-3 to be displaced or replaced due to unfair competition. Therefore, Sec. 329(b) (2a)at page 3, line 7 should be revised to read: "; Provided however, the Secretary shall, in the course Section 329(d) of the Act, authorizes the Secretary of HEW to make "such arrangements" as the Secretary determines to be "necessary" to allow personnel of the Corps to "utilize the health facilities of the area to be served." The Kennedy-Magnuson Amendments would require the Corps to "utilize the facilities and organizational forms adapted to the particular needs of the area". The phrase "organizational forms adapted to the particular needs of the area" should be clarified and include private physicians in these areas whose capacity to deliver health care can be supplemented and augmented with the help of PHS personnel as stated in the language of Sec. 329(d) as quoted above. At page 3, line 11, the following language should be incorporated; after "area": (including arrangements with existing practitioners Also at page 3, line 12, the following should be in cluded; after "area": (including services in augmentation of or supplementary -4 We consider the idea of PHS personnel sharing existing public or private facilities and working in close proximity with private physicians to be magnificent in its potential, for PHS personnel can be utilized in areas of prenatal care, well baby services, routine immunization, health screening for such diseases as sickle cell anemia, and tuberculosis, eye examination, dietary supplements and a wide plethora of other related services. Section 329(d) of the Act should sanction such an arrangement for utilization of existing facilities and future construction of new facilities. Therefore, we urge that reference to "such arrangements" determined necessary for the utilization of local health facilities in shortage areas be expanded to encompass the "lease, acquisition and disposal of real or personal property". To achieve this, it is recommended that a new paragraph (2) be incorporated into Sec. 329(d) at lines 3 and 4 on page 5. "(2) by adding after the word "arrangements" the words "(including lease, acquisition, or dis- To assure that the words "health facilities of the area to be served" in Sec. 329(d) of the Act are interpreted as inclusive of facilities owned or operated by existing practitioners, a new paragraph (3) should be added immediatly after the new paragraph (2) as follows: "(3) by inserting before the period at the end of the Page 5, paragraph (2) should be renumbered paragraph (4), paragraph (3) renumbered as paragraph (5) and the paragraph beginning at line 15 should be renumbered as paragraph (6). For reasons previously set forth, those portions of S. 3858 which provide for the use of PHS hospitals to service shortage areas should also state that these hospitals are to be used to augment and supplement the capability of local private physicians to deliver health services. Therefore, following the word "area" at page 4, line 25, the following should be added: "to augment or supplement services rendered by -5 existing practitioners in the area" Section 329(b) of the present law requires that the Secretary of HEW collect if possible from the individual served, and in any event from any responsible third party provider such as medicare, medicaid, private insurance if the individual treated has such coverage. Such requirements is continued under the Kennedy-Magnuson amendments. Effect being given to the policy of the Act, it is conceivable that health care would be jointly provided, partly by existing practitioners and partly by PHS under cooperative arrangements envisioned herein. Such possibility would require amendment of Section 329(b) of the Act. Specifically, we suggest, adding at page 4, line 3, the deletion of the period after the words, "without charge", and substitute the following language: "Provided however, where the Secretary enters As indicated above, we are very much concerned that the National Health Service Corps is not reaching inner city and poverty areas to the extent that is indicated. As we understand the situation far more requests for assignment of personnel have been made than the National Health Service Corps has been able to honor. We do not know what factors are taken into account in making decisions on assignment, other than the declaration that an area has a health manpower shortage, and approval by the National Advisory Council on Health Manpower Shortage, discussed above, and the provisions of 329(f) (3) of the Act, Section 329(f) (3) requires the Secretary in determining -6 "which communities or areas may receive assistance", to consider community "need", and willingness of the community or area and the appropriate governmental agencies to assist and cooperate with the service". Also Section 329(f) (3) (d) of the Act, continues the requirement that recommendations from medical, dental, and other health associations, as distinct from the provisions of Section 329(b) requiring certification of need from such organizations, which latter requirement the Kennedy-Magnuson Amendments would repeal. While the requirements for community cooperation, and medical society recommendations were never intended as barriers to the delivery of health care, we can point to several instances wherein the requirement that the community cooperate and that the local government endorse the assignment of PHS personnel can operate to allow administrators to bar the assignment of personnel to a community where controversy surrounds the assignment of personnel. In this context, Marianna Arkansas, the site of the Lee County clinic stands out. Another area (even though it involves an OEO health clinic is Mound Bayou Mississippi). We are of the view, and believe that HEW should likewise be of the view that local hostility of the white community to assignment should not bar assignment of needed personnel to serve an essentially under-served Black community. We hesitate to suggest specific language of Section 329(f) for we believe that even though willingness of local governments to cooperate is a factor, the National Health Service Corps administrators could still make assignments to such areas even if there were hostility to the delivery of health care to the Black and the poor. Respectfully yours, Robert A. Watkins Robert D. Watkins, Administrative Affairs Enclosures 4A ARKANSAS GAZETTE, Sun., Feb. 13, 1972. Marianna: A City of Tension and Confrontation Lon Mann: The White View For almost two weeks, Ga-' gette newsmen have een at Marianna interviewing the prin cipals in the school, business and VISTA controversy. This is the first of a series of articles that will be concluded Monday. Lon Mann could easily be that captain of a giant 747 Jetliner crossing the Atlantie. He is tail and handsome and has the grace of an athlete. His hair is graying at the temples and his eyes are steely blue. He's a farmer and a ginner; a man genuinely concerned with the future of his town. "Hop in," he says, motioning to the new pickup beside his gin office just a few blocks from the Lee County Co-operative Clinic. Then without a word he drives a few blocks to where new homes are under construction across streets from dilapidated shacks. A black woman throws a pail of dirty water from the open door of one of the tumbling structures onto the muddy front yard. "This is what we've been trying to do for these people, Mann says in that soft elegance of the East Arkansas upper class. He points to the row after row of neat houses, the new apartment buildings. He's distressed that because of a bureaucratie foulup more than $1 million was lost to the town to finish the job and get rid of the last of the shacks. Then, back in his dusty office at his gin across the street from the old Missouri Pacific Lines depot he leased for his own use and later rented to the Welfare Department-he talked about VISTA, boycotts, Olly Neal Jr. his counterpart in the black community, and the future of his town. First he explains why he is considered a "leader," probably "the" leader, in the white community: "I've been on the School Board for about 15 years and we, bave seen the problems, complications and complexities associated with integration of the schools all the way from the start. "We have talked to many peo ple and gotten to know a lot of them, and they've gotten to know us - myself and the Board members and the administration. "I recognize the problems and try to keep my mind open to where I can deal with these problems intelligently and try to find solutions to them rather than make the problems worse." To Mann, this is not the tack Feels Militants Build For instance, he says, refer ring to the 'chool boycott, "Their whole philosophy is "I think this group feels like it has the numbers and if they can generate enough interest on the part of the black community to get out and vote that they can take over the political control of the county and with that would go the handling of all state and federal funds, all school funds." Mann says he has no objections to Negroes voting and no objection to people opposing other people "if they can do it in a constructive, intelligent manner,' But I can't sit idly by and not object to pitting one set of people against the other and wrecking the community in the proc ess in order to gain political control." Mann is the grandson of W. B. Mann, who managed the Marjanna Cotton Oil Gin and was partowner of a cotton gin and about 100 acres, and the son of John W. Mann, farm manager of Soudan Plantation in the late He attended Hendrix College, He is married to the former Charges Pressures This feeling was best ex- "This combination of pres --Staff Photo LON MANN sures is driving more and more "Private schools are gaining new support because many peoiple who were willing to give the are most distressed to see so public schools a try for one year little regard being paid to education in the unified school system. Integration has been accepted as the law of the land. even though reluctantly by sone. but these same people are not willing to continue to keep their children in a school that does not offer some hope of improving." He concludes with obvious foreboding. "If education can't take priority over integration, it should at least be put on a par with it, or there won't be any integration in the schools in those areas with beavy black populations. The blacks will have the buildings, but their op portunities for a better educa-i tion will evade them." Was Co-operative Ironically, Mann was co-oper ative when VISTA entered his |