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563877907
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AHC General Correspondence December 1990 [3]
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563877907
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document
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AHC General Correspondence December 1990 [3]
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04012-005c
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Records of the White House Office of the Chief of Staff to the President (George H. W. Bush Administration)
Andrew Card's Files
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1990
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Originally Processed With FOIA(s): FOIA Number: 2025-0373-S 2025-0373-S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: George H.W. Bush Presidential Records Collection/Office of Origin: Chief of Staff, White House Office of Series: Card, Andrew, Files Subseries: OA/ID Number: 04012 Folder ID Number: 04012-005c Folder Title: AHC General Correspondence December 1990 [3] Stack: Row: Section: Shelf: Position: G 15 21 6 Withdrawal/Redaction Sheet (George Bush Library) Doc. No. / Type Subject/Title Date Restriction Classification 01. Letter Amy L. Bouchard to Hunter H. Lohman, Re: Enclosed financial 11/26/90 (b)(6) statements. (2 pp.) Page 1 of 1 Collection: Record Group: Bush Presidential Records Office: Chief of Staff, Office of the Series: Card, Andrew H., Jr., Files Subseries: WHORM Cat.: File Location: AHC General Correspondence December 1990 [3] Pinksheet Number: RML16119 OA/ID Number: 04012-005c Date Closed: 3/13/2025 FOIA/Sys Case #: 2025-0373-S Re-review Case #: P-2/P-5 Review Case #: THE WHITE HOUSE WASHINGTON Mr. William B. Webb President Science Center of New Hampshire P.O. Box 173 Holterness, New tampshire 03245 THE WHITE HOUSE 17.26.90 Dear Bill- - Thank you for your letter regarding the Science Center of New Hampshire. It is much too early to predict with accuracy what Mrs. Bush's august '91 schedule will be. (I ex pect she will be in Kennebunkport.) you should, however, correspond directly with her office. Susan Porter Rose is Mrs. Bush's chief of staff Good luck. Please keep in touch. Andy Card AC HAS SEEN Science Center of New Hampshire at Squam Lakes Post Office Box 173 Holderness, New Hampshire 03245 Telephone 603/968-7194 December 12, 1990 Mr. Andrew H. Card, Jr. The White House 1600 Pennsylvania Avenue Washington, D.C. 20500 Dear Andy: I know I would never catch you by phone so I wanted to get off a short note to ask for your advice. As you know from our conversation in the spring, I am President of the Science Center of New Hampshire. In 1991, the Center will celebrate its 25th anniversary. To recognize this milestone we are planning a gala event on August 17. The Board of Trustees would like to invite Mrs. Bush to be our guest of honor. The Science Center has long been committed to increasing children's awareness of the impact they have on the world around them. We conduct classes and programs which reach 25,000 school kids each year as well as 25,000 other visitors. Our focus is on native New Hampshire wildlife and plant life. We believe the best way to improve our environment and preserve it is through education. We hope to have 500 people at our celebration. It will be a major event in central New Hampshire. It seems to me the political advantages of an appearance like this are obvious - environment, children, education, New Hampshire a year before elections, all rolled into one. Can you offer any advice on how I could best proceed to ensure Mrs. Bush's attendance? Who should I contact? What things would be of most interest to them as they make the scheduling decision? Any guidance you can offer would be greatly appreciated. I think this could be an excellent opportunity for both Mrs. Bush and the Science Center. Thanks for your help. Best regards, Bill William B. Webb WBW:jr P.S. I would have asked for advice on how we could invite the President, but I assume that would be too much of a long shot. Opening a Window to the Natural World andrewHlard THE WHITE HOUSE WASHINGTON Mx. Edward D. Murname 436 South Belmont arlington Heights, Illinois 60005 THE WHITE HOUSE 12-26-90 Dear Ed — Thank you very much for your letter. I am a big Ed Murname Pan! yes, I want to see what can be done to melude you in other Bush/Quante Team activities. Indeed, Ron Kanfman has told me of your interests. He and I will work together with you in mind. Happy New year! Sincerely, Andy Card THE WHITE HOUSE WASHINGTON Date: 12-26-90 FOR: Ron Kaufman FROM: ANDREW H. CARD, Jr. fudy Action Your Comment Let's Talk FYI EDWARD D. MURNANE 436 SOUTH BELMONT ARLINGTON HEIGHTS, ILLINOIS 60005 (312) 394-8847 708 AC HAS SEEN December 11, 1990 Mr. Andrew H. Card, Jr. Assistant to The President and Deputy to The Chief of Staff The White House Washington, D.C. 20500 Dear Andy: I enjoyed our brief visits in both Paris and Uruguay and hope you survived both trips. I was happy to get home after 34 days away. Some of the sheep in Uruguay were starting to look pretty good. I'm taking the liberty of sending you a copy of my resume and a bio. I'm not sure how much you know about me and I hope you will think of me as more than one of The President's Advancemen. I think I have performed that function well for Presidents Reagan and Bush, but I think I have a lot more than that to contribute to President Bush. I cannot complain about being an SBA Regional Administrator. It was my preference to stay in Chicago following the 1988 election and the SBA position is a good one and pays well (I'm SES-Level 5). However, my reasons for wanting to stay in Chicago have changed somewhat -- my two oldest children have both graduated from college since 1988 and the burden of moving to Washington (or commuting) wouldn't be so great. In addition, I think I have outlived my usefulness at SBA and I am not in total accord with the management of the agency by the current Administrator. I've talked to Ron Kaufman several times and Ron is being very supportive. I don't want Ron to think that in writing to you I am going around him because I am not; I simply want you (and everyone else) to keep your eyes and ears open for other ways in which I can make a contribution to this Administration -- now, in the 1992 campaign, and through 1996. Mr. Andrew H. Card, Jr. Page Two I have no specific position in mind. I have strong qualifications in management of people, in public affairs and public communications, (both oral and written), in international relations and in transportation. My preference would be something at the Assistant Secretary level that would allow me to make a positive contribution to government, while at the same time permitting me to play a role in the campaign, perhaps as a surrogate speaker. I think the people who are most familiar with me in Illinois (Governor Thompson, Gov-Elect Edgar, Sam Skinner, Ed Derwinski, Henry Hyde, etc.) will say good things about me, and I think the people with whom I've worked in Washington (Haley Barbour, Ed Rogers, Mary Matalin, Susan Engeleiter, Steve Studdert, Craig Fuller, etc.) will do the same. Andy, thanks for paying some attention to this. If nothing works out, fine. I just want to let you know that I'm ready for a change and perhaps there is another way for me to be helpful to The President (who also has been known to say good things about me). With all good wishes, Sincerely, Edward D. Murnane SMALL 1953 U.S. Small Business Administration Edward D. Murnane Illinois Regional Administrator Indiana Michigan Minnesota 230 South Dearborn Street 510 Ohio Chicago, Illinois 60604 Wisconsin (312) 353-0357 EDWARD D. MURNANE 436 SOUTH BELMONT ARLINGTON HEIGHTS, ILLINOIS 60005 (312) 394-8847 708 Career History 1989-Present U.S. Small Business Administration; Regional Administrator, Region V (Chicago). Responsible for overall management and direction of largest regional office in U.S. (400 employees, States of Illinois, Indiana, Wisconsin, Michigan, Ohio and Minnesota). During most of 1990, assumed additional responsibility for direction of SBA's participation in Bush Administration's assistance effort to Eastern Europe. Involved visits to Poland, Hungary and Soviet Union, and frequent contact with government and private sector officials from Poland, Hungary, Czechoslovakia and USSR. 1987-88 Bush For President; Bush-Quayle '88; Executive Director for successful Primary and General Election campaigns in Illinois. (Three days following Illinois Primary, Senator Dole withdrew from the race). 1985-88 Regional Transportation Authority, Chicago; Served initially as Executive Assistant to RTA Chairman Samuel Skinner, later as Public Affairs Director. Directed public information, government relations, customer information and marketing for second largest mass transportation system in U.S. (On leave of absence during campaings.) 1984 Reagan-Bush 184; Communications Coordinator and Deputy Director for Re-election campaign in Illinois. 1976-83 Ed Murnane and Associates; Owner of public relations-public affairs-government relations consulting firm. Clients included Illinois and national associations, firms and candidates. Activities included lobbying, campaign consulting, lecturing and production and hosting of public affairs television program. 1979-80 Reagan for President, Reagan & Bush; Communications Coordinator for five Midwest states. 1971-76 Congressman Philip M. Crane, R-Illinois; Press Secretary, later Administrative Assistant and Chief of Staff. Edward D. Murnane Page Two 1966-71 The Daily Herald, Chicago; Reporter, then Political Editor for third largest daily newspaper in Illinois. Twice honored for "Distinguished Reporting of Public Affairs" by American Political Science Association. Education: Northern Illinois University, 1966. B.S. (Journalism-Political Science) Personal: Born March 2, 1944, Chicago, Illinois. Married, three children. SMALL BUSINESS U.S. SMALL BUSINESS ADMINISTRATION * * REGION V 1953 EDWARD D. MURNANE Edward D. Murnane, a former award-winning journalist, small business owner and congressional aide, was appointed Regional Administrator for the U.S. Small Business Administration on January 3, 1989. Murnane, a native of Chicago, oversees SBA activities in the six- state region of Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin. Prior to his appointment, he served as Executive Director of the George Bush for President Campaign in Illinois. He had previously held senior management positions in the 1976, 1980 and 1984 campaigns of former President Ronald Reagan. As a reporter and political editor for The Daily Herald in Chicago's suburbs in the late 1960's and early 1970's, he was twice honored for "Distinguished Reporting of Public Affairs" by the American Political Science Association and he was one of only eight U.S. journalists selected as Congressional Fellows in 1971. He spent five years in Washington, D.C. on the staff of Congressman Philip M. Crane, R-Illinois, serving first as Press Secretary and later as Administrative Assistant and Chief of Staff. He left Crane's staff in 1976 and formed his own political and public relations consulting firm in Chicago. Clients included more than 70 political candidates and 30 corporations, government agencies and trade associations. Murnane has extensive international experience. He has directed the planning and scheduling for visits of Presidents Reagan and Bush to Japan, China, West Germany, Egypt, the United Kingdom, Costa Rica and Mexico. In early 1990, he was appointed coordinator of SBA's programs for Eastern Europe and he serves on the Interagency Committee planning U.S. government economic assistance to Eastern European countries. He also coordinated the 1990 visit of an official government delegation from the Soviet Union studying American small business operations and he accompanied the Soviet delegation on most of their two-week stay in the United States. He also directed the planning for Soviet President Mikhail Gorbachev recent visit to Minneapolis and he previously had coordinated the visit of President Li Xiannian of the People's Republic of China to the United States in 1985. Chicago Regional Office, 230 S. Dearborn St., RM 510, Chicago, IL 60604-1593 Serving the States of Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin He has served on the White House volunteer advance staff since 1981 and has assisted on dozens of domestic and international trips of Presidents Reagan and Bush and Vice Presidents Bush and Quayle. Murnane has delivered more than 700 lectures throughout the United States on the role of the free enterprise system and the relationship between business and government. He also produced and hosted a weekly public affairs television program in the Chicago area in 1983 and 1984. Between 1984 and 1988, he was Public Affairs Director for the Regional Transportation Authority in Chicago, the second largest mass transit system in the United States, working with former RTA Chairman and current Secretary of Transportation Samuel K. Skinner. Murnane is a journalism and political science graduate of Northern Illinois University. He and his wife, Laurel, have three children and live in Arlington Heights, Illinois. Andren Hard.). THE WHITE HOUSE WASHINGTON The Honorable William J. Flynn 195 S whiting Sheet Hingham, Massachusetts 02043 THE WHITE HOUSE 12-26-90 DearBill- Thank you Per your not. I enjoyed seeing you and the other House members when I was in the Chamber not long ago. I have passed on your interest in the F.D.I.C. to the appropriate people here. Keep in touch and best wishes for '91. Sincerely, Andy Card THE WHITE HOUSE WASHINGTON Date: 12-26-90 FOR: Ron Kayman FROM: ANDREW H. CARD, Jr Andy Action Your Comment Let's Talk FYI William J. Flynn, Jr., J.D. AC HAS SEEN Counsellor at Law 195 Whiting Street (617) 749-5554 Hingham, Massachusetts 02043 December 7, 1990 Mr. Andrew Card Office of the President White House Washington, D.C. 20205 Dear Andy, Nice to see you at the State House about ten days ago. As you are aware, I am leaving the Massachusetts House at the end of this month after 16 years. I have applied for a job with the Professional Liability section of the F.D.I.C. here in Boston: a copy of the ad is enclosed along with a copy of my resume. The contact person in Washington is a Mr. Jack Smith, Deputy General Counsel. Any help you could give me in this regard would be greatly appreciated. The best place to reach me is at my Hingham law office. As a back up option, I would also be interested in an Administrative Judge's position. Happy holidays to you and your family. With kindest personal regards, Bill Hynn William J. Flynn, Jr. BOSTOM GLUBE SUM B76 11/18/90 PROPESSIONAL HELP PROFESSIONAL HELP PROFESSIONAL HELP ATTORNEY VACANCIES Boston The FEDERAL DEPOSIT INSURANCE CORPORATION (FDIC) is seeking qualified attorneys to support the Professional Liability Section in its Boston, MA Consolidated Office. Attorneys will specialize in directors' and officers' liability, attorney malpractice, accountants' liability, securities and commodities brokerage liability, appraiser liability and bankers' blanket bond suits which arise from the FDIC's role as receiver, conservator or liquidator of closed and assisted insured financial institutions. Counsel (Office Chief) Senior Attorney GG-905-14/15 GG-905-13/14 $55,375 to $84,675 $46,861 to $71,991 LD-365 LD-366 1 Vacancy 3 Vacancies Applicants must have bar membership, possess good writing skills, decision-making abilities and have the ability to meet and deal effectively with financial institution and government officials. These positions offer excellent benefits. U.S. citizenship is required. In addition, applicants at the 13 level must have 3 years, at the 14 level 4 years and at the 15 level 5 years of progressively responsible legal experience which demonstrates that they possess the knowledge, skills, and abilities required to perform the duties of the position. At least 1 year of professional legal experience must have been at a level of difficulty and responsibility comparable to the next lower grade in the Federal service. Team leader or supervisory experience is a plus for the Counsel (Office Chief) position. Entrance salary will be based on ability, experience and previous earnings. To be considered, a completed "Application for Federal Employment" (SF-171). available at most Federal agency personnel offices, must be received no later than close of business December 19, 1990 at: Federal Deposit is Insurance Corporation Legal Division, Room 3011 550 17th Street, N.W. 102222 Washington, DC 20429 NOTE: PLEASE INDICATE ON YOUR SF-171, THE VACANCY ANNOUNCEMENT NUMBER AND LOCATION FOR THE POSITION IN WHICH YOU WISH TO BE CONSIDERED. SEPARATE SF-171S MUST BE SUBMITTED FOR EACH POSITION AND LOCATION IN WHICH YOU WISH TO BE CONSIDERED. FAILURE TO SUBMIT MULTIPLE SF-171S WILL CAUSE LOSS OF CONSIDERATION: 5910 The FDIC is an Equal Opportunity Employer Minority Candidates are Encouraged to Apply WILLIAM J. FLYNN, JR. 131 Tower Hill Drive Hanover, MA 02339 (617) 826-4555 EDUCATIONAL BACKGROUND: Boston College A.B. Ecomonics 1960 Boston College Law 1961-1962 New England School of Law L.L.B. 1963-1964 CAREER EXPERIENCE: 1965-Present Practicing Attorney 1975-1990 Member, Massachusetts House of Inclusive Representatives 1975-1990 1967-1974 Town Counsel-Town of Hanover 1963-1974 Claims Adjuster 1952-1956 U.S. Navy PROFESSIONAL MEMBERSHIPS: Plymouth County Bar Association Massachusetts Bar Association OTHER ACTIVITIES: Baseball and Basketball-Coach in Youth programs Regional Interviewer for Boston College Member, Country Club of Halifax Member, Hingham V.F.W. Post and Hingham American Legion Post Director for Hanover Permanent Scholarship Fund Member, Charitable Irish Society andrewH.Card.J. THE WHITE HOUSE WASHINGTON Mr. herse C. Worthey MIR, LTD. Suite 365 2100 Pennsylvania ave., N.W. Washington, D. C. 20037 MIR, LTD. INTERNATIONAL TRADE RELATIONS GEORGE C. WORTLEY PRINCIPAL 2100 Pennsylvania Ave. N.W., Suite 365 Washington, D.C. 20037 Paris and Moscow (202) 785-0500 Fax: (202) 785-5277 THE WHITE HOUSE 12.26.90 Dear George- Jeff Taylor passed on to me some information about MIR. Ltd. and your activities. I will make sure that the appropriate people here are aware of MIR's project. Best wishes Poi the new year. Please keep in touch. Sincerely, Andy Card THE WHITE HOUSE WASHINGTON Date: 12/26/90 FOR: NSC FROM: ANDREW H. CARD Andy X Action as approprials 1 Your Comment Let's Talk FYI 12-11-90 JEFFREY L TAYLOR AC HAS SEEN DEAR ANDY- MER, CTD, A WASHINGTON BASED INTERNATIONAL TRADE RELANONS COMPANY, ITAS BEEN ACTIVALL/ FOLLOWING THE RECENT HAPPENINGS WITH REGARD TO U.S. Assistance TO THE Sevisr UNION. I AM urining This NONE 10 INTRODUCE you To ntis FINK ORGANIZATION And PRESSNT A PROPOSAL which COLLD Bh of GREAT INTEREST And BENEFIT TO THE BUSH Administration VANDER 17th LEADERSHIP OF FORMER CENGRESSMAN SECRITE C. horrey (R-N4), MIR, CTD HAS CREATED A PROGRAM which IS GEARRD TOUARD DELIVERING NUTRITIOUS FOOD INTO THE HANDS LF THE Sovisr people - - FAST, SAFE, And FOR con COST. (LLER) Ar ntis TIME, I'd like 10 A3K your itsep And GUIDANCE IN dinearing This PROPOSM 10 THE APPROPRIATE decision MAKER IM THE AdMINISIRATION. MER, LTD is willing 10 discuss nhi profect FURNTER you OR WHOELER you FEEL is APPROPRIATE in ntis SIRANCE Pernse FORWARD Any RESPONSE TO my ATTENTION inc c/o Wonney Ar MIR, LTD. As ALWAYS - Thank c/or. My very BESI 10 you, CANNY And its SWITHE Family during DHE HOLIDAY SEASON. JEFF EMERGENCY FOOD SUPPLIES FOR THE SOVIET UNION MIR, Ltd., a Washington-based international trade relations company whose principals include retired Congressman George C. Wortley (R-NY), has been actively involved in negotiating with an "international organization" within the Soviet Union to import needed canned and processed foods. We continue these discussions and have identified numerous U.S. resources capable of providing large quantities of canned meats, vegetables and other packaged foods at costs of $.015-$.055 per ounce or $.0175-$.064 per ounce delivered to Moscow. Foods which have been identified as available are: Canned meats: whole chicken, beef chunks, beef stew, chili and meat, spam, hash, creamed sliced beef, brunswick stew. Canned vegetables: green beans, corn, peas, carrots, spinach. Macaroni and cheese, beef ravioli, spaghetti and meat balls, beefaroni. White beans and ham, chili and beans, pinto beans. The Soviet Union is in desperate need of processed foods ready for immediate distribution to citizens through the country. The Soviet Red Cross is active not only in Moscow (Russia), but in other republics and has the capability, and credibility, to see that emergency food supplies are quickly and equitably distributed. If hoarding, pilfering and corruption are to be avoided, it will be imperative to identify a credible organization to handle distribution, and MIR, Ltd. has excellent contacts directly with the Red Cross. ACTION The United States should immediately offer to send ready-to-eat foods to the Soviet Union in time to arrive by Christmas as a gesture of goodwill, solidarity and in the spirit of the upcoming holiday season. The U.S. Government should arrange for a number of plane loads of food stuffs to arrive in various Soviet cities December 17-24. MIR, Ltd. should be asked to coordinate the initial shipments since the sources have already been identified and shipment can be facilitated. The initial shipments of perhaps $10-20 million in cost should be done non-competitively in order to expedite these first plane loads. Future shipments could go through a competitive procurement process if time allows. MIR, Ltd. MIR, Ltd., was formed in 1990 in association with the French trading organization CANOPUS as an outgrowth of the consulting activities of the firm's principals. Originally created to identify opportunities with the Soviet Union and to assist American companies in developing and successfully completing various types of business transactions, MIR, Ltd., is now identifying specific import and export opportunities, locating companies who can take advantage of these opportunities, and initiating discussions on joint ventures bringing needed technology and equipment to establish Soviet manufacturing capabilities for domestic and international (regional) markets. MIR, Ltd., and its associates facilitate trade, identify priority commercial issues, work on these business priorities to assure Soviet hard currency is available for purchases, arrange meetings with decision-making Soviets to provide American companies with the opportunity to present and close deals, as well as arrange for the shipment of goods to and from the Soviet Union. MIR, Ltd., has established itself in a position to work closely with senior Soviet ministry officials at both the central and republic levels and emerging enterprise executives to identify specific export commodities and those import items for which hard currency or suitable barter is available. Discussions are held with people who have the authority to make decisions and our associates are fully conversant in Russian and have all necessary legal and support services throughout the Soviet Union. MIR, Ltd., principals have considerable experience in international affairs and are experts in government relations in the United States, the Soviet Union, France and numerous Third World countries. MIR, Ltd., works closely with the U.S. Departments of Commerce and Agriculture, as well as the Office of the U.S. Trade Representative, the U.S. Customs Service, and the Congress of the United States. The principals are dedicated to private initiative, entrepreneurship, and free market economies and encourage these concepts whenever they work with developing and East Bloc countries. They have found that trade facilitation can be used to leverage changes in the way enterprise sectors work and can be used to foster and expand private businesses. MIR, Ltd., Principals GEORGE C. WORTLEY Congressman George C. Wortley, retired four-term member of the U.S. House of Representatives, was actively involved with European, Latin American and Pacific Rim leaders on financial and development bank matters. A strong business advocate, he was a moving force in the formulation of legislation on money laundering and public housing. He serves as a consultant to The Carmen Group and the Financial Institutions Services Corporation of Washington, D.C. Mr. Wortley is also the President of Manlius Publishing Corporation, the publisher of seven weekly newspapers in upstate New York. He currently serves on several Central New York business and foundation boards. Mr. Wortley holds a Bachelor of Sciences degree from Syracuse University. He served in Merchant Marine Reserve and the United States Naval Reserve during World War II, with sea duty in the North Atlantic, Pacific and Philippine Theaters. ALBERT G. OUELLETTE Mr. Ouellette has been a principal with Ouellette & Associates since 1983 providing political consulting, legislative research, and fundraising. He is chairman of the Western States Caucus, a political and policy organization regarding Western environment, Western land and water. Since 1982 he has served as an Oil Shale Advisor to the Secretary of Interior and is on the Board of Directors for the Colorado State University Foundation. Previously, he was President of Sun Eagle Inc., a Colorado development company in Vail, Beaver Creek and Durango. He served as finance director for CFTR, President Reagan's political action committee. Mr. Ouellette holds a Master of Arts degree from Northern Arizona University and Bachelor of Arts degree from Colorado State University. ROGER C. DIERMAN Mr. Dierman has been a Senior Associate with The Carmen Group and the Financial Institutions Services Corporation. He returned from Geneva, Switzerland, in 1989 where he was the President and one of the co-founders of the International Enterprise Foundation of Geneva. This private sector development group of 20 multinational corporations focused on business-to-business initiatives in developing countries, primarily Africa. Previously he served as Chief of Staff to the U.S. Ambassador to the United Nations in Geneva and as an executive at the U.S. General Services Administration where he led major cost-reduction initiatives. He also served the government with assignments with The White House, the President's Management Improvement Council, the Department of Transportation, and the Department of Housing and Urban Development. Prior to his government assignments, Mr. Dierman was an executive in the insurance industry. Mr. Dierman holds a Bachelor of Business Administration degree from Georgia State University. andrewHCard. THE WHITE HOUSE WASHINGTON Ms. Many Gagorian 10 Glen Ellen Road Worcester, Massachusetts 01602 THE WHITE HOUSE December 24,1990 Dear Mary- Mytickle Pile" has your recent letter in it. Is there any updat to your request regarding the Massachuritts Federation s( Women's Clubs? Best wishes for the New year. Sincerely, Andy Card MEMORANDUM OF CALL Previous editions usable TO: LC YOU WERE CALLED BY- YOU WERE VISITED BY- Mary GUZURIAN OF (Organization) Mass. Few. OF women PLEASE PHONE FTS AUTOVON 508/443-4569 WILL CALL AGAIN IS WAITING TO SEE YOU RETURNED YOUR CALL WISHES AN APPOINTMENT MESSAGE She clAIMS you ARE working ON getting The VPOR ElizAbeth Dole TO ADDress her group. RECEIVED BY DATE TIME 63-110 NSN 7540-00-634-4018 STANDARD FORM 63 (Rev. 8-81) Prescribed by GSA FPMR (41 CFR) 101-11.6 * GPO : 1986 0 - 157-353 Document Originally Attached to Following Page now asks for Mrs. Quayle if VP cannot make it. Forget Mrs. Dole. AC HAS SEEN LC spoke 12/14 a 508/755-3978 Andrew Card Jr (h) assestant to the President 508/443-4569 Deputy to the Cheef of Staff The white House Dear Andy, We missed you at wave Lionetts Birthday party in Betober We are happy he was a winner and of Course, Paul winning the for governship was just great. We all worked very hard. If you recall & talked to you that night on the phone about being disappointed because Barbara Bush could not speak to our Mass, State Federation of Women's Chiba on Oct. 29, 1990. I'm asking for your help for Jan. 29, 1991 Call day Conference) we would be very happy to have Vice President guayle be our keyrote speaker. Our attendance is about 500 women from all areas of massachusetts. Andy, please help us and arrange this meeting which is our mid-Winter Conference and is usually in the Boston partisan it would not hurt to give area. Cas you know the group is non- - our Vice President more exposure to women's groups) another favor, andy, we dicussed having Elizabeth Dole asour speaker for our annual Conference may 6-9th at Sea Crext in north Falmouth Can you help No with that date? we can switch the dates for Perhapoif its more convenuent these two dates with Vice President Guayle and Elizabeth Dole. ??? Andy, I sincerely appreciate must you help, l know you have many requests from other groups Beat wishes fn you continued Many, many thanks for your help. good work ! whicester, ma01602 10 glen Ellen Rd. gratefully mary gazorian Tel. 1-508-755-3978 THE WHITE HOUSE WASHINGTON Mr.Donal d a. Clarey B. M.A. Inc. 1825 K Street, N.W. Washington, D.C. 20006 Suite 807 THE WHITE HOUSE December 26,1990 DearDon - your thoughts of 11/20 are very appreciated. - The Bennett situation is a bit different. Hopefully solution #2 will be as good. Keep in touch. Happy New year! Sincerely, AndyCard AC HAS SEEN November 20, 1990 MEMORANDUM FOR ANDREW H. CARD, JR. FROM: DONALD A. CLAREY xX) SUBJECT: "Deja vu. all over again" "The election results were mixed, perhaps shaded slightly in favor of the Democrats. The Republicans had lost 9 seats in the House ... The Republicans took a licking. so that Democratic governors outnumbered Republicans again by 29 to 21 a Senate [had] 55 Democrats and 45 Republicans. " Outside the iron grillwork of the White House, the reactions of Republicans were far less restrained, far more shrill. For the first time since the [President's] inauguration, workers and leaders of his own party were denouncing him, still privately and not for publication but with increasing despair and anger. Clearly, the Presidency of Richard Nixon had hit bottom. "* Just remember, he won 49 states two years later. I was reading this book last night and the similarities just jumped off the page at me. While I know you are too busy to read unsolicited advice (its worth what you pay for it) I thought that as you begin the SOU process you might put this in the back of your mind. The first move to place William Bennett was a master stroke. You have put the cork in the bottle of any assault from the right. Now you can begin to concentrate on the main business at hand -- 1992 from the Democrats. One point that has not been put forward is the fact that, on the Presidential politics level, the Democrats suffered a major defeat. Mario Cuomo barely made a majority against Bozo the Clown and Zippy the Chimp. Bill Bradley barely made it back to the Senate. This point should be stressed. In addition, you have California, Michigan, Ohio, Massachusetts, and Illinois. Governors in these state provide a pivotal strategic advantage. Even the Democrats will concede Texas and Florida to the President in 1992. Now is the time to go to a war footing and I believe there are a few steps worth taking: The State of the Union is the kick-off. The points raised should be the themes of 1992. Blue collar issues, middle class issues should prevail. The line should be drawn against new taxes and new spending. " What we need are spending cuts so we can have tax cuts." "I will veto any bill which unnecessarily raises spending - period." * Nixon in the White House, Evans and Novak, 1971 -2- This was the message of the 1990 election and the Administration can get back on the right side of this equation. There has been a lot of criticism on message -- two approaches should be developed. First is a monthly " report to the people" to respond to the increasing criticism of Desert Shield. This should be televised and should be similar to the President's tour de force speech to the nation before he left for Malta last year. These updates will recapture the rhetorical and policy advantage, as well as, remind the country who is leading this successful effort. He should launch a speaking tour of several legislatures were he can hold Mini State of the Union Addresses. In this environment he can pin point single points of the agenda and receive a glowing response. This also is a good environment for underscoring the no new spending approach. Finally, there are numerous success stories in American business which can be underscored. Trips to such areas would be worthwhile. I would suggest that no city visited should have a population of more that 100,000. In these towns a presidential event is an historic occasion, not a political event. President Nixon recaptured the agenda and proceeded to inflict a disastrous defeat upon the Democrats. This Administration is a similar position. All it requires is keeping the message focused and recapturing the agenda. The State of the Union begins that process for President Bush. THE WHITE HOUSE December 26,1990 Dear Lett- your note lingued in my file longer than appropriate. I apologize. I like your suggestion regarding the Massachusetts Senate Presidency. The "players" recognize the opportunity but seem to lack the will to make change a reality. May promises to be A busy month. My number two daughter graduates on May 11 and daughter number one marries on May 26th het me know your plans. - Sincerely, Andy Card andrew Hardf. THE WHITE HOUSE WASHINGTON President Harry R. Feldman Inc. 112 Shawmust avenue Boston, Massechuritts 02118 FELDMAN. Harry R. Feldman, Inc. Civil Engineers and Jeffrey M. Feldman Land Surveyors President AC HAS SEEN 112 Shawmut Avenue Boston, MA 02118 617-357-9740 November 8, 1990 Mr. Andrew Card The White House 1000 Pennsylvania Avenue Washington, DC 20500 Dear Andy: I imagine that life continues to be exciting and I'm pleased that you have this opportunity. You will have some very interesting stories to tell your grandchildren. Andy, I would appreciate it if you would pass a thought along to the current Republican leadership in Massachusetts: Instead of losing an election for Senate President, it seems much more sensible to elect someone other than Bill Bulger! With 16 Republican votes, it shouldn't be difficult to find an ambitious Senate Democrat who can get 4 other votes and get himself elected Senate President. While I would prefer a Republican Senate President, I don't think it will happen this time, so why not take credit for dumping Mr. Bulger, even if it means electing another Democrat? Perhaps the voters would pay back the favor in 1992 by giving the Republicans a Senate Majority! One thing is pretty clear, Mr. Bulger's future is in the hands of the Massachusetts Republican Party. Hopefully, they will use their new power quickly and wisely. I'll be in Washington on May 11 and 12 for my son's graduation from George Washington University. I'd love the chance to say hello if you are in town and available. Many thanks for your consideration of this thought. Best regards, M Jeff Feldman THE WHITE HOUSE WASHINGTON The Honorable Brian P. Less Massachuritts State Senator 10 Parker Street Indian Ordrand, MA 01151 THE WHITE HOUSE December 26,1990 Dear Brian- Thank you for your corres ponduce regarding The Basketball Hall of Fame 100th anniversary Celebration. as you may expect, it is not possible for the President to be in Springfield on January 6th I have also learned that the Societ President is not available to havel to the United States for the edebration. Best wishes for 1991. Sincerely, Andy Card COMMONWEALTH OF senate STATE HOUSE, boston 02133 AC HAS SEEN 12/26 SENATOR BRIAN P. lees 10 PARKER street SECOND hampden DISTRICT indian ORCHARD, MA 01151 ROOM 517, STATE house (413) 543-2167 (617) 722-1291 December 3, 1990 Mr. Andrew Card The White House 1600 Pennsylvania Avenue Washington, DC 20500 Dear Cardey Mr. Card, I would like to bring to your attention an event which will be held in Springfield at the Basketball Hall of Fame in January. The event, which will celebrate the 100th anniversary of Basketball, may include (by then) Governor William Weld. Festivities will include a reception on Saturday evening, January 5th from 7:00 P.M. to 9:00 P.M. On Sunday, January 6, the Postmaster General will announce the issue of a commemorative stamp in a ceremony from 10:00 A.M. to 11:00 A.M. This will be followed by a brunch from 11:00 A.M. till 1:00 P.M. The weekend will be capped off by a game in which Notre Dame University will play against the National Team of the Soviet Union. I am informing you of this occasion because the President is also being asked to attend by the organizers, and they have also contacted the Soviet Embassy to inquire about the availability of the Soviet Premier. I would greatly appreciate it if you could see what can be done to assist in this request. If you need further information, please do not hesitate to contact me. With best wishes, I am to Sincerely, Brian P. Lees State Senator, Second Hampden District BPL/bhc THE WHITE HOUSE WASHINGTON Ms. Mary O'Sullivan 124 Elm avenue Quincy, Massachusetts 02170 THE WHITE HOUSE December 26,1990 Dear Ms. O'Sullivan- 8 Steve M 'Grath contacted me regarding your interest in working with the U.S. First Circuit Court as an assistant circuit Executure. The Judiciary is independant of the Executive Branch so there is little that I can do to assist in your effort. your correspondence should be directed as indicated in the Boston Globe. - -Best wishes for 1991. Andy Card DEC 07 '90 15:48 CITY_OF_QUINCY__IE P.1 AC HAS SEEN STEPHEN J. MCGRATH CITY OF QUINCY CITY SOLICITOR OFFICE OF THE SOLICITOR JAMES S. TIMMINS JOSEPH A. MACRITCHIE CITY HALL ASSISTANT CITY SOLICITOR LEGAL COUNSEL KEVIN J. MADDEN 1305 HANCOCK STREET JEFFREY W. BRIDS ASSISTANT CITY SOLICITOR QUINCY. massachusetts 02169 SPECIAL COUNSEL TELEPHONE (617) 773-1380 FAX NO. (617) 328-9265 December 7, 1990 Andrew H. Card Deputy Chief of Staff BY FAX The White House Washington, D.C. Dear Andy: along with the job description for an Assistant Circuit Enclosed is a resume of Mary E. O'Sullivan of Somerville Executive is for the U.S. First Circuit Court. Mary's family a very good friend of mine from Quincy and if there is anything that could be done for Mary, I would appreciate it. advise. Should you require any additional information, please Very truly yours, Stephen J. McGrath City Solicitor SJM:bd enclosures CC: Daniel O'Sullivan 124 Elm Avenue Quincy, MA 02170 DEC 07 '90 15:48 CITY_OF_QUINCY__IE P.2 MARY E. O'SULLIVAN 62 Dover St., #8 Somerville, MA 02144 (617) 628-7177 EDUCATION M.Ed., Business Management Cambridge College Cambridge, MA 1990 B.A., History University of Massachusetts Boston, MA 1976 EXPERIENCE CORPORATE HUMAN RESOURCES MANAGER Cambridge Analytical Associates, Inc. Boston, MA 1988-1989 Seasoned professional reported directly to the Director of Administration and Finance of leading national environmental management consulting company. High visibility position responsible for managing all aspects of corporate human resources Officer. function. Reported indirectly to the President/Chief Executive * Researched plans. and analyzed numerous compensation and benefits * Introduced innovative comprehensive company-wide compensation package and employee handbook. * Compiled extensive data and statistics on diverse personnel- related projects. * Prepared budget reports and cost analyses. * procedures. Developed and implemented human resources policies and * Supervised Human Resources Administrator. * Worked successfully for and with President/Chief Executive Officer on myriad of undertakings. * Recruited, interviewed and placed in-house and field professional and managerial staff. * * Advised employees on career counseling and pathing. Promoted positive employee relations. REGIONAL HUMAN RESOURCES MANAGER Stars To Go, Inc. Marlboro, MA 1987-1988 Seasoned professional reported directly to the Regional Vice visibility position responsible for managing all aspects of human President of leading national video distribution company. High resources function in the Northeastern Region. Reported indirectly to the Corporate Vice President of Human Resources. DEC 07 '90 15:49 CITY_OF_QUINCY__IE P.3 Recruited, interviewed and placed in-house and field exempt and non-exempt staff. Promoted positive employee relations. Advised employees on career counseling and pathing. Designed communication, safety and training programs. Administered compensation package including commission and bonus plans. Oversaw administration of benefits package. Prepared budget reports and cost analyses. Compiled extensive data and statistics on diverse personnel- related projects. Developed and implemented human resources policies and procedures. Promulgated Equal Opportunity Employer and Affirmative Action measures. Provided personnel and appropriate support for start-up of a National Distribution Center in Memphis, Tennessee. SENIOR HUMAN RESOURCES ADMINISTRATOR Waltham, MA Thermo Electron Corporation 1983-1987 Recruited, employees. interviewed and placed exempt and non-exempt Identified, sourced and referred candidates for positions through computerized recruiting system. Administered comprehensive benefits packages. Administered wage and salary programs. Administered Equal Opportunity Employer and Affirmative Action programs. Interacted with Corporate Human Resources and Benefits Departments on myriad of human resources projects. Resolved both in-house voice and data telecommunication problems. Supervised Personnel Clerk and Switchboard Operator. PERSONNEL ADMINISTRATOR Boston, MA Guardsmark, Inc. 1982-1983 employees. Recruited, interviewed and placed exempt and non-exempt Oversaw employee orientation and training programs. Administered benefits package, safety program and Equal Opportunity Employer and Affirmative Action programs. Devised systems to reduce employee absenteeism and turnover. PERSONNEL REPRESENTATIVE Somerville, MA Preferred Care, Inc. 1980-1981 * employees. Recruited, interviewed and placed exempt and non-exempt Planned and conducted employee orientation and training programs. Oversaw administration of benefits and compensation packages. Devised systems to reduce employee absenteeism and turnover. DEC 07 '90 15:49 CITY_OF_QUINCY__IE P.4 ASSISTANT TO BUSINESS MANAGER Bay Cove (Tufts) Mental Health Center Boston, MA 1978-1980 * Prepared budget reports and cost analyses. * packages. Oversaw the administration of benefits and compensation * Maintained employee records. ASSISTANT TO PROGRAM MANAGER Office of Emergency Medical Services Boston, MA 1976-1978 * Acted as liaison between office and field personnel. * Maintained personnel inventory. * competence. Devised systems to pinpoint employee distribution and * Prepared statistical reports. REFERENCES * Available upon request. DEC 07 '90 15:50 CIJY_OF_QUINCY__IE P.5 61990 ASSISTANT CIRCUIT EXECUTIVE UNITED STATES COURTS FOR THE FIRST CIRCUIT Provides staff support to the Circuit Executive in all areas of administration, with specific emphasis on planning and analysis. Must possess strong written communication and analytical skills. B.A. required. Salary $42,601 to $65,444. Send resume to: Vincent Flanagan, Circuit Executive, 1403 John W. McCormack Post Office and Courthouse, Boston, MA 02109. BOSTON SUNDAY GLOBE NOVEMBER 11, 1990 PROFESSIONAL SECTION PAGE B58. MARY E. O'SULLIVAN 617-628-7177 THE WHITE WASHINGTON Ms. Ellen M'Cauley-M'Garty 21 Glen Green Winchester, Massachusetts 01890 THE WHITE HOUSE December 26,1990 Dear Ms. M'Cauley-MiGarty - Thank you for your letter and the article by David R. Carlin ,t. I enjoyed particip ating in the arthites Foundation's Massachuretts Chapter testimonial dinner. The cause is important The November 9,1990, Commonweal article has been shared here. I encourage you to read amounty International's most recent report. -Best wishes for 1991. Sincerely, AndyCard ELLEN McCAULEY McGARTY 21 Glen Green Winchester, Massachusetts 01890 (617) 729-1436 AC HAS SEEN November 29, 1990 Mr. Andrew Card Assistant to the President The White House Washington, D. C. Dear Mr. Card: I attended the Arthritis Foundation testimonial dinner Tuesday evening at the Copley Plaza. The enclosed article which appeared earlier this month in COMMONWEAL makes such enormous sense that I can't resist sending it to you with the hope that you will give it to the President to read. The sentiments in the article clearly express the feelings of many of us in your audience Tues- day evening. As a trustee of the Arthritis Foundation's Massa- chusetts Chapter (and a long-time registered Republican, just recently switching to Independent), I very much appreciate your taking time out of your hectic schedule to participate in Tuesday evening's program. You can take pride in knowing that you helped the Foundation gross $100,000 that evening and when our final cost figures are in, I believe we will have netted a sub- stantial sum for research and programs for our patients. With many thanks. And I do hope the President will read Mr. Carlin's article. Yours sincerely, Ellen TTC Cauley-TiTeGarty speak up very bluntly about things that mat- Clients wrote as well. The most moving she meant to them. ter to you reminded me that lawyers don't letter began: "Mary touched my life as well. One friend summed it up this way: "We always have to equivocate-that some I was incarcerated at the time. Thanks to all loved Mary very much; her intelligence, issues require us to take a firm stand even Mary, my incarceration came to an end sev- of course; her common sense; her sense if it's unpopular." eral months later Over the years I have of outrage; and, most of all, her sense of A lawyer who was a clerk to a judge felt that Mary's sudden appearance in my humor." when Mary was in the Public Defender life (after six years in prison and after a Another wrote from California: "Mary Service wrote: "Certain experiences in our petition for reduced sentence had been long should have had many more years with us lives make an indelible impression-things ignored) was rather mysterious. I believe and we with her. There is a very empty we hear and see that make such an impact that Mary's efforts to my benefit were place she had filled with her passion, her we can remember every detail with great greater than she ever acknowledged to teaching, her wit, and her insight. We clarity years later. Your representation of me I had the sense that Mary believed shared many projects, dinners, values, a your clients was such an experience for she was merely doing her duty, and for that few arguments, and a warm caring friend- me. I have vivid memories of what I have no praise or thanks was warranted ship. Some of my best memories center come to call the 'Mary McCarthy' school However, it is not possible to think of my around Mary's bottomless soup pot and of law. I call it that because you were truly freedom without thinking of Mary. I sin- the lively gatherings of colleagues that she unique, bringing to each case, no matter cerely wish that I could have given to Mary brought together in the beach cottage she how seemingly 'routine,' a fresh perspec- as she gave to me." so loved." tive on some statutory phrase, legislative His wife added: "Many people are gift- And a friend who came a few days history, or obscure clause in a court rule ed-but few use their gifts as Mary did. before Mary died said: "I was surprised that no one had ever bothered to read We are just plain people-Mary had noth- and enormously pleased that she was well before. ing to gain by helping us. But she did any- enough to talk for a while She still had "Your endless quest for new ways to way. I can never repay my debt to Mary, her delightful sardonic sense of humor and challenge 'the system' was amazing-and but I think she would have been glad to was still able to be almost as wonderfully sometimes, a little scary Although you know that when I found a way to give to present as ever. The visit comforted me a made my job a thousand times harder, I another I said inside, 'That's a "Thank you" lot have admired you greatly from the start. to Mary.' We were a little moment in There have been so many letters like "The zeal, the freshness, and the dili- Mary's life. She gave us our life. We want- these and they are still coming-from con- gence with which you represented your ed you to know." temporaries and from former neighbors and clients at PDS (Public Defender Service) Mary had a gift for friendship. As long-ago convent-school classmates, too. was and always will be an inspiration to Professor Stephen Cohen said at her grave- One of her high-school friends wrote to me. I believe that my own clients have ben- side, the love and support she received from say, "I have such fond memories you efited in turn, from the many lessons I her friends was a reflection of her own gift. were blessed to have such a special daugh- learned as a young 'kid' who had the Her friends were faithful and constant- ter-bright, warm, funny, feisty, and lov- chance to watch a true master in action." many traveled great distances to see and ing." One colleague wrote that, "Mary cared be with her in that last year. And those we Yes, we were, and it is very hard that deeply about teaching and devoted an inor- did not know wanted us to know how much she is not with us still. dinate amount of time and energy to her students. She treated everyone as an indi- vidual and generated in return deep affection OF SEVERAL MINDS David R. Carlin, Jr. and respect." And many students and former students wrote to us enforcing that. One stu- dent's letter was typical: "Personally, I am HOLD THAT LINE stunned and enormously sad. Mary was a HUSSEIN'S TANKS, HANNIBAL'S ELEPHANTS very special role model for me. She showed me how to be a loyal and thorough advocate for my client, how to maintain the highest ethical standards at all times, and how to be calm in the midst of legal chaos. She ow odd that the United that served us so well in that protracted was also a friend, a faculty member whom States, despite having struggle that went by the name of the cold I could call by first name, who was interested just prevailed in a war? in other parts of my life, not just my legal Fabian struggle that When I say "Fabian" I am alluding of education. I want her back for my selfish lasted more than forty course to the strategy adopted by Fabius reasons, and I am also upset that this new years, should be contemplating a plunge Maximus, the Roman general who first-year class won't get to learn from her into armed struggle with Iraq. Why not play opposed Hannibal when the great example." the waiting game, the game of containment Carthaginian invaded Roman territory in Commonweal 9 November 1990:637 the late third century B.C., marching from When Hannibal inflicted a terrible defeat following Cannae, we may find some of Spain and descending through the Alps to Rome at the battle of Lake Trasimene our friends defecting. Contain Iraq, and the plains of northern Italy, elephants and (217 B.C.), the frightened Romans appoint- we have the world on our side; get all. The Fabian strategy was one of delay: ed Fabius Maximus "dictator," a post of involved in a prolonged shooting war, and stay close to Hannibal, but don't engage exceptional powers created in great emer- we'll be increasingly on our own. him in a pitched battle; eventually you'll gencies. But the dictator proved unpopular. Critics of a Fabian policy in the Persian wear him down. His strategy was to "contain" Hannibal, Gulf region contend that Americans are The U.S. has just won the cold war. It to let the invader wear himself out roaming constitutionally impatient, too impatient didn't end with a bang; it ended, not with up and down Italy, far from his North to bear the figurative heat of the day that a whimper, but a sigh of relief; at all events African home, short of supplies and allies. such a policy demands. They say that it ended quietly. Perhaps that is why the But the Roman-in-the-street was too impa- unless something dramatic happens soon, magnitude of our accomplishment has yet tient for this long-term strategy; he wanted President George Bush's popularity will to sink in with most of us. But this cold a quick fix, a knockout punch. Fabius was plunge, whereupon the president will feel war victory is one of the great military- charged with being a wimp. compelled to prove yet again that he is political accomplishments in our national So when the dictator's term expired, a not a wimp by launching an attack on Iraq. history, probably the greatest of all. For general more to the popular taste, Terentius What planet have these critics been liv- more than four decades we contained the Varro, took command; and he promised ing on for the past half-century? True, the Soviets, waiting for their system to crack the impatient Romans to destroy Hannibal American public will become impatient under the strain, which it eventually did. the first day he set eyes on him. Well, Varro with drawn-out conflicts they don't believe And we did this, not alone, but at the head soon set eyes on Hannibal at Cannae; true in, e.g., Vietnam. But they are prepared of a large and complex alliance, put togeth- to his promises, he joined battle; the result to support a conflict they believe in, e.g., er and kept together on a voluntary basis. was that the Romans suffered the worst World War II and the cold war. The real Never perhaps in history has so extensive military catastrophe they had ever expe- question is not whether the American pub- a voluntary alliance held together for so rienced (216B.c.). After the battle Roman lic will support a Fabian policy in the long a period and with so little internal allies in southern Italy defected to Persian Gulf, but whether they believe in divisiveness. Yet during that long era Hannibal, providing him with a base of the cause to which this policy is directed. Americans and Soviets never killed one operations and supplies. Eventually the And this, I think, is President Bush's another on a battlefield (though the U.S. Romans, who stood so near to total defeat problem: he has yet to define the cause did fight two wars that were incidental to after Cannae, rallied and won the war, but in such a way that the public will support the cold war: a necessary war in Korea, only after many years (in 202 B.C.), and it patiently over the long haul. He said it an unnecessary one in Vietnam). World only after the war had expanded from Italy was about our "way of life"-which, I take War III, though always feared and often to Spain, Greece, and Africa. it, is a pious way of saying "cheap oil." expected, never arrived. If an attack on Iraq would result in a But that won't do, especially when oil has All in all, a truly amazing achievement! complete victory after a week or two, some- become more expensive. He compared But do we realize how much we have thing might be said for it. But Iraq is not Iraqi aggression against Kuwait to Nazi accomplished? And do we appreciate how to be confused with Grenada or Panama. aggressions in Europe. But that won't do we accomplished it? If so, why are so many The result of such a war will be not only either; Iraq is not Nazi Germany, and Americans-including, it seems, some many dead Americans and even more dead Saddam Hussein, wicked though he no near the center of power-eager for a quick Iraqis, but increased ill will toward the U.S. doubt is, is no Hitler. Finally, the president fix in the Persian Gulf? Why do they want from hundreds of millions of Muslims, has said the cause we are struggling for to throw away the lessons of patience we Arabs, and non-Arabs, from Indonesia to is the sanctity of international law. This should have learned from our great Fabian Central Africa. Arab hostility, great enough is more promising. But he will have to rec- success in the cold war? Why are they to begin with because of our long record oncile America's relative tolerance of bruising for a fight with Saddam Hussein, of support for Israel, will be especially Israel's retention of the West Bank, etc., instead of continuing to contain him sharp; and it could grow to such an extent with our complete intolerance of Iraq's with embargo, blockade, and troops in the that it will threaten Arab governments cur- retention of Kuwait. desert? rently friendly to the U.S. Like the Romans This is a test of President Bush's capac- ity for "the vision thing." He knows there is a good reason for us to be in the Gulf region; but he hasn't been able to translate his sound intuition into persuasive words. Unless he can do that, his popularity will continue to fall, until one day he is tempted to prove he's no wimp by bashing Saddam Hussein as he earlier bashed Michael Dukakis and Manuel Noriega. 638: Commonweal andrewH.Cord THE WHITE HOUSE WASHINGTON Mr. Will Feltus The Republican Conterner Hart Senate office Building United States Senats Washington, DC 20510-7060 THE WHITE HOUSE 12-24-90 Dear Will- Thank you for your note and your suggestion regarding the RNC. Congratulations on your appointment. I Look forward to working with you. The Republican Conference will play an important role in the months ahead. We should have meaklest or lunch soon, Please give me a call. Sincerely, Andy Card United States Senate AC MEMORANDUM andy- N320 Dive been called to active political duty, and I'm at your service. Tree advice: Bill armstrong for RNC Chairman. Best - Will AC HAS SEEN OFFICE E D STATES S * a THAD COCHRAN 4 SENATE UNITED STATES SENATOR MISSISSIPPI FOR IMMEDIATE RELEASE SENATOR COCHRAN NAMES STAFF DIRECTOR OF REPUBLICAN CONFERENCE (WASHINGTON, D.C.)---U.S. Senator Thad Cochran (R-Miss.) announced today his appointment of William J. Feltus as Staff Director of The Republican Conference of the United States Senate. Feltus, a native of Natchez, Mississippi, is president of Market Consensus Surveys, Inc. Before starting the company in May 1988, he was vice-president of Market Opinion Research, Inc., and a pollster on the staff of Robert M. Teeter. He first worked for Senator Cochran as a summer intern and later served as Press Secretary in Cochran's 1978 campaign for the U.S. Senate. He also served as the Senator's Press Secretary in the Senate until July 1979. Feltus is a graduate of Yale College and the Harvard Graduate School of Business Administration. He and his wife, Lou, have two children. Senator Cochran, who was elected Chairman of the Conference last month, said the appointment will be effective when the Senate reconvenes on January 3. The Senate Republican Conference includes all Republican members of the Senate. The Conference elects the party leadership, confirms Republican committee assignments, and is the forum of discussion of party policies, programs and legislation. --12/11/90-- CONTACT: Lynnette Moten (202) 224-6407 THE WHITE HOUSE WASHINGTON AC HAS SEEN Date: DEC 14 TO: ANDY FROM: RON KAUFMAN Deputy Assistant to the President I THINK MR. CUBICK IS A LITTLE aver-THE-LINE? Rouk:- work. This Lets won't talk. Ands ABB Harris A. Cusick Manager ASEA BROWN BOVERI Contracts Administration Daember 8, 1991 Ron- The enclosed one for you and Andy. My home phone number is 614 246 -2656 DEC 10 1990 should you need to reach me in the evening. Harry ABB Environmental Services, Inc. Southern New England Division Corporate Place 128 Telephone (617) 245-6606 107 Audubon Road Fax (617) 246-5060 Wakefield, Massachusetts 01880 COPY FOR Ron Document Originally Attached to Following Page Harris Albert Cusick 5 Brewster Road Wakefield, Massachusetts 01880 The Honorable Andrew Card Assistant to The President Deputy to The Chief of Staff 1st Floor West Wing The White House Washington, D.C. 20500 December 8, 1990 Dear Andy: The copy of the enclosed letter to Bill Weld and its enclosures will clearly outline an event I am working on here in Wakefield. I talked with Ron the night of our great victory on November 8th and he requested I contact him in Washington regarding a request for a Presidential visit to Wakefield on April 14, 1991. That request will come directly from The General John Rogers Galvin Committee as soon as the Committee's letterhead is printed. In the meantime I would appreciate it if I could receive authorization to have President Bush serve as the Honorary Chairman of our Committee. In addition, there is the potential of having a fundraiser for the Fund For Massachusetts Future at the Colonial Hilton Resort on the same day. When Tom Flatley held an open house to officially reopen the resort last Summer, I talked with him concerning such an event. Tom has invested at least 5 million dollars in refurbishing the Colonial and it is perfect for a Presidential visit. He assured me that he personally would provide all the necessary logistical support required by such a visit. Clearly it would be feasable to have me coordinate that event through Ron and my associates at CURE. As the Treasurer of CURE there is no question the experience we have had in organizing fundraisers is the best anyone could ask for. Regarding the logistics of a Presidential visit to Wakefield we have helicopter pads at the Massachusetts National Guard Headquarters at Camp Curtis Guild on the Reading/Wakefield town line and at the Colonial. An approximate itinerary would be: 13:30 arrival Camp Curtis Guild, Reading 13:35 arrive Wakefield Junior High School Auditorium, Main Street (Presentation of Freedoms Foundation Award and Honoring Justice Souter) 13:55 dedication ceremonies at the General John Rogers Galvin Americal Civic Center (located next to Jr. High School) 14:15 attend private banquet inside Civic Center 14:45 arrive Colonial Hilton Resort 15:30 depart Camp Curtis Guild, Reading This potential two hour visit would provide President Bush an opportunity to honor two outstanding Americans in their hometown as well as honoring the Town of Wakefield which has played a major role in the rebirth of the Massachusetts Republican Party. Due to the fact General Galvin is due to retire in 1991 it would be appropriate to have him honored by his Commander and Chief while he is under his command. As you know the significance of the Generals career was that he was an enlistee in the Massachusetts Army National Guard at the building to be named in his honor. He took an examination for entry into West Point and was appointed by Governor Dever and as history tells us he came very close to being appointed Chairman of The Joint Chiefs of Staff. Whatever you might be able to do to assist me in this most honorable endeavor is truly greatly appreciated. With every good wish for a happy and joyous Christmastide. Sincerely, Home Harris A. Cusick Chairman, The General John Rogers Galvin Committee CC: Ron Kaufman Enclosures Harris Albert Cusick 5 Brewster Road Wakefield, Massachusetts 01880 William F. Weld, Governor-Elect Commonwealth of Massachusetts Hale & Dorr 60 State Street Boston, Massachusetts December 8, 1990 Dear Governor Weld: This communication is to formally request the use of your name as the Honorary Vice-Chairman of The General John Rogers Galvin Committee. We expect President Bush will be serving as the Committee's Honorary Chair- man. This Committee of distinguished Wakefield residents will: honor General Galvin by having the Wakefield Massachusetts National Guard Armory rededicated as the "General John Rogers Galvin Americal Civic Center" request a Presidential visit to have President Bush attend the dedicat- ion ceremony and to present the General with the Freedoms Foundation George Washington Honor Medal which was recently awarded to him honor Associate Justice David Souter, another Wakefield native son, as an Honored Guest This event is tentativly scheduled for Sunday April 14, 1991 during the Patriots Day Holiday weekend. Accordingly, I have contacted Ron Kaufman and Andy Card to assist me in coordinating a fundraiser at the Colonial Hilton Resort in Wakefield on the same day for the "Fund for Massachusetts Future" ; the receipts of which would help retire some of yours and Paul's campaign debt. The Committee would appreciate written authorization for your serving as its Honorary Vice-Chairman so its letterhead may be printed. Sincerely, Him Harris A. Cusick Chairman, The General John Rogers Galvin Committee Enclosures FREEDOMS FOUNDATION AT VALLEY FORGE VALLEY FORGE, PENNSYLVANIA 19481 August 13, 1990 Honorary Chairman The Hon. George Bush BOARD OF DIRECTORS Officers Mr. Harris A. Cusick Chairman 5 Brewster Road Dr. Ken Lipke Wakefield, MA 01880 President and Chief Executive Officer Robert W. Miller Dear Mr. Cusick: Kenneth E. Behring Rodney H. Brady The Directors and Trustees of Freedoms Foundation at Hon. Clarence J. Brown Valley Forge are pleased to inform you that your Hon. Arnold I. Burns Walker Cisler nomination of GEN John R. Galvin has been selected by the Joseph Coors 1990 National Awards Jury to receive a George Washington John B. Curcio Honor Medal in the category of Individual Achievement for Carl N. Karcher Gen. P.X. Kelley (USMC Ret.) the entry entitled "Promoting and Understanding History". Peter H. Noznesky Milan Panic We appreciate your participation in the National Awards Blanka A. Rosenstiel Leslie P. Schultz Program and look forward to receiving future nominations. Gov. Raymond P. Shafer John Sloan, Jr. If you need assistance in submitting entries I will be Daniel M. Tabas Hon. C. William Verity available to answer any of your questions. Hon. Ronald H. Walker Most cordially, Batherine wood E. Katherine Wood Director of Awards EKW/bar 215-933-8825 FAX: 215-935-0522 Gen. John R. Galvin, U.S. Army Supreme Allied Commander, Europe THE MINUTE MEN THE FIRST FIGHT: MYTHS & REALITIES OF THE AMERICAN REVOLUTION An AUSA Book GALVEN ABOUT THE AUTHOR Gen. John R. Galvin is the Supreme Allied Commander, Europe (SACEUR), and the Commander-in-Chief, United States European Command (CINCEUR). A native of Wakefield, Mass., General Galvin earned a bachelor's degree at the U.S. Military Academy, holds a masters in English from Columbia University, did additional graduate work at the University of Pennsylvania, and was a fellow at the Fletcher School of Law and Diplomacy. He is also a graduate of the U.S. Army Command and General Staff College and the Army War College. General Galvin has held a wide variety of command and staff positions in Europe, Puerto Rico, Colombia, Vietnam, and Panama. Although much of his service has been outside the United States, Gen- eral Galvin has also served as an assistant professor at the U.S. Military Academy and as military assistant to the secretary of the army. General Galvin's other published works include Air Assault, an analysis of the development of air mobility in twentieth century warfare, and Three Men of Boston, a study of the political events that led up to the American revolution. lacket designed by Ben Santora PERGAMON-BRASSEYS Distributed in North America to ksellers and wholesalers by the ml; , Publishing Company, N.Y., N.Y. CC .n on Samuel Adams Thomas Hutchinson James Otis Three Men of Boston R John R. Galvin's interest in writing Three Men of Boston was a natural outgrowth of his first.book, The Minute Men, a definitive.study of the battles of Lexington and Concord. His desire to know what led up to those battles resulted in seven years of research. Galvin, a native of Massachu- setts, is a West Point graduate and hàs a master's degree in English from Columbia University A colonel in the infantry, he is presently stationed in Europe. Colonel Galvin is married and has four daughters. Thomas Y. Crowell Company Established 1834 666 Fifth Avenue New York, New York 10019 2: AIR THE DEVELOPMENT OF AIRMOBILE WARFARE ASSAULT by JOHN R. GALVIN Foreword by James M. Gavin + Advance comments on AIR ASSAULT: "Lieutenant Colonel Galvin traces with accuracy the story of one of the most important military innovations of this century-the use of air vehicles to help the soldier fight the ground battle. The book is a sound portrayal of the developments that led to the present-day para- chute and helicopter units." General William C. Westmoreland, U.S. Army Chief of Staff "John Galvin has a real flair for writing about men in battle. His accounts of airborne operations are vibrant and alive." Charles B. MacDonald, author of Company Commander and The Mighty Endeavor "It is a fascinating account of the individual and small-unit actions that made possible the successes of the master planners. It is a remark- able story." From the Foreword by James M. Gavin, Lieutenant General, U.S.A. (Ret.) Wakefield Daily Item GRAVEYARD and Reference Library Name or Classification Address (Need not be filled in if in Wakefield) Date of Entry SEP 18 1939 A son, David Hackett, was born at the Melrose Hospital, last hight, to Mr. and Mrs. Josenh A. Souter (Hel- en Hackett) of 41 Richardson ave. Maternal grandparents are Former Postmaster Frank H. Hackett and Mrs. Hackett of Wakefield and East Weare, N. H. Mr. and Mrs. Joseph A. Sout and son, David, of 7 Park st. moving next week to East Wear a N. H., where they will make the permanènt home. All entries MUST be made on typewriter or in black ink. Analysis JUL 241990 point of view, complained about many of the sensitive subjects- that lack of knowledge. facing the court. "This is a very dangerous With most of his judicial career spent in the New Hamp- process. To have someone nominated that the president shire state court system, Souter knows all about and who we was able to avoid having to know nothing about is very tangle with many of those dangerous,' claimed Der- critical questions. And if his brief comments to showitz. reporters Monday are any guide, Souter, 50, is showing no indication that he will freely discuss any of those matters with the Senate when his con- firmation hearings begin, pro- bably in September. While such an approach may rankle some liberal senators who will be looking for ways to stop the court from moving fur- The 50 year-old Wakefield barbershop on Albion Street. first haircut at Mr. Murch's at the Lincoln School and his come a long way since his days Hackett Souter certainly has WAKEFIELD David By BURGESS ther to the right, it also is con- 2 sidered prudent judicial prac- tice and should, at a minimum, keep some ammunition away from Senate opponents. Also working in Souter's favor is his recent confirmation to the federal appeals court. "The Senate Judiciary Com- mittee hears nominations to both courts, so it makes it more difficult, having said 'yes' to him six months ago to say 'no' to him today," noted University confirmation step away from room, knowing that he is one day in the White House press President George Bush yester- Court nominee stood next to general and now U.S. Supreme New Hampshire state attorney native, Rhodes Scholar, former of Virginia law professor A.E. Dick Howard. "It means Souter has run the gauntlet of the con- firmation process and emerged unscathed. If there were skele- tons in the closet they already would have come out." Unlike Reagan, who in sen- ding Bork to the Senate was virtually begging for a fight with Senate Democrats, Bush tried hard Monday to pave the way for Souter. The president repeatedly said Much like another native of Bush JUL wants 4 1990 Wakefield native for high court Nation's eyes trained on David H. Souter man described as possessing a tant positions in the country. A gaining one of the most impor- Galvin, Souter is on the brink of the town, NATO chief Gen. John final and most gratifying peak. seeing his legal career reach its no single issue, including abor- tion, played a role in his selec- tion and he also tried to downplay Souter's lack of fed- eral bench experience by com- paring him to Brennan. "In choosing to nominate Judge Souter, who like Justice Brennan is largely a product of the state court system, I have As national news operations high court Friday. looked for the same dedication to public service and strength of intellect exemplified by Justice Brennan," the president said. justice who resigned from the the liberal Supreme Court Justice William J. Brennan, Jr., nominated yesterday to replace vative intellect, Souter was "classic," "riveting" conser- And in a clear signal to Senate Democrats that he ex- pected fair play on Capitol Hill, the president added that he had "stressed within the White House, to the attorney general, that our process could not be dominated by politics or special interests." He also tried to put some pressure on the Senate by noting that it was "important to restore the bench to full have caught g many m a strength by the first Monday in nomination, which seems to president at length for the yesterday. He did thank the tions about his legal opinions swayed into answering ques- words, Souter refused to be penned and videotaped his October when the Court begins its 1990 term." Bush's surprise choice also caught some traditional oppc- nents off guard. Most of the initial reaction guard. from those organizations, in- cluding some groups which were pivotal in Bork's defeat, showed they were not very fa- miliar with Souter's record. Alan Dershowitz, professor of law at Harvard Law School and Page 18 a frequent commentator on legal issues from the liberal Ginsberg, the press in Robert Bork and Douglas Supreme Court nominees As it did in the cases of Washington completely off- Judge Souter's Wakefield roots Sept. JUL241990 on, Dates 7/24/90 David Hackett, was born at the He is also a member of Phi Melrose Hospital last night, by Gov. Meldrim Thomson to Beta Kappa. Sept. 17, 1939, to Mr. and Mrs. become the state's next at- Sept. 25, 1961 - David H. Joseph A. Souter (Helen torney general. If confirmed, he Souter leaves Boston tomorrow Hackett) of 41 Richardson Ave. will replace Warren B. Rudman for New York City, from which Maternal grandparents are of Nashua, N.H. He is soon con- former Postmaster Frank H. he will sail on Thursday to firmed to the post. Hackett and Mrs. Hackett of England where he will study in- March 6, 1978 - Nominated Wakefield and East Weare, ternational law in England for by Gov. Meldrim Thomson to N.H. two years under the Rhodes the state superior court and Scholarship program. (He later Oct. 13, 1950 - Mr. and later confirmed, serving till graduated from Magdelin Col- Mrs. Joseph A. Souter and son, 1983. lege at Oxford University with a David, of 7 Park St. are moving Sept. 9, 1983 - David Souter, degree in jurisprudence.) next week to East Weare, N.H., 43, was sworn in as the newest 1963-1966 - Harvard Law where they will make their member of the five member School permanent home. David had New Hampshire Supreme been a student at the Lincoln 1966-1968 Employed by Orr Court. Governor John Sununu School. and Reno, a noted Concord law administered the oath of office. firm. May 20, 1957 - David H. Oct. 28, 1987 - David H. Souter of East Weare, N.H., 1968-1971 - Named New Souter is said to be on President Hampshire Assistant State At- Concord (N.H.) high school, is Ronald Reagan's "short list" of torney General. one of six New Hampshire four or five potential nominees Feb. 4, 1972 - Named Depu- youths receiving scholarships to the U.S. Supreme Court ty Attorney General of New as entering freshmen at Har- April 30, 1990 - Named to Hampshire by Gov. Walter vard University. Souter is the first Circuit Court of Ap- Peterson. Souter is the youngest receiving a national scholar- peals in Boston. man to hold office in the ship, the first award of this Granite State. July 23, 1990 - Nominated by category to a New Hampshire President George Bush to the student. National scholarships Dec. 26, 1975 - David H. U.S. Supreme Court. were first established in 1934 to Souter. 36, has been nominated encourage outstanding young - men to enter Harvard and to have the fullest opportunity for academic and personal achievement. They are the uni- versity's highest awards to in- coming freshmen. Dec. 19, 1960 - David H. Souter, formerly of Wakefield, was named among a group of 32 students from 26 states atten- ding New England colleges to Rhodes Scholarships. Souter is a native of Wakefield and is now in his senior year at Har- vard University. Five of those named are from Harvard, four from Yale and three from the U.S. Military Academy at West Point, N.Y. June 14, 1961 - David H. Souter, a former Wakefield young man, a consistent schol- arship winner during his college career, will receive a Bachelor of Arts, magna cum laude, from Harvard University at annual commencement exercises tomorrow and will continue his studies abroad. He has majored in international law and as a Rhodes Scholar will study abroad for the next two years. DATES see Page 18 THE WHITE HOUSE WASHINGTON December 16, 1990 Dear Harris: Thank you for sending down the material on the General John Rogers Galvin Committee. It looks like quite an exciting event. I'll be happy to do all that I can to help get the President to town. I'm sure you realize however that the President is inundated with invitations so it is best to keep expectations low and hope for the best. Wishing you the best for the holiday season. Sincerely, Rm Ronald C. Kaufman Deputy Assistant to the President Mr. Harris Cusick 5 Brewster Road KEEP IN тачн! Wakefield, MA 01880 THE WHITE HOUSE WASHINGTON Me. Rene J. Bouchard, He. 173 Indian Pond Road Kingston, Massachusetts 02364 R. J. Bouchard 173 Indian Pond Road Kingston, MA 02364 THE WHITE HOUSE December 26,1990 Dear Mr. Bouchard- Thank you for your recent letter. I hope that the SBA matter has been favorably addressed. The cry for same leadership in Massachusits has been answered. The New year will bring a welcome change. Kathi joins me in sending rest wishes for 1991. Sincerely, Andy Card AC HAS SEEN TYPE-ERASE November 26, 1990 USA Mr. Andrew Card Deputy Chief of Staff White House Washington, D.C. 20500 Dear Andy: Just a short note to say it's rewarding to see all the hard work finally beginning to produce. The next target is to bring about a change in the 10th Congressional. Almost made it, next time we will. State House is in great shape, two more offices next time, and a new Senate President. It can be done and we'll do it. My own situation is pretty much whereit was. Three excellent part-time jobs this "old timer = had went belly-up this year, thanks to the great shape of the Commonwealth's economy. But that will change too. I'm still networking and eventually the ice will break. I've enclosed a letter that my daughter sent to the person we're working with on resolving an SBA loan we had in the mid-80's for your information. We expect everything will work out alright. Needless to say, in spite of everything that's going on, we'll continue to work very hard to brina two party politics back. We're on the way, and we've got to keep that tide going. Looking forward to a great campaign in 1992, and four more in the White House. As ever, best regards. Sincerely, Rene J. Bouchard, Jr. 173 Indian Pond Road Kingston, MA 02364 (617) 585-6893 Withdrawal/Redaction Sheet (George Bush Library) Document No. Subject/Title of Document Date Restriction Class. and Type 01. Letter Amy L. Bouchard to Hunter H. Lohman, Re: Enclosed 11/26/90 (b)(6) financial statements. (2 pp.) Collection: Record Group: Bush Presidential Records Office: Chief of Staff, Office of the Series: Card, Andrew H., Jr., Files Subseries: WHORM Cat.: File Location: AHC General Correspondence December 1990 [3] Date Closed: 3/13/2025 OA/ID Number: 04012-005c FOIA/SYS Case #: 2025-0373-S Appeal Case #: Re-review Case #: Appeal Disposition: P-2/P-5 Review Case #: Disposition Date: AR Case #: MR Case #: AR Disposition: MR Disposition: AR Disposition Date: MR Disposition Date: RESTRICTION CODES Freedom of Information Act (FOIA) - [5 U.S.C. 552(b)] Deed of Gift Restrictions (b)(1) National security classified information C(1) Closed by Executive Order 13526, governing access to national (b)(2) Release would disclose internal personnel rules and practices of an security information agency C(2) Closed by statute or by the agency which originated the information (b)(3) Release would violate a Federal statute C(3) Closed in accordance with restrictions contained in donor's deed of (b)(4) Release would disclose trade secrets or confidential or financial gift [formerly listed as only C] information PRM. Removed as a personal record misfile (b)(6) Release would constitute a clearly unwarranted invasion of personal privacy (b)(7) Release would disclose information compiled for law enforcement Presidential Records Act - [44 U.S.C. 2204(a)] purposes (b)(8) Release would disclose information concerning the regulation of P-2 Relating to the appointment to Federal office [(a)(2) of the PRA] financial institutions P-5 Release would disclose confidential advice between the President and (b)(9) Release would disclose geological or geophysical information his advisors, or between such advisors [(a)(5) of the PRA] concerning wells andrewH.Card.). WHITE HOUSE J. WASHINGTON Kingston, MA 02364 173 Indian Pond Road R. J. Bouchard Me. Leonard Little Finger Sitanka Tiwa'he Foundation for Community Development RRI Box 5-A Pine Ridge, S.D. 57770 THE WHITE HOUSE December 26,1990 Dear Mr. Little Finger- It was a pleasure to meet with you earlier today when you visited The white House. I appreciated learning more about Chief BrigFoot. The photograph and information you presented will be shown to the President. Best wishes for 1991. Sincerely 'Andy Card THE white HOUSE washington December 26 To: Mary McClure From: Bob Sar Andy Card's Office Andy met with these three indians today and promised them pictures of the president. Can you take care of them for us? 12/26/90 Leonard Little FINGER chief SITANKA TIWA'he Foundation (Big Foot's Family) FOR COMMUNITY Development RRI Box5.A Pine Ridge, SD 57770 w/ Eugene L. Krigek President Christian Relief Services 6911 Rechmond Heghway Suite 300 alexandria, VA 22306 Paul E. Krizek Executive Duector Running Sting for american Indian youth ( same address) all want Pix of the POTUS us one extra for the Foundation. AC HAS SEEN UNIVERSITY OF SOUTHERN CALIFORNIA 840 CHILDS WAY LOS ANGELES, CALIFORNIA 90089-2542 VICE PRESIDENT FOR (213) 740-7466 EXTERNAL AFFAIRS December 10, 1990 The Honorable Andrew H. Card, Jr. Assistant to the President Deputy Chief of Staff The White House Washington, D.C. 20500 Dear Mr. Card: It is with great pleasure that I learned of the meeting you and Dr. J. Burton Lee had during President Bush's recent trip to Latin America with Dr. Gonzalo Sepulveda, Professor and Chairman of Cardiology at the University of Chile and personal physician to President Aylwin. The dinner in the Chilean Presidential Palace marked a very special moment in the relationship between Chile and the United States. Congratulations for what the Chilean authorities considered to be a most productive visit. From our perspective in California, where a long-standing friendship has existed with Chile, I am particularly pleased by today's Los Angeles Times report praising the President's trip to Latin America. We all look forward to the implementation of the President's announcement of his decision to create further working opportunities between our two nations. On this point the University of Southern California (USC) has been deeply involved with the University of Chile and the Chilean Ministries of Health and Foreign Affairs, following President Alywin's election last December, as is indicated in the enclosed correspondence. Mr. Pablo Valencia, Director of Technology Transfer at USC School of Medicine, has visited, on behalf of the University several times this year with Chilean authorities to explore potential joint programs. Dr. Ralph Bledsoe, Director of the University's Washington, D.C. Public Affairs Center has also been made aware of these developments. The results of these discussions have led to the enclosed proposal which has been jointly prepared by the University of Chile, the Chilean Ministry of Health and USC. The first of these three projects contained in this proposal was that addressed by Dr. Sepulveda in your meeting. Please be aware that USC is interested in assisting and in being a partner to further the development of these valuable initiatives. The emphasis of The Honorable Andrew H. Card, Jr. December 10, 1990 Page Two President Bush on education can lead to an even larger objective in this project by joining his international initiatives with the Chilean emerging democracy, where health care and higher education are special needs. We believe that this project will have a significant potential return both for the Chilean and American people, and I again want to express our desire as an academic institution to participate in any way that might be helpful. As a possible step, for example, might the bilateral commission on trade proposed by the President include the areas of health care and education? I would appreciate any suggestions you may have by which we could further the implementation of these ideas, and I hope that our support for President Bush's initiative in this area can contribute to the consolidation of this valuable project for the Chilean and American people. If you have any questions, please do not hesitate to contact Dr. Bledsoe or me directly. Congratulations again on this fine outcome that President Bush achieved on his recent trip to Latin America. These are important issues for all of us, and I would appreciate your assistance in helping to think through how best to proceed in this matter. Sincerely yours Robert P. Biller Vice President for External Affairs CC: Enclosures October 29, 1990. Dr. Robert P. Biller Vice President of External Affairs University of Southern California Dear Dr. Biller: I have been informed that the University of Chile and the Chilean Ministry of Health have been involved in the development of joint technological and academic programs with the University of Southern California through Mr. Pablo Valencia. These kind of activities reflect the position of President Aylwin in the sense that our country is determined to seek international collaboration in the process of consolidation of democracy in Chile. There is an immediate need to rebuild infrastructure and collaboration in Health Care and in academic activities at the University of Chile. I have been told of your gracious attitude when Dr. Jimenez, Minister of Health, visited you in Washington last February. I am also aware of the communications you have exchanged with Dr. Lavados, Chancellor of the University of Chile. Furthermore, I understand that a proposal to establish an agreement between your University and the Chilean Government, similar to the one you established with the Government of Bahrain, is being studied at the Ministry of Health and at the University of Chile. This week, I have become aware of an initiative to seek the collaboration from the Executive Branch of the United States, taking advantage of the projected visit of President Bush to Chile on December 6th, 1990. I would appreciate sincerely any support that your University could lend us in this important opportunity. Mr. Plablo Valencia will provide you with the details of this project, in which he has developed extensive communications with the appropriate authorities at the academic level and at the Ministry of Health. RECEIVED NOV 191990 EXTERNAL AFFAIRS I will alert Mr. Patricio Silva, our Ambassador in Washington of this project, and I will ask him to cooperate with you as deemed necessary. We, at the Government of President Aylwin, are sincerely grateful of the activities of persons and universities of your caliber, who are helping our people in this historic return to democracy. Your attitude brings us the spirit of the well demonstrated value of the democratic institution of the United States of America. I will follow with interest this initiative, and if there is anything I can do, please contact me directly. Looking forward to a lasting collaboration of mutual benefit with your University, I remain, Sincerely yours, Enrique Silva Cimma ] Minister of Foreign Affairs NOV 05 '90 19:33 MINISTERIO DE SALUD (562) 336981 P.2/4 República de Chile Ministerio do Salud November 5th, 1990. Dr. Robert P. Biller Fax: 213-740-7459 Vice President of External Affairs University of Southern California U.S.A. Dear Bob: As we continue to build up the relationships between your University and our Government, we are preparing the first draft of -an agreement, based on the Bahrain document that Pablo Valencia brought us in his last visit. Key people from my staff, at the Ministry of Health, has met with the representative of the Chancellor of the University of Chile to join our institutions in such agreement. I believe that this is the first time that such a joint effort is committed by the Ministry of Health and the University of Chile. I am convinced that our joint efforts will set a new trend in productivity and in mutual benefits for years to come. Your support to this project, together with your substantial experience are excellent assets for a successful venture. On our side, we will try our best to reach for objectives with deep meaning to the health care of the Chilean people, as well as to the academic community at the University of Chile. Within this framework, we are working with Pablo on several, tasks, including a massive project to equip our hospitals with advanced technologies. For many years, hospitals wich attend to low income population have been virtually abandoned in this area. The task to rebuild this infrastructure is enormous and is being aided by special loans from Spain, Germany and France. In view of this international cooperation, and of the possible visit to Chile of President Bush on December 6th, we thought of presenting some projects to the Executive Branch of NOV 05 '90 19:34 MINISTERIO DE SALUD (562) 336981 P.3/4 República de Chile Ministerio de Lalud 2. the United States. These projects would become and evidence to the Chilean people of the support of the American people to democracy, a system we are trying to rebuild in our country. The value of these projects is not only in the deep meaning of the symbolism involved but also in their strategic importance and visibility in our community. The first project involves providing a complete renovation of equipment at the University of Chile Hospital (J.J. Aguirre). This hospital, through a recent agreement between the Ministry of Health and the University of Chile has become the tertiary reference of all the hospitals of the Ministry throughout the country. The second project involves the completion of a hospital (San Borjas/Paula) wich has remained unfinished for about 18 years. Although the main part of the hospital is functioning (some departments in temporary quarters), a structure of three floors and two sublevels has remained unfinished. This building would cover an area of 21,140 square meters (228,000 sq.ft.). The third possible project is the plan already developed early this year for towers of diagnostic and ambulatory services to be attached to existent hospitals. The Government of President Aylwin, the Chancellor of the University of chile and specially I would sincerely appreciate it if you would be so kind as to help us in reaching the Executive Branch of the United States with these projects. Pablo has compiled the details of these projects and he will prepare them in a special package containing the Univer- sity of Southern California as an active partner in the next few days. The final details of the trip by President Bush have just reached us, and we barely have time to prepare for the first official visit by a US President in 30 years. Dwight Eisenhower visited Chile in 1960 leading to important links and cooperation between our two countries. Our Minister of Foreign Relations has been alerted of our project and he will try to communicate with you, time permitting, on this endeavor. NOV 05 '90 19:35 MINISTERIO DE SALUD (562) 336981 P.4/4 República de Chile Ministerio do Lalud 3. Bob, we see this visit as a challenge and a great opportunity to institutionalize the kind of relationships that you and I, representing our institutions have already developed. I thank you in advance for your efforts in this project, and for your support in facilitating the visits and activities by Pablo on behalf of USC. with great faith in the future of our joint efforts, sincerely yours, Jorge. JORGE JIMENEZ, M.D., M.P.H. Minister of Health AIRBILL FEDERAL PACKAGE 8417326853 TRACKING NUMBER QUESTIONS? CALL 800-238-5355 TOLL FREE 249M 8417326853 Date RECIPIENT'S COPY 12/10/90 From (Your Name) Please Print Your Phone Number (Very Important) To (Recipient's Name) Please Print Recipient's Phone Number (Very Important) 1 Robert P. Biller 213-743-45916 Andrew H. Card, Jr. ( 202) 456-2533 Company Department/Floor.No. Company Department/Floor No. UNIV OF S CAL/EXTERNAL AFFAIRS Deputy Chief of Staff Street Address Exact Street Address (We Cannot Deliver to P.O. Boxes or P.O. 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See DECLARED VALUE LIMITS current Service Guide for further information The highest declared value we allow for FedEx Letter and FedEx Pak shipments is $100. For other shipments, the highest declared value we allow is $25,000 unless your package contains items of "extraordinary value," in which case the highest declared value we allow is $500. Items of Part #119500/119501 "extraordinary value," include artwork, jewelry, furs, precious metals, negotiable Rev. 8/90 HEALTH CARE PROJECTS IN CHILE PRESENTED BY JORGE JIMENEZ, M.D., M.P.H. MINISTER OF HEALTH GOVERNMENT OF CHILE AND JAIME LAVADOS, M.D. CHANCELLOR UNIVERSITY OF CHILE IN COORDINATION WITH THE UNIVERSITY OF SOUTHERN CALIFORNIA that government of the people, by the people, for the people, shall not perish from the earth. Abraham Lincoln, Gettysburg Address TABLE OF CONTENTS page # Executive Summary 1 Introduction 2 Project 1. Technological Renovation of University Hospital 3 Introduction 3 Project Description 4 Equipment Renovation 4 Faculty Training Program 4 Facilities Upgrade 5 Budget 6 Project 2. Completion of San Borja/Arriaran Hospital 7 Introduction 7 Project Description 8 Budget 10 Project 3. Diagnostic and Ambulatory Care Centers 11 Introduction 11 Project Description 12 Budget 15 Consolidated Budget 16 Appendix 17 1 EXECUTIVE SUMMARY - An outstanding opportunity to show the international role of President Bush as an advocate of democracy exists as a following up of the successful visit of President Bush to Chile. - Three high visibility projects in Health Care development have been prepared by the Government of Chile with assistance by a major U.S. university. - The projects involve equipping the University Hospital, finishing the San Borja/ Arriaran Hospital and developing Outpatient Centers. All of them will have a major effect on the health care of millions of Chileans. - Announcement of U.S. support for these projects would add significant impact to the first visit to Chile in thirty years by a President of the United States. - The United States could be seen as the leading supporter of the transition to democracy in Chile. - The resulting enhancement of relations between Chile and the United States would send a positive message to other countries in Latin America. - The projects presented in this document are not controversial, would fulfill a genuine need to the Chilean people and are located in safe, low income areas of Santiago. - The projects link the academic activities in health care of the University of Chile to the development of improved health care systems for the people of Chile. - The University of Southern California, in addition to providing training, would serve as a link to other academic institutions in the United States. - Several other countries including France, Spain, Germany and Holland have already committed substantial support to the transition process. - A combined program of donations and preferred loans is sought from the Government of The United States. 2 INTRODUCTION In the midst of substantial transformations at a world level, Chile is facing a most significant task, as the country attempts to resolve some basic social and health problems, while maintaining the present financial viability. The Government of President Patricio Aylwin has received a mandate from the Chilean people to consolidate the stages of development towards a complete return to democracy. This is a task which carries a strategic importance beyond the Chilean society. The issues at stake involve the balance required to provide health care to the population at large with scarce resources, attempting to reach the maximum technological implementation within fiscal viability. The Chilean Public Health System tends to the needs of about 80% of the Chilean population through a network of state health care facilities of various levels of complexity. This system is under the direction of the Ministry of Health with a decentralized administrative structure. Specifically, the Public Health System faces a daunting task of addressing the needs of low income, high density population. Failure to deal effectively with this issue would have far reaching negative effects on the process of reconciliation which is the hope for the future of the Chilean society. As Chile reaches out for national unity, the support of the international community is desperately needed for the consolidation of true democracy. In particular, the role of the United States, in leading this effort, will demonstrate once again the commitment of the American people, their Congress and the Executive Branch to democracy as the best form of government. In this document, three projects of high visibility and strategic importance are presented for consideration by the Executive Branch with the hope that they could become demonstrative icons of the relationships between the American and the Chilean people. 3 PROJECT 1 TECHNOLOGICAL RENOVATION AT THE JOSE JOAQUIN AGUIRRE TEACHING HOSPITAL OF THE UNIVERSITY OF CHILE Introduction The Jose Joaquin Aguirre Teaching Hospital is an 885 bed facility located in the north section of Santiago. It was founded in 1929 as San Vicente Hospital and moved into the present building in 1952. It is the teaching hospital of the University of Chile, whose School of Medicine was founded in 1833. The faculty consists of about 1400 members of which about 830 are full time positions. The Jose Joaquin Aguirre Teaching Hospital is the most important tertiary hospital of the Ministry of Health and the University of Chile. In a recent agreement between these two institutions, they declared this hospital as the tertiary reference for all the public hospitals in Chile under the Ministry of Health. At this time, the Hospital provides a clinical setting for the Departments of Internal Medicine, Surgery, Emergency Medicine, Anesthesiology, Obstetrics and Gynecology, Psychiatry, Ophthalmology, Otolaryngology, Urology, Neurology, Neurosurgery, Dermatology, Endocrinology, Nephrology, Cardiology, Gastroenterology, Hematology, Oncology, Genetics, Nuclear Medicine, Pathology, Radiology, Rehabilitation, Intensive Care Units, Blood Bank and Immunology. Despite of the strategic importance of this hospital, it has not received any substantial support in the form of equipment renovation for the last 18 years. As a consequence, the available technology in key areas as Radiology dates back more than 20 years. The facilities and equipment have deteriorated significantly, in spite of efforts by personnel and the hospital management to substitute technology by labor intensity. In order to fulfill the mission that the Ministry of Health is assigning to this hospital a global program of equipment renovation, a faculty training program, and a facilities upgrade program are urgently needed. The benefit resulting from such investment would be very substantial because this hospital serves as a tertiary reference, and is a key component of the advanced medical education for the whole country. This project carries a very high visibility due to the large number of medical and clinical professionals in Santiago who are or have been connected to this facility. A substantial improvement would be seen as a rebirth of a once highly prestigious academic institution which serves the poor and the needy. 4 Project Description The project contains three components, a global program of equipment renovation, a faculty training program, and a facilities upgrade program. In each Department, a study which assessed the immediate and long term needs has been updated. Equipment Renovation In the Equipment Renovation program, certain areas appear more drastically in need. For example, the Department of Radiology is presently working with some equipment which is more than 25 years old. There is an urgent need for Radiological rooms, CT and MRI facilities as well as angiographic imaging equipment. The Clinical Laboratory needs more than equipment as the laboratories are set up in grossly inadequate facilities. New quarters have been designed but the lack of funds has prevented any substantial improvement. A computerized system of communication, a regular feature in this class of hospitals in the US, is an important need as well. An active Department of Cardiology is lacking the necessary equipment for adequate catheterization procedures as well as monitoring facilities in intensive care units. Upgrade of the cardiac surgery equipment is also needed. The Department of Obstetrics and Gynecology, which has developed international prestige for its research does not have even the basic monitoring equipment. Nuclear Medicine is in need of an appropriate nuclear camera such as Spect. Also, the Department of Rehabilitation, which has a significant workload, needs a series of nerve stimulators and research devices. In summary, almost every Department needs desperately the basic clinical and research tools that are common place in less sophisticated hospitals in the US. Faculty Training Program The advent of new technology would bring to light the need for advanced training for the faculty. This is one of the most important features in a complete program, to differentiate from just providing equipment. In order for this process to succeed, it is essential to establish a technology transfer program, which would address all aspects of training at several professional levels. Through an agreement being prepared between the University of Southern California(USC) and both the Chilean Ministry of Health and the University of Chile, USC would be able to provide the training and support necessary to fulfill the Chilean requirements. The Health Sciences Campus at USC contains the second 5 largest hospital in the United States (Los Angeles County-USC Medical Center), which is a county hospital, with similar features to the Chilean Teaching Hospital. A variety of interdisciplinary programs available at this campus allows USC to provide an entire program of training at many professional levels. At the medical level, it would be necessary to provide training in the form of fellowships, to advance the newer faculty in the techniques and methods of research and clinical care, using advanced technology. At the clinical level, a program of seminars and conferences would allow the exchange of information. This approach can be combined with the efforts by equipment manufacturers to train technologists in the proper operation of new research and clinical care devices. At the management level, USC has developed a partnership with National Medical Enterprises, one of the largest chains of private hospitals in the United States. This resource, combined with the experience of managing the medical care at the Los Angeles County Hospital, would allow USC to provide a wide range of management training. At the technology support level, USC would be able to provide, through its Office of Technology Transfer, a program oriented to develop their own service organization at the Chilean hospital. In summary, a joint effort between USC, the Chilean Ministry of Health and the University of Chile would provide the necessary training and support to make this program a unique experience for the Chilean environment. Program of Facilities Upgrade As part of the technological renovation, it would be necessary to develop a program of facilities upgrade. This would include standard areas such as adequate housing and shielding for Magnetic Resonance Imaging equipment, air conditioning when required by devices, adequate electrical power and others. Also, it would be necessary to examine the allocation of space for some of the Departments. The most crucial one is the Central Clinical Laboratory, which would require a new location. Fortunately, the majority of these plans have already been developed and will be contained within the present physical plant of the hospital. ID @ 85141 The available technology has become totally obsolete in many critical areas such as Radiology and Clinical Laboratory 6 Budget for Project 1 In spite of the labor intense operation of this hospital, the annual budget is a small fraction of the budget at a similar facility in the United States. This is due to the low wages for the personnel. In this environment, the essential teaching and research component suffers by the lack of development funds. A key part of the budget for this project deals with the expansion of the academic activities by stimulating the advanced training of faculty. The creation of endowed funds for teaching and research is a necessary complement to the described advanced training. The idea is to create an endowment which will expand in the future, by contributions of the private sector, to support wider academic activities at all levels of the operation. The Chancellor of the University of Chile has already started the necessary steps to create a foundation which will aim at reaching self support of the academic activities at the J.J. Aguirre Teaching Hospital. This kind of funding has the advantage of providing a seed for a process that eventually will reach total self sufficiency from a financial point of view. In the difficult budgetary conditions of developing countries, this is a solution with a view to the future, which has not been tried in Chile before. Within this context, the budget for this project contains the following categories: 1. Equipment Acquisition: This will include the acquisition of replacement equipment in many cases, as well as new technologies like Magnetic Resonance Imaging and Lithotriptsy. A complete equipment list has been prepared together with the necessary prepararation of the facilities (included in the Appendix). With the exception of the Magnetic Resonance, which might need special facility, all of the equipment will reside in the present building of the hospital. Total Equipment Budget $15,5M 2. Faculty Training Program: As described in this document, an extensive program of training in coordination with the University of Southern California has been envisioned. Total Training Budget $2.0M 3. Teaching and Research Endowment: This budget will allow the start of a foundation, aimed at the cooperation from the private sector. Total Teaching Endowment Budget $3.0M 4. Facilities Upgrade Program: This will include the necessary renovation of existent facilities to accomodate the new equipment. Total Facilities Upgrade Budget $2.5M TOTAL BUDGET FOR PROJECT 1 $23.0M 7 PROJECT 2 COMPLETION OF SAN BORJA/ARRIARAN HOSPITAL Introduction The San Borja/ Arriaran Hospital was founded in the colonial period, at the end of the eighteenth century. Throughout its long presence in the health care of Chileans, it has undergone many transformations, yet it has remained an important element of the clinical education system in Chile. The San Borja/ Arriaran Hospital is an associated hospital of the University of Chile, with an attending faculty who, in addition to teaching, provides health care to a vast population. Such situation gives this hospital a strategic importance within the organization of the Ministry of Health. University faculty are currently teaching in the Departments of Medicine, Surgery, Pediatrics, Obstetrics and Gynecology, Gastroenterology, Oncology, Pathology, Urology, Orthopedics, and the units of Cardiovascular Surgery, Burn, Infertility and Digestive Pathology. The San Borja/ Arriaran Hospital has 860 beds presently in service, covering a population in excess of 1 million people in the south sector of Santiago. The present building, whose construction started in 1967, was partially finished in 1977. A large area (227,550 sq. ft.) containing among others, the projected operating rooms, has remained unfinished. Temporary locations were arranged for the missing sections within the hospital and in buildings around the facility, some of them 2 miles from the hospital. Those temporary arrangements remain as of today, diminishing considerably the efficiency in the health care delivery of the institution. From a perspective of financial efficiency, it is far more economic to finish this hospital than to start a new construction, reaching almost the same effect at a fraction of the total cost of a new hospital. The completion of this hospital would have a deep impact in the services it provides while becoming an ideal symbol of the revival process of democracy. The main structure and the elements to make it successful are there: it needs decisive effort and resources to reach the objectives delineated 23 years ago. The visibility of this project is very high due to the fact that hundreds of thousands of patients have suffered through the physical deficiencies of the hospital, while having to watch for many years this massive structure, which has remained unfinished. The completion of the hospital will bring many desired facilities, but will also bring hope in the future of the country and the democratic process. 8 Project Description The present San Borja/ Arriaran hospital is housed in a nine story building which was finished in 1977. Connected to this building, a structure of three floors and two sublevels was erected. This structure is complete, but without any of the necessary finishings to make it operational. Today it can not be utilized at all, notwithstand- ing the highly visible and massive building. The structure holds 300,315 sq. ft., of which, 227,550 sq. ft. have remained unused for almost two decades. The structure is solid and of good construction quality, having survived several earthquakes with no damage at all. This project involves the completion of this structure and the equipping of the finished facilities. Also, the purchasing of land immediately adjacent to the facility will be necessary to expedite the access to the services. This acquisition has been envisioned for some time and the proper arrangements have already been done. According to the original construction study finalized in 1973, the structure was scheduled to hold the following facilities and services: Sublevel 2 Electrical Substation Personnel Dressing Rooms Storage Sublevel 1 Pediatric Emergency Room Sterilization Medical Records Central Kitchen Storage First Floor Admissions Data Collection and Statistics Radiology Second Floor Ambulatory Care Neurology Psychiatry Ophthalmology Ears, Nose and Throat Dermatology Oncology Gynecology Endocrinology Hematology Departments Urology 9 Gastroenterology Cardiology Respiratory Third Floor Operating Rooms Recovery Room Intensive Care Unit Attic Air conditioning Heating Electrical distribution Other Construction: Access and Parking (no structure) at the North Entrance Most of the Ambulatory Care is presently provided at temporary facilities about 2 miles from the hospital. This situation complicates significantly the health care delivery to the public and decreases dramatically the efficiency of the services and personnel. In an environment where the shortage of clinical personnel is a pressing issue, this condition decreases even more the capacity of the system. The operating rooms have also been set up in temporary quarters. The need for complex support to these facilities have not been satisfied and, as a consequence, these areas operate at a fraction of the projected efficiency. The result is that the entire hospital suffers significantly in terms of operating efficiency, increasing the congestion of the already stressed system of medical care in the area. In a recent study of the project, it was deemed appropriate to include in the structure the Center for Gastric Cancer which has grown significantly in scope and population over the last few years. Also, the size of the pediatric Intensive Care Unit needs to be increased to cope with the growth in demand. The medical equipment would include the furnishing of the operating rooms, a pediatric intensive care and the outpatient center. In addition, ancillary equipment to produce special air conditioning to the operating rooms including dedicated gas lines and vacuum would be located in the attic. A program of training at the clinical, managerial and service level would also be organized jointly with the University of Southern California as part of an agreement with the Ministry of Health. In summary, this project is completely designed and ready for its execution. If it is implemented, it will provide a dramatic impact in productivity and visibility for a relatively small investment. AMBULANCIA AMBULANCIA The second and third floor of the new structure have remained unfinished for the last 13 years. 10 Budget for Project 2 The studies originally made at the time of planning the construction of this facility are still valid in many areas. The operating rooms will be located in the third floor as planned. In a recent study some modifications were made to the plans in order to include the growing Center for Gastric Cancer. These modifications are included in the budget. A training component, although not as crucial as in the Project 1 (University Hospital) is also included. The acquisition of land (already arranged) will facilitate significantly the access to the new development. The following is an updated budget for this project (details about equipment and construction plans can be found in the Appendix). 1. Completion of Construction (final phase) 227,550 sq. ft. @ $45/sq. ft. $10,239,750 2. Land Acquisition 100,764 sq. ft. @ $15.00/sq. ft. $1,511,460 3. Access Road and External Facilities 100,764 sq. ft. @ $9.00/sq. ft. $906,876 4. Equipment (does not include medical equipment) 227,550 sq. ft. @ $6.00 $1,365,300 5. Medical Equipment Operating Rooms Adult Intensive Care Unit Pediatric Intensive Care Sterilization $4,450,950 Ambulatory Care Center $1,000,000 6. Clinical Training $500,000 7. Initial Operating Funds $850,000 TOTAL BUDGET FOR PROJECT 2 $20,824,336 11 PROJECT3 DIAGNOSTIC - AMBULATORY CARE CENTERS Introduction There is now a national consensus about the existence of problems in the Public Health System in Chile, mainly in the excessive wait of patients for hospitalization and procedures. This results in failure to resolve adequately clinical conditions and consequently, in patient suffering and higher costs to the country. The large hospitals located in urban areas of low income and high population density have high patient load indexes, which, combined with the excessive wait for hospitalization, demonstrate a condition of hospital congestion. The considerable congestion currently seen at the emergency services of the larger hospitals can be explained on the basis of inadequate and untimely management of ambulatory patients. Because all the diagnostic equipment is located at the major hospitals, this further contributes to complicate and to congest the emergency services. This already obvious congestion is compounded by the fact that a sizable proportion of the patient population is inadequately managed at the smaller satellite clinics, and thus referred to the larger hospitals. It should also be emphasized that outdated equipment, long waits and shortage of medical supplies all contribute in a very significant way to drastically decrease the quality of medical care at the hospitals. Based on the above considerations, the Ministry of Health have launched an initiative to increase the diagnostic efficiency and quality of medical care. This initiative include the creation of Ambulatory Care and Diagnostic Centers, referred by the Minister of Health, Dr. Jimenez, as the "Hospitals of the Twenty First Century". These centers, with state of the art equipment, represent a rational solution to the problems of patient management and overcrowding at the larger hospitals. First, these centers could enable a more efficient use of the hospitals' bed capacity by decreasing the number of referrals. In addition, the Centers could manage and serve the medical needs of patients at the primary care level. The Centers could also avoid the need for building new facilities and for expanding the number of beds at the larger hospitals. This project represents the most advanced solution to the problem of congestion in health care and would carry a high visibility. The Centers offer the opportunity of combining new concepts with effective solutions which would be appreciated by the Chilean people for years to come. 12 Project Description The National Network of Diagnostic and Ambulatory Care Centers is envisioned as a group of medical facilities distributed along the country and in close relation with the major hospitals of the Chilean Public Health Care System. As previously described in this document, the lack of diagnostic capacity at the larger hospitals, has become an incentive to the admission of patients, as a way to accelerate the diagnostic procedure, instead of the normal outpatient route. Furthermore, a significant number of surgeries which could be done on an outpatient basis, freeing hospital beds, are done in an inpatient modality. Conservative estimates suggest that as much as 30% of the hospital admissions are related to these two modalities. The purpose of the Centers would be to provide immediate and timely diagnosis of a wide variety of diseases through physical examination, laboratory tests and diagnostic imaging as well as to manage minor surgical cases. These centers could function independently with their own administrative staff. The Ministry of Health have already conducted preliminary feasibility studies by regions throughout the country. These studies and related statistic analyses have indicated the locations where the diagnostic resources are most needed. For example, there are areas where the wait for a radiological examination reaches six months on an ambulatory basis and seven days for inpatient cases. According to this study, and field visits to those places the following locations appear viable and in definite need of a Center. This table also includes the population directly served by those hospitals. Region Population Hospital Antofagasta 250,344 Antofagasta Iquique 131,224 Iquique Coquimbo 499,000 Coquimbo Valparaiso 320,312 Van Buren Santiago North 505,180 J.J. Aguirre Santiago West 805,303 S. Juan de Dios Santiago South 825,081 Sotero del Rio Maule 799,600 Talca Concepcion 534,260 G. G. Benavente Nuble 359,152 Chillan Araucania 709,960 Temuco 13 Functional Component Below, some of the medical services to be included in the Centers are outlined: - Specialty Services - Imaging Services - Endoscopic Procedures - Clinical Laboratory - Pathology Services - Surgical Suites Minor Surgery Ophthalmological Surgery ENT Surgery Urological Surgery Gynecologic Surgery Minor Orthopedic Surgery - Diagnostic Wards - Therapeutic Wards - Pharmacy - Physical Therapy - Blood Bank - Computer Data Management Unit - Library and Biomedical Resources In addition, the Centers should be provided with vehicles(e. g. ambulances, vans, trucks) to transport patients, medical supplies and for fast delivery of medical samples. Based on a worldwide experience with similar diagnostic and ambulatory care centers a modular-type facility appears adequate. This distribution of the physical space at the Centers could facilitate a dynamic flow of the different factors involved in the diagnostic process. It is also important that the Center establish and maintains a formal collaborative agreement with the university and with university hospitals. This would allow a timely exchange of information by accessing clinical and scientific data bases and for training of professional and support personnel. The Centers should also have electronic and mechanical shops for maintenance and repair of sophisticated laboratory equipment, and for in-house consultations on pre- purchase of certain equipment items. Training Component As a new entity in the Chilean Health Care System, the Diagnostic and Ambulatory Care Center would require the training of significant number of personnel to reach 14 the desired efficiency. This training would have several phases: a clinical phase where the adaptation of procedures to the new environment will be necessary. An administrative phase where the diagramation and execution of modified routines will be completed, and finally a self supporting phase, where all elements of support from the technical services to the marketing will be studied and implemented. The University of Southern California through an agreement with both the Ministry of Health and the University of Chile would lend support to this training phase both in the United States and in Chile. The administrative nature given to the Centers by the Ministry of Health (autonomous administration) would provide the basic foundation, which could be then adapted to the task without having to deal with the burden of already established hospitals and their organizations. This malleable structure has been specifically outlined by the Ministry of Health, as an initial base to build efficiency into the health care of the future in Chile. Technical Service and Training Component In many developing countries, where an effort to transfer technology has been made, it has been necessary to create an infrastructure of technical support. Failure to develop such capabilities has often resulted in equipment poorly utilized and, in general, in an inefficient investment. The objective is to develop an organization which could, at an early point, completely take over the technical tasks of service, maintenance and personnel training. This type of organization does not exist in Chile, relying now on the service support provided by equipment manufacturers. With the significant amount of medical equipment expected to be acquired during the present administration by the Ministry of Health, training agreements are being discussed with the manufacturers, in such a manner that an initial group of local engineers could be prepared for the task ahead. This means to create the organization and to provide tools, training and a base from where these activities could grow up to a national scale operation. It is expected that due to their high level of technology, the Centers would become the ideal seed for a national system of technical self support, with all the necessary logistics associated in this type of operation. In this sense, the Centers would really become strategic elements, generating solutions to the operational problems of the hospitals, as well as new support mechanisms. The impact of this strategy should be long lasting and positive to the health care of millions of Chileans. 15 Budget for Project 3 The initial study about the Diagnostic- Ambulatory Care Centers was one of the first tasks by a team of specialists in public health under the direction of the Minister of Health, Dr. Jimenez. He asked a group of multidisciplinary specialists to study the need and the feasibility of these Centers as an alternative to the standard approach of building more hospitals(trying to resolve the present shortage of beds). The members of this group, headed by Dr. Cristian Baeza, developed a prototype Center and the demographic study to assess possible locations. The results of this study constitute the basis of this project, as presented in this document. One of the concerns of the specialists was the observation that without a financial support at least in the initial years, a specialized Center like these ones would have a difficult time surviving. This is due to the lack of support structure, both financial and technical, in the present environment. While there was no doubt that this is a correct solution to the Chilean problem, it was strongly suggested that an adequate operating budget for the initial years should be included in any planning. At present, the Ministry of Health does not have the capability to include these Centers in the extremely limited budget, and, therefore, it is presented here as part of the Project 3. It includes the salaries, basic services and supplies in addition to the costs of maintenance for the building and the equipment. 1. Diagnostic -Ambulatory Care Center - Land $360,000 - Building $9,189,000 - Equipment $7,795,000 2. Associated Maintenance and Training Center - Land $60,000 - Building $195,000 - Equipment $221,000 3. Clinical Training $500,000 Total Fixed Expenses For Project 3 $18,320,000 4. Operating Funds per Year - Maintenance $1,050,000 - Operations $4,093,000 Total Operations per Year For Project 3 $5,143,000 16 CONSOLIDATED BUDGET Budget For Project 1 J.J. Aguirre University Hospital Medical Equipment $15,500.000 Faculty Training $2,000,000 Teaching Endowment $3,000,000 Facilities Upgrade $2,500,000 Total Budget Project 1 $23,000,000 Budget For Project 2. Completion Of San Borja/ Arriaran Hospital Completion of Construction $10,239,750 Land Acquisition $1,511,460 Access & External Facilities $906,876 Equipment (non medical) $1,365,300 Medical Equipment $4,450,950 Ambulatory Care Equipment $1,000,000 Clinical Training $500,000 Initial Operating Funds $850,000 Total Budget Project 2 $20,824,336 Budget For Project 3 Diagnostic - Ambulatory Care Centers Land $360,000 Building $9,189,000 Equipment $7,795,000 Maintenance & Training Center Land $60,000 Building $195,000 Equipment $221,000 Clinical Training $500,000 Total Fixed Expenses Project 3 $18,320,000 Operating Funds per Year Project 3 Maintenance $1,050,000 Operations 4,093,000 Total Operations per Year Project 3 $5,143,000 17 APPENDIX The documents to be included in this Appendix are the original summaries prepared by the described Hospitals, officials at the Ministry of Health and the University of Chile. For space reasons, they will be submitted in a separate package.