastern Oregon Health Systems Agency 
, are ; Q167752-1519 PO Box 520 1 
ie - BanesGesiesi Redmond. Oregon 97756 
ee “ Depastment of AgneulturatEconomics soo eerotee a 
t , : University of California, Davis Marsha Kilgore 
- , Dav's California 95616 Office of Rural Health, 
, Km Ne "State Health Planning and Meee 
. rn Wittam Culwell . . Agency “a eS 
«* "  Sdctology Graduate Student 3886 Beverly Street Nw. 2 
. Medical/Rurdl Suite 19 
' University of Idaho 7 : Salem, Oregon 97303 
. Moscow, Idaho 83843 : 503/378-4684 
: Gerald Doeksen Susan Klein 7 
Department of Agricultural Economics Health Resdurces Program Director 
- : : Oklahoma State University PO Drawer P 
; ae 4 _  StiiWater, Oklahoma 74047 . Bouider Colorado 80302 
“Indidates conference organizers aeSI 24: 6081 , od 303/497-0216, eo ° 
oe, a? 6 7 

: o 
ry e . 
2 4. . 7 © i 
Jopnr xusrman : Borre SajenS - if 
Departmen of Agricultural Economics Aaministranve Assstant 
Urn, abe ofCa forma Easte:r Cregcr Healtn Systems Agency : 
PO Box 52° 
Redrorga One 307 37786 

7. “ok * = 
Veestere Centerto: sea tm Planning MereSarger! “F 
"U2 Mamet Su te S54 F Rura ONO OGy Re esearcn Associate 
Sar Frare sto Ca Foes gata? sbacrert co Agncu tural &conomics 
255 S40 760 * i 
S '9a6 55525 
Tega Mantras. Sees. oe oe 
Pl cy Mat ager ac’ 34d Coorgrator OS ae 
. Faery mae AIT stator “La a"o. ; - : 
Depatmert Ar oltre AS poten "of Program 
pS Ag clue BL ans = (OF “3G. idennes OPEL 
-Riem pita He es poe elation 

‘ : TI La Ne ore at Roar! Healt 

. Pe aee aise ant FF a ia i ey rtf dc orem MU v 
Motors a 7 
eer ak “ey . 

. a ae a - * 
yy Fk Pa Geogr St ade: 
oe ee Ere ae recto 
af ott ty oe? 
ae ae - y OAC rarer Health Planning 
COT NES Crago Meath Syctenm Ages, : ation 
< Su Wes BATE LT yee es an wn recta a 
Hack 2a ae cat our FystAvanue 
en Hee ee i aseviea 
Bie, b ecprdee 7 29 Ma ot WI WOGsIN SAG . 
o Loge acs “ 

E . a 
tea Jane Voge : 
me ath pe Ss” * 
ea Mek yer a" = Whote Ho i Ct 4 of Intergovernmantal 
ASEAN ty are Sree Atte ¢ 
7 ai 
AGe DA Bloc ntn 4s 
Te = 2 wo Hee an 41364 Old Exec ute OM ic 2 Building ; 
PRP ont : 
we a y Roorr 4% : , 
qe Hares | oe eee OC 21503 
= ee . 
Parner MMiiT yet Cregan He, 2th ’ 202/458. agit ‘ ‘ 

eee . 7 Henry Witiswonr 
"ye Director Qregon State University 

Coanerative Extension Service 
- {Oregon State. University 

Coral Oregon 47344 
Detentas be ide Section IDNA * 593'75ag2714 

JeQartrrant of Fam ny , 
a a Jack Whitney . 
geass. EES ON ray 2 Oreector Division of Health Resources : 
i At a’ 

. Development, 
Seat hart 1¢ ? ef ’ 
oe nea te eee a5 ; es Health Service 

gy re rs ry te “ 
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