OPTION C
ALL radiation related didesses da the exposad aad control proups on Rongelap and
tedrik plus alt low level cadlation exposed patients who hava alrenly pone
through @ull xcreeaiag = ferespective of Cindians of diac
Tt.
Establish the broad obfectives
Ub.
Present Jevels of care
through the BNL screening procedures,
This represents the currest level of
Exiscing Policy
radfation, who have already gone
operation,
In che future,
the
servening Vill be modi f{ ded as detatled
for the “Jleected data buse - cisk
hugsed appraisal" approach of
Robbins and Wall.
As
As
UL, Transtathunn
Cumsacradnes
As in Options A and 8 buc adding
all patients, exposed fo low bevel
in Opcions A ond B.
ia Uptions A and
§.
This option refleces exinting
de facto field policy.
Faistinganddemands
As in Upeton A and 8. Adding 3
portion of the Bikini population will
probubly not fulfidl the Marshallese
demands of aceds.
As in Option A und BU.
le seems
probable itt we will be unable ta
separate, fur medical purposes,
the Bikini people who returned ca
Biking from the rematnder om Kili,
The Endwetok people-will probably
also demand cqual
treatment.
Planning at other levels
Aa in Option A und H.
Powerful
U.S. congressional groups (Yates
Committee + on appropriations,
etc.) are interested in and Investigating che well-being of
the Marshallese,
Existing factiietes
Ag
in Uptlon A and B.A fe~
desige and conatruction of a Clealble,
mobibke screening and treatment support
facility = would tn che long cnn
increase vl fictency and reduce
cust/putdeac,
Elawnefal
As in option A and 3. The slgniflcane variable will be che (7) addition of the peuple of
Bikini wad Caiwerok.
Manpower
Aa iq Uptlon A and B.
Again the addlifon of Bikinl and
Enivetok would more chan double che outpatient load, Wovwever, the stalf could
probably handle the increased luad with che addition of a Physician Assiscant
and 2 flucse practitioner.
Timing
As to Option A and 6B,
Demoertapiie Povulacton Chacactyristles
As in Option Ao 5.
ucraened,
No further censctraiags (opeteum ciming).
Plus all patients (exposed to low Juve) rodiatiun) previously
Adding Blkint
(450) + Endwetuk
(450),
Restiugemeat of
refined objectives
in gonatilerarion
of restratoes,
4s in Options A and
B = Since this
is our
Present level of
Opecacion with cxlacing
funds - no significant
translation of
Objectives 16 ueeded.
IV.
Analysis
Vv.
Develop possaible approaches to
attaloing the objectives, with
each approach being stated in
termes uf:
What:
Aa in Qpefons A and B.
kho: As in Options A and B. plus all pattencts, exposed
to law level cadiation who have
already gone through BNL
screening procedure - spain
scatus of Blkint and Entwetok
will change requirements,
Where; As in Options A and & Pius KRiit, Jolute, 7
Enivetok ? Ujelang.
When:
As in Options A and B.
Now: If che patient load ta
doubled and increased,
primary care ia expected.
There will need to he approxi-
mately 3 doubling of the operac
ing budgec with a 662 increase
in personnel and a ship
assigned specifically to the
wedical program. It wuuld be
peudent ta separate the
identify of che BikiniEniwetok group from BNI Whe could retain administrative contro} and
funcelun ay advisors,
bul
3 subconcractor might
alleviate some of the
angiety of the new mtuwdy
-gtvup Chat world arise from
the “radiation” orlented
BNL group, We vould suggest
the University of Huwall as
the muse suitable aud in+
terested party. Funding for
this Jacrease in primary care
wight be obtained by pasathrough funding from DOI.
Selection Criteria
Set forth ‘the eriteria for the seleecion of an apprvach:
_ Porfurmunce of results
As in Optiona A and 5.
Total cost
Au in Options A and 6
See coluan IV,
~ Now: for discusstua of costa,
Ficxibilicy
As in Options A und B - Locreasing Flexibility due to
largee responsibility for care aad better support (Logistic
and manpower} + peraite better sehedul ing. :
Avutdance of untoward consequences
Aa in Options A and & - plus addw credit for more
couprchensive care,
.
Rink
Aw in Options A and B = With increasing valuac of
patlent care the possibility of suboptiosl or poor
pecformance may increase - 7 Overcomnituent - this
eun be offset by adequate planning and legtetic
support - Expanded operations without these elenents
ahauld not be attempted.
Cost/ef€uctlvenons
As in Optiona A and 8B,
Timing
.
Ax in Options A and B. This te the optimum time, In light
of the political and sociologic situation fq the Marshalls
Co enlarge che program and to eske a positive effort to
chinge the daage of the study,